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Public Mistrust of the U.S. Health Care System's Profit Motives: Mixed-Methods Results from a Randomized Controlled
Jennifer Richmond1,2, Wizdom Powell3,4,5, Maureen Maurer6
1Domestic Research and Evaluation, American Institutes for Research, Chapel Hill, NC, USA. jrichmond@air.org.
Informed individuals may accept healthcare cost-saving measures, even with mistrust of the system. Transparency in decision-making is key to building public trust for reducing societal healthcare costs.
Area of Science:
- Health economics
- Public health policy
- Medical sociology
Background:
- Healthcare cost reduction is a priority, but public trust is a concern.
- Public deliberation can inform diverse groups on complex healthcare issues.
Purpose of the Study:
- To examine public perceptions of healthcare costs.
- To understand the intersection of cost considerations and medical mistrust.
Main Methods:
- Mixed-methods study using a randomized controlled trial.
- Included 96 participants in deliberation groups and 348 in a control group.
- Analyzed survey data and qualitative transcripts from 2012 in four U.S. regions.
Main Results:
- Deliberation participants were more likely to support considering costs in treatment decisions.
- Qualitative analysis revealed mistrust of healthcare profit motives.
- Participants ultimately accepted payer-imposed cost boundaries after deliberation.
Conclusions:
- Informed public may accept cost-saving measures despite mistrust, if rationale is transparent.
- Transparent communication and policies are crucial for gaining public trust in healthcare cost initiatives.
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