National Survey of Small Business Executives on Health Care Chart Pack Kaiser-Harvard Program on the Public and Health/Social Policy in conjunction with American Small Business Alliance Education Fund June 17, 1998 Small Business’Experiences and Practices with Health Insurance and Managed Care Chart 1 Health Benefits Provided by Small Businesses Percent of small businesses that Most commonly cited reasons for provide health benefits to... not offering health coverage Most FT Employees Some FT 8% Employees 9% Cost 57% Not Necessary 8% All Full-Time All/Most Employees Employee Covered Elsewhere 6% No FT Employees 55% 27% Company Too Small 6% Don't 0% 20% 40% 60% 80% 100% Know/Refused 1% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 2 Larger and Higher Wage Businesses More Likely to Offer Coverage Percent of small businesses offering health insurance to all full-time employees 80% 80% 73% 72% % Offering Coverage to All FT 70% 68% 70% % Offering Coverage to all FT 59% 60% 60% 51% Employees 50% 50% Employees 41% 40% 40% 31% 30% 30% 20% 20% 10% 10% 0% 0% 1 to 3 4 to 9 10 to 19 20 to 99 None Few/Less than Half Half or More Number of Full-Time Employees # of Employees Earning More than $30,000 Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 3 Health Plan Choices Offered by Small Businesses Number of health plans Percent who say each is a major company offers employees reason for not offering more health plan choices Only one plan It's too expensive to 81% offer more choices 51% Health plan rules require all or most employees to be in the same plan 51% There would be too much administrative burden 40% More than one plan 17% Not enough plans available locally 21% Don't know 2% 0% 20% 40% 60% 80% 100% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 4 Making Decisions About Health Plans Percent of small business executives who say... When you last made a decision about Dealing with health insurance which health plan to offer employees, the issues is... amount of information you had was... Most of what you needed Somewhat easy Somewhat 37% and difficult and straightforward confusing 20% 31% Some of what you needed 11% Very difficult None of what you needed and confusing All you needed 3% Very easy and 15% 43% straightforward Don't know Don't know 6% 30% 4% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 5 Small Business Executives’Experiences with Health Plans Percent of small business executives who say... They or someone they knew experienced 51% problems with health plan Company had to switch health plans in past two 30% years They intervened on behalf of another employee who was 20% having problems with his/her plan 0% 20% 40% 60% 80% 100% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 6 How Would You Rate Your Health Plan? Percent who give their health plan a grade of... Small business executives All Americans (largest plan offered) A 25% A 30% B 42% B 42% C 23% C 19% D 3% D 4% F 3% F 2% Don't know 4% Don’ know t 3% 0% 10% 20% 30% 40% 50% 0% 10% 20% 30% 40% 50% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998; Kaiser-Harvard Program on the Public and Health/Social Policy National Survey of Americans’Views on Consumer Protection in Managed Care, January 21, 1998. Chart 7 Source of Personal Health Coverage of Small Business Executives Not covered 6% Other source 5% Private individual Company plan coverage 55% 12% Spouse/family member Don't know/refused 21% 1% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 8 Small Business Executives’Views of Managed Care Percent who say during the last few years HMOs and other managed care plans have... Small business executives All Americans 65% Decreased the amount of time doctors spend with patients 61% 7% Increased the amount of time doctors spend with patients 16% 58% Decreased the quality of health care for the sick 51% 28% Increased the quality of health care for the sick 32% 57% Made it harder for the sick to see medical specialists 59% 20% Made it easier for the sick to see medical specialists 25% 43% Not made much difference to health care costs 55% 31% Helped keep health care costs down 28% 43% Made it harder to get preventive services 31% 31% Made it easier to get preventive services 46% 0% 50% 100% 0% 50% 100% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998; Kaiser-Harvard Program on the Public and Health/Social Policy National Survey of Americans’Views on Managed Care, November 5, 1997. Small Business Executives’Views of Consumer Protection Proposals and Their Potential Effects Chart 9 Small Business Executives’Views of Proposed Consumer Protections Would you favor or oppose a law requiring health plans to... Oppose Don’t Favor Provide people with information about how the health plan operates, such know as the benefits covered, the doctors in the plan, and how to get 89% 5% 6% complaints resolved Allow people to appeal a health plan's decision to an independent reviewer if they are denied coverage or a particular medical treatment 88% 8% 4% Allow a woman to see a gynecologist without having to get permission or see her regular doctor first 84% 11% 5% Pay for an emergency room visit when someone might reasonably believe they need immediate medical attention -- even if the problem doesn't turn 77% 18% 5% out to be serious Allow people with serious medical conditions to see a specialist without always having to get permission or see their regular doctor first 75% 21% 4% Allow patients to sue a health plan for malpractice, like they can now sue a doctor 61% 30% 9% 0% 20% 40% 60% 80% 100% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 10 What if Costs Rose as a Result? Would you still favor this law if you heard it might increase the cost of people’ health insurance premiums? s Yes, would still favor No, would oppose Don’ know t Provide people with information about how the health plan operates, such as the benefits covered, the doctors in the plan, and how to get 69% 21% 10% complaints resolved Allow people to appeal a health plan's decision to an independent reviewer if they are denied coverage or a particular medical treatment 72% 20% 8% Allow