The cost of health system change: Public discontent in five nations

Karen Donelan, Robert J. Blendon, Cathy Schoen, Karen Davis, Katherine Binns

Research output: Contribution to journalArticlepeer-review


Many nations have undergone changes in health care financing and services. The public notices policy changes in health care and frequently bears new and unexpected costs or barriers to care unwillingly. This paper presents data from surveys of about 1,000 adults conducted during April-June 1998 in each of five countries-Australia, Canada, New Zealand, the United Kingdom, and the United States-to measure public satisfaction with health care. In no nation is a majority content with the health care system. Different systems pose different problems: In systems with universal coverage, dissatisfaction is with the level of funding and administration, including queues. In the United States, the public is primarily concerned with financial access.

Original languageEnglish (US)
Pages (from-to)206-216
Number of pages11
JournalHealth Affairs
Issue number3
StatePublished - 1999
Externally publishedYes

ASJC Scopus subject areas

  • Health Policy


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