2018 Minnesota General Population Survey of Attitudes and Outlook Regarding Healthcare Services and Costs
In 2004, Governor Tim Pawlenty appointed former US Senator David Durenberger to head the Minnesota Citizens Forum on Health Care Costs. The Forum was tasked with addressing a "crisis of affordability" of health care. Its 18 members traveled the state for three months, conducting Town Hall meetings and listening sessions, gathering ideas from fellow citizens on what the state's health care system should look like.
"There's no question in my mind that we can find a great deal of common ground in health care reform," said Governor Pawlenty. "We can't afford to politicize this issue, but need to come together on real solutions designed to cut health care costs for Minnesotans."
The Minnesota Citizens Forum worked with the Minnesota Board on Aging and the Governor's Council on Developmental Disabilities to develop and conduct a 20-minute telephone survey of a representative sample of 800 Minnesotans. The resulting Health Care Opinion Poll obtained measures of satisfaction with health care quality and costs, perceptions regarding changes in costs and payment responsibilities, and preferences for universal health care versus private health care insurance.
Fourteen years later, in 2018, the Governor's Council on Developmental Disabilities replicated the opinion poll and surveyed over 1000 Minnesotans. The results are available here:
The vast majority of the respondents had some kind of health insurance coverage (92%).
Just over half (56%) of survey respondents have private health insurance through their employer, and another 8% purchased insurance through the Health Insurance Exchange recently. Forty percent (40%) have some kind of government-provided healthcare coverage (21% Medicare, 19% Medicaid); Medicaid coverage has grown from 7% in 2004 to 19% in 2018.
In the words of Minnesota State Senator John Hoffman, "When this study was first commissioned 14 years ago, a pressing issue was running buses to Canada to buy prescription drugs. In this study, a pressing issue is the high cost of prescription drugs and the need for government oversight."
Most respondents believe healthcare coverage costs are rising, and that it matters.
Two-thirds of Minnesotans (65%) who have any kind of health insurance coverage believe their cost for premiums and additional costs have been going up over the past couple of years; however, these perceptions of rising costs are not as severe as they were in 2004, when 89% of respondents believed the same thing. These perceptions of rising costs made a difference in whether people actually went to the doctor when they thought they needed to.
- Just over one-third of Minnesotans (38%) have delayed medical treatment because of the cost they would have to pay.
- Of the 38% of Minnesotans who have delayed treatment, one-half, or 19%, had a serious or somewhat serious condition or illness.
Survey Respondents gave Minnesota a "6.4" out of a possible "9" for Overall Health Coverage and Care.
On a scale of 1-9, with "1" indicating a perception of poor health coverage and care, and "9" indicating excellent health coverage and care, Minnesotans gave their healthcare system an overall average rating of 6.4. That rating is supported by the fact that Minnesotan households expressed more satisfaction than dissatisfaction with many aspects of their healthcare-related experiences.
- For example, respondents seemed mostly satisfied with their ability to be able to choose the healthcare provider they wanted, including specialists, and to get in for an appointment when they wanted, as well as the amount of time they were able to spend with their provider.
- Respondents were most dissatisfied with the amount of money they had to pay for health insurance and prescription drugs, as well as the whole process of pricing, billing and reimbursement for medical services.
Comments ranged from the positive: "…I've been fortunate enough to have doctors who spend a lot of time listening and working together to come up with diagnosis and treatment plans," to the negative: "… [because of changes in insurance allowances,] doctors are forced to have a 'treat them and street them' mentality."
Minnesotans perceived the overall quality of the healthcare system in the U.S. to be one full point lower than that of the quality in their own state.
On average, Minnesotans with government-provided healthcare coverage (Medicare or Medicaid) had more positive perceptions of their overall health coverage and care, as compared to Minnesotans with private insurance. This seemed due, in part, to frustrations over confusion related to the billing and payment process, as well as by the "baffling" array of plans available, and uncertainty in how to "navigate the options."
The future of healthcare does not look bright according to 27% of survey respondents.
One-out-of-four respondents (27%) believe they will be worse off in 3 years regarding access to good quality, affordable healthcare. In households with a family member with a developmental disability, this pessimism was particularly pronounced, with respondents indicating fear of potential:
- federal cuts to Medicaid,
- rising costs of healthcare premiums, deductibles and co-pays, and
- decreased access to health insurance and medical services for people with preexisting conditions and disabilities.
As for attitudes on "public or government-run" versus "private" health insurance coverage, Minnesotans are evenly split.
In order to assess Minnesotans' attitudes on government healthcare policies, this question was asked: "Do you think it is the responsibility of the federal government to make sure all Americans have healthcare coverage, or is that not the responsibility of the federal government?" Just over half (54%) of all respondents believe the federal government is responsible for ensuring that all Americans have healthcare coverage. The differences between the yes and the no answers are well characterized with these two quotes from citizens on each end of the attitudinal spectrum.
Yes: Healthcare companies, insurance companies and healthcare providers are not properly incentivized to provide care for everyone. It is expensive and logistically hard to provide healthcare to the poor and people with disabilities. The government needs to make sure that everyone, regardless of whether they need high or low levels of care, have continued access at a price that is not going to make them lose their financial freedom.
