Dissatisfaction with Current Healthcare landscape

AUSTIN, Texas—As the Trump administration explores possible revisions to the federal government’s role and responsibilities in healthcare, a significant portion of the American public is expressing a desire for fundamental changes in how healthcare operates in the United States. this sentiment is highlighted by recent survey findings that underscore growing concerns about affordability and accessibility.

According to new research, a considerable majority of Americans are giving the current healthcare system a failing grade. The survey, conducted in February 2025, reveals that a staggering 72% of Americans rate the U.S. healthcare system “C” or lower. This dissatisfaction stems largely from the financial strain healthcare costs place on individuals and families, with nearly half forced to make arduous choices between healthcare and basic needs.

“Our latest original research shows that more than seven in ten Americans (72%) give the US healthcare system a grade C or lower.Within the past ten years, nearly half (46%) say they’ve had to choose between paying medical bills or paying for basic necessities. It’s a sad commentary on the state of our healthcare system. In fact, a majority tell us that they are willing to reconsider key provisions of the 2010 Affordable Care Act (ACA), if it makes their coverage more affordable.”

Fran Soistman, former eHealth CEO

This willingness to reconsider the affordable Care Act (ACA) highlights a critical shift in public opinion. While the ACA aimed to expand coverage and improve access to healthcare, rising premiums and out-of-pocket costs have left many americans feeling financially vulnerable. the survey data suggests a growing appetite for alternative approaches that prioritize affordability, even if it means modifying some of the ACA’s core tenets.

Potential Changes to ACA and Individual Choice

The survey sheds light on specific areas where Americans are seeking greater control and flexibility in their healthcare coverage. A significant majority, 83%, expressed a desire to select health plans that exclude benefits they believe they won’t use, emphasizing the importance of tailoring coverage to individual needs and possibly lowering costs. This reflects a growing frustration with the “one-size-fits-all” approach of some ACA plans, where individuals may be paying for services they don’t require.

This push for personalized healthcare mirrors trends seen in other sectors, like personalized finance, where individuals are increasingly demanding customized solutions that align with their specific circumstances and preferences. For example, a healthy 30-year-old might prefer a plan with lower premiums and a higher deductible, focusing on catastrophic coverage rather than comprehensive benefits. Conversely, someone with a chronic condition might prioritize a plan with robust coverage for specialist visits and prescription drugs, even if it means paying a higher premium.

However, critics argue that allowing individuals to opt out of essential benefits could lead to adverse selection, where healthier individuals choose less comprehensive plans, leaving sicker individuals in more expensive plans. This could drive up premiums for everyone and destabilize the insurance market. Finding the right balance between individual choice and ensuring affordable coverage for all remains a key challenge.

The Debate over Lifestyle and Healthcare Costs

The survey also touched on the controversial topic of lifestyle choices and their impact on healthcare costs. Over half (56%) of respondents indicated that individuals who maintain an unhealthy lifestyle should pay more for their health insurance. This perspective reflects a growing awareness of the link between personal behaviors and healthcare expenditures, as well as a sense of fairness among those who prioritize healthy habits.

This viewpoint, though, faces significant ethical challenges. Critics argue that penalizing individuals for unhealthy lifestyles could disproportionately affect low-income communities and those with limited access to resources that promote healthy living. Moreover, it raises questions about who gets to define “unhealthy” and how such policies would be implemented fairly and effectively.

Consider, for example, the debate surrounding taxes on sugary drinks. Proponents argue that these taxes discourage consumption of unhealthy beverages and generate revenue for public health initiatives. Opponents, however, contend that these taxes disproportionately impact low-income individuals and are a regressive form of taxation.

The discussion about lifestyle and healthcare costs needs to be approached with caution, considering the complexities of individual circumstances and the potential for unintended consequences.

Support for Restrictions on Drug Advertising

One area where there appears to be broad consensus is the regulation of pharmaceutical advertising.Robert F. Kennedy Jr., the newly appointed HHS Secretary, has proposed barring pharmaceutical companies from directly marketing to consumers, an idea that enjoys widespread support. The survey reveals that two-thirds (66%) of Americans support a ban on drug advertisements, with backing from both Democrat and Republican voters.

Newly appointed HHS Secretary Robert F. Kennedy Jr. has proposed barring pharmaceutical companies from directly marketing to consumers, and our research shows most Americans agree with him. Two thirds (66%) tell us they would support a ban on drug advertisements,including a majority of both Democrat and Republican voters, according to former eHealth CEO Fran Soistman.

The rationale behind this support stems from concerns that direct-to-consumer advertising drives up drug prices, encourages needless prescriptions, and can mislead patients about the benefits and risks of medications. Critics of drug advertising point to the United States as one of the few developed countries that allows it, arguing that it contributes to higher healthcare costs compared to other nations with similar healthcare systems.

As an example, The Kaiser Family Foundation has published numerous reports detailing the impact of pharmaceutical advertising on drug spending and consumer behavior. These reports suggest that advertising can influence patients to request specific medications from their doctors,even if those medications are not the most appropriate or cost-effective treatment options.

Looking Ahead: Reforming Healthcare in the U.S.

The survey findings provide a valuable snapshot of the shifting attitudes toward healthcare in the United States. As policymakers grapple with the ongoing debate over healthcare reform, it is crucial to consider the voices of the American people and address their concerns about affordability, access, and individual choice.

The path forward likely involves a multi-faceted approach, encompassing:

• exploring alternative insurance models that promote affordability and flexibility.
• Addressing the rising cost of prescription drugs through regulatory reforms and negotiation strategies.
• investing in preventive care and public health initiatives to improve overall health outcomes.
• Fostering greater openness in healthcare pricing and quality.

By engaging in open and honest dialog, and considering a wide range of perspectives, policymakers can work towards creating a healthcare system that meets the needs of all Americans, regardless of their income, health status, or lifestyle choices.