a woman to see a gynecologist without having to get permission or see her regular doctor first 66% 26% 8% Pay for an emergency room visit when someone might reasonably believe they need immediate medical attention -- even if the problem doesn't turn 66% 27% 7% out to be serious Allow people with serious medical conditions to see a specialist without always having to get permission or see their regular doctor first 59% 33% 8% Allow patients to sue a health plan for malpractice, like they can now sue a doctor 51% 36% 13% 0% 20% 40% 60% 80% 100% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 11 What if Government Involvement in Health Care Increased? Would you still favor this law if you heard it might get the government “too involved” in health care? Yes, would still favor No, would oppose Don’ know t Provide people with information about how the health plan operates, such as the benefits covered, the doctors in the plan, and how to get 49% 37% 14% complaints resolved Allow people to appeal a health plan's decision to an independent reviewer if they are denied coverage or a particular medical treatment 44% 42% 14% Allow a woman to see a gynecologist without having to get permission or see her regular doctor first 46% 43% 11% Pay for an emergency room visit when someone might reasonably believe they need immediate medical attention -- even if the problem doesn't turn 45% 42% 13% out to be serious Allow people with serious medical conditions to see a specialist without always having to get permission or see their regular doctor first 41% 50% 9% Allow patients to sue a health plan for malpractice, like they can now sue a doctor 33% 54% 13% 0% 20% 40% 60% 80% 100% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 12 Government Involvement vs. Ensuring People Get Care They Need Would you favor laws that would require HMOs, managed care plans and health insurance companies to do each of the following to make sure people get the care they need or oppose such laws as unnecessary government involvement in health care? Oppose as unnecessary gov’ Don’ t. t Favor to ensure people get care involvement know Provide people with information about how the health plan operates, such as the benefits covered, the doctors in the plan, and how to get 88% 8% 4% complaints resolved Allow people to appeal a health plan's decision to an independent reviewer if they are denied coverage for a particular medical treatment 86% 10% 4% Allow a woman to see a gynecologist without having to get permission or see her regular doctor first 81% 12% 7% Pay for an emergency room visit when someone might reasonably believe they need immediate medical attention -- even if the problem doesn't turn 74% 19% 7% out to be serious Allow people with serious medical conditions to see a specialist without always having to get permission or see their regular doctor first 76% 19% 5% Allow patients to sue a health plan for malpractice, like they can now sue a doctor 66% 25% 9% 0% 20% 40% 60% 80% 100% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 13 Who Should Regulate Managed Care? Percent who say each is the “best” way to ensure consumers are treated fairly and get the proper care A non-government independent organization developing and enforcing 62% standards that plans must follow 57% 12% The government developing and enforcing standards that plans must follow 23% The managed care industry monitoring itself and setting voluntary standards 14% for plans to follow 15% 2% None/other(vol) 2% 10% Don't know/refuse 3% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Note: Vol means response was volunteered by respondent, not an explicitly offered choice. All Americans Small Business Executives Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998; Kaiser-Harvard Program on the Public and Health/Social Policy National Survey of Americans’Views on Consumer Protection in Managed Care, January 21, 1998. Chart 14 How Small Businesses Who Now Offer Coverage Say They Would Respond to a Cost Increase If your share of health insurance premiums for a single employee increased by $1-5/$15-20 what would your company be most likely to do? Increase of one to five dollars Increase of fifteen to twenty dollars per month per employee per month per employee Absorb this additional cost 50% 45% 33% Pass on SOME cost to employees 35% 9% Pass on ALL of cost to employees 8% 1% Drop coverage entirely 3% 2% Switch to a plan with lower premiums (vol) 3% 5% Don't know 6% 100% 80% 60% 40% 20% 0% 0% 20% 40% 60% 80% 100% Note: Vol means response was volunteered by respondent, not an explicitly offered choice. Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 15 What Small Business Executives Say Might Happen If proposed consumer protections were passed into law, percent of small business executives who think... The cost of health insurance premiums ...employers would drop health coverage would increase... for their workers A little A lot 25% None Only a few None would 37% 30 42% drop coverage 9% Not at all Some (vol) 7% 2% Many Some (vol.) 18% 1% Don't know Don't know 30% 29% Government involvement in health care The law would lead to... would be... Better health Not much improvement to care/more A lot more A little more patient care and information 41% 22% information 21% 49% No more 10% Some more Don't know (vol) Don't know Would make things 26% 1% 28% worse (vol) Note: Vol means response was volunteered by respondent, not an explicitly offered choice. 2% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998. Chart 16 How Closely the Consumer Protection Debate is Being Followed Percent who followed news reports about health care consumer protection legislation... Small business All Americans executives Fairly closely Not too closely Fairly closely Not too closely 26% 24% 22% 30% Very closely Very closely 11% 8% Don't know Not at all Don't know 6% Not at all closely 14% closely 22% 37% Source: National Survey of Small Business Executives, Kaiser-Harvard Program on the Public and Health/Social Policy and the ASBA Education Fund, June 1998; Kaiser-Harvard Health News Index, March/April 1998.