No: Healthcare you don't pay for is a handout. Social security payments to individuals who have never paid premiums is a handout. Welfare for individuals who are capable of working is a handout. Money for this does not grow on trees. It comes out of our taxes, insurance premiums, etc.
Minnesotans make recommendations to Congress.
Minnesotans anticipate that federal changes in Medicare and Medicaid are coming, and expressed their opinions on how best to deal with any loss in federal funding. Survey respondents were provided with the following five choices and asked which path Minnesota should choose:
- Reduce rates paid to service providers who are paid with Medicaid dollars,
- Draw funds from other state priorities,
- Raise state taxes to pay for the growth in Medicaid costs,
- Cut services that are currently being offered through Minnesota's Medicaid program, or
- Cover fewer people.
As Senator John Hoffman has stated, "Minnesotans registered strong support for honoring the commitment to Medicaid by the federal government. This is critical for the lives of people with developmental disabilities."
The majority of Minnesota respondents (60%) believe the federal government should continue to "honor the commitment" to match the state's spending for Medicaid, as opposed to putting a limit on federal Medicaid spending.
- If cuts are needed, then the respondents recommended that provider rates be reduced rather than cutting services or covering fewer people.
When it comes to the government's role in the pricing of drugs, the majority of Minnesotans (83%) believe the government should play a role in drug pricing, with 39% believing the government should be very involved in controlling prices.
2017 Minnesota Racial & Ethnic Survey of Attitudes Towards People with Developmental Disabilities
2017 Minnesota General Population Survey of Attitudes Towards People with Developmental Disabilities
In 1962, a survey of the Minnesota general population was conducted to measure awareness and attitudes about developmental disabilities. The survey was updated and repeated in January 2007 (45 years post) and again in 2012 (50 years post). A 2017 survey was also conducted and the results are now available.
While attitudes changed dramatically between 1962 and 2007, those attitudes have remained unchanged over the past ten years. The 2017 study reveals that, for a majority of Minnesotans, the most important services provide access to quality, coordinated healthcare; and protection services to prevent the abuse of people with developmental disabilities.
Over 70% of Minnesotans favor employment services, special education services and early childhood special education services. A majority also believe that the State should move away from corporate foster care by providing housing supports directly to individuals with developmental disabilities so they can choose where to live, their roommates, and their staff or providers.
Survey of Individuals for Five-Year State Plan
The Minnesota Governor's Council on Developmental Disabilities is in the process of developing a new Five-year State Plan for FFYs 2017-2021. A survey of individuals with developmental disabilities and their families was recently conducted to identify important issues to be addressed.
A Survey of Providers was also conducted to learn their opinions about a range of issues including employment, health care, quality assurance, housing, and self advocacy.
Minnesota Special Education Experience Study 2014
In followup to the K-12 Education Study for Students with Developmental Disabilities that MarketResponse International conducted in 2013, and based on the insights gained from that study, the Minnesota Special Education Experience Study was conducted in 2014. This study was done in collaboration with the Minnesota Department of Education, Special Education Division. The purpose of this recent study was to obtain benchmark measures of overall quality and satisfaction levels of the special education experience from the perspective of parents and the students themselves. The results show satisfaction levels by grade level and geographic location, quality drivers of the education experience, and awareness of and attitudes about Positive Behavioral Interventions and Supports.
*PDF version contains accessible text that can be accessed through the "Read Aloud" feature in Adobe Reader
K-12 Education Study for Students with Developmental Disabilities 2013
In 2012, MarketResponse International conducted a general population survey of Minnesota households to track changes in attitudes about people with developmental disabilities over the past 50 years. A parallel survey was also done with households with a family member with developmental disabilities. Both surveys also contained questions about quality of life issues, including the future outlook of education services.
Based on findings, the surveys showed a significantly more negative outlook about education services among households with a son or daughter with developmental disabilities. As a result, education was not only selected for this year's study but a relatively new approach and methodologies, referred to as Narrative Research, were used. Rather than framing a study around a preconceived idea and testing it out, narrative methods rely solely on the stories shared by participants and their personal experiences around a specific topic.
This study explains Narrative Research and what was learned about education services in Minnesota from students with developmental disabilities, parents, teachers, school administrators, and case managers.
1962/2012 Minnesota Survey of Attitudes Regarding Developmental Disabilities
Perceptions, awareness, beliefs, and attitudes about people with developmental disabilities have changed substantially in the past 50 years. MarketResponse International has just completed a survey of the general population in Minnesota that shows these marked shifts. (April 2013)
Survey of Individuals for Five-Year State Plan
The Minnesota Governor's Council on Developmental Disabilities is in the process of developing a new Five-year State Plan for FFYs 2012-2016. A survey of individuals with developmental disabilities and their families was recently conducted to identify important issues to be addressed, and how and where services and delivery systems can make improvements over the next five years. The survey also measured levels of independence, productivity, self determination, integration and inclusion among people with developmental disabilities as was done in 2005 and based on the Quality