Americans feeling loss of control of their health care

By WILL LESTER, Associated Press Writer

WASHINGTON (AP) - Americans are generally happy with their health insurance coverage, but four in 10 adults say insurers have a bigger say than doctors in the care they receive, according to a new poll.

Women are more critical than men, with 40 percent saying the health care system is in worse shape than it was five years ago, says the poll conducted for The Associated Press. The biggest complaint was the inability of people to choose their own doctor.

As these concerns grow, Congress is again considering how to give people more control over their own health care without substantially increasing costs.

Nine out of 10 Americans said they were very satisfied or somewhat satisfied with their health insurance coverage, the survey found.

But among those with concerns about health care, much of that dissatisfaction is centered around the growing loss of control people feel over their medical care, an intensely personal issue.

The poll of 1,008 people taken Friday through Tuesday was done by ICR/International Communications Research of Media, PA.

Making some changes in the system sounds like a good idea to Thomas Feagley, a 42-year-old father of three, whose health plan required him to change family doctors last year.

"There needs to be an investigation or some kind of fine tuning," said the custodian of athletic fields at schools near Huntington, in central Pennsylvania, who used the team doctor as his family physician for years. "I would have been a happy camper if I could have gotten my insurance and kept my doctor."

The growing loss of personal control over health care has left Feagley uneasy about the future. He changed doctors a year ago and now that doctor is leaving his practice.

When people were asked their biggest concern about health care, the most-mentioned complaint was limits on their ability to pick the doctor of their choice, cited by 28 percent, followed by concerns about cost and quality.

"I know they have to have guidelines," Feagley said, but he noted his former doctor treats many others in his family. "We had kind of a family thing going on."

The findings reflect some continued frustration with managed care, such as health maintenance organizations, which have controlled health care costs by preventing unnecessary treatment. But Americans also worry they may not get treatments that they someday need.

A big movement to HMOs, has taken place over the past two decades. Most Americans who get insurance from an employer are now enrolled in an HMO, said Larry Levitt, director of the changing health care marketplace project at the Kaiser Family Foundation in Menlo Park, Calif.

"For many people, there has been a sea change in how they deal with their insurance companies," Levitt said.

Of the people in the AP poll who said they were very satisfied, the majority said they felt their doctor had the bigger say in their care.