Almost one-fifth of Americans with private insurance did not get the care they needed this past year due to the high cost of health care, according to a new survey conducted by the Associated Press-NORC Center for Public Affairs Research. The survey was funded by the Robert Wood Johnson Foundation and interviewed 1,004 privately insured Americans between ages 18 and 64, including 267 who have health plans with high deductibles.

For those with high deductible plans, 29 percent of them reported that they don't get medical care when they are sick or injured and 24 percent didn't receive any preventative care in the last 12 months.

Anne Weiss, the leader of the RWJF's efforts to improve the quality and value of U.S. health care, wrote to DOTmed News that health care costs are high because the payment system is still rewarding physicians for volume instead of value. "Patients often receive tests, procedures and medications that are unnecessary, which ultimately translates into wasteful spending," she added.

She did admit that there is some evidence that the growth of health care costs in the U.S. has slowed recently, but stated that the reasons for the slowdown are unclear and it's "far too early to declare victory."

The survey also found that for Americans who changed their health care plans, 41 percent reported that their costs rose, but only 18 percent of them believe that they are getting higher-quality care in return.

"The structure and cost of the coverage U.S. insurance plans offer continue to rapidly evolve, and many consumers do not have access to information to effectively evaluate the quality of their plans," wrote Weiss.

Weiss thinks that the solution is to give patients access to information about the cost and quality of care that their local physicians provide. The RWJF is currently supporting a few initiatives that promote the transparency of health care costs including Aligning Forces for Quality, the DOCTOR Project and Buying Value.

The foundation is also supporting the ABIM Foundation's Choosing Wisely campaign that is urging physicians and their patients to discuss ways to use the most appropriate tests and treatments to prevent unnecessary care.

"Ensuring that all Americans receive the care when they need it will not be easy, but it's an essential component of building a national culture of health," wrote Weiss. "Creating a system where information is transparently shared is an important first step in achieving that goal."

Weiss believes that it takes a team effort among physicians, insurers, employers, the technology community and state and federal governments to bring down the cost of health care.

"Together, all health care stakeholders can play a role in building a more transparent system, where consumers have the opportunity to access the information they need to make informed choices about their care," she wrote.

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