Is Health Care Affordable?


 by Ed Martinez, July 2018



Most Americans consider “affordability” to be the most urgent priority for reforming today’s existing health care system.  An early 2018 Gallop Poll reported that 78 percent of Americans have significant concerns regarding high-cost barriers associated with accessing and paying for health care services.


Another national study published by the Kettering Foundation/Public Agenda (“Where Americans See Eye to Eye on Health Care,” 2018) explored the public’s views on the subject of health care affordability, and reported the following perspectives of survey respondents:


Finding 1:  “Affordability” was participants’number one priority for health care reform. Unlike leaders, participants were not concerned about how much government spends on health care, but they were angry about the costs they face.


Finding 2:  Simplicity and transparency were high priorities for participants. Participants often described health care costs as not just too high but irrational or suspect. The exasperations of respondents were evident in how they described the system, using terms such as ‘nightmarish’ or ‘makes no sense’.


Finding 3:  People viewed prices as out of control and were intrigued by the idea of states doing more to control prices.


Finding 4:  Everyone should have access to health care.


Finding 5:  Participants were angry at politicians and politics. They felt that the odds for progress would improve if politicians had the same frustrating, expensive insurance coverage that their constituents do.





A 2017 Kaiser Health Tracking Poll asked consumers if a $500 unexpected medical bill would be too much for many families to pay. 45 percent of respondents said they would have a difficult time paying such a large medical bill—and, about 19 percent of all respondents said they wouldn’t be able to pay the bill at all. 20 percent of the survey respondents reported that they would pay the bill by putting it on a credit card and paying for it over time.




The health care affordability issue does concern district residents—consider the following:


According to the County of San Diego, Grossmont Hospital’s primary service area included the City of El Cajon (pop. 130,000); the City of Lemon Grove (pop. of 31,000); and the unincorporated area of Spring Valley (pop. 87,000).


When conducting community health needs assessments, public health researchers generally consider household-income and health insurance coverage as indicators of a community’s overall environment/risk status—i.e.low-risk, moderate-risk or high-risk. The following data indicates that the three communities making up Grossmont Hospital’s primary service area may be considered ‘high-risk’ in terms of experiencing significant barriers to accessing routine (preventive and primary care) health services. 



CommunityIndividuals from Lower-Income HouseholdsIndividuals Without

Health Insurance

El Cajon45,00020,800
Spring Valley19,00011,500
Lemon Grove7,8005,300




  1. The affordability of health care services represents a major health policy concern for all District residents.


  1. The affordability issue is of special concern to the 37,600 District residents that are uninsured, and the 71,800 residents from lower-income households.


  1. The combined populations (109,400 residents) of the above two groups look to the Grossmont Healthcare District to moderate prices for patient services provided in District-owned facilities.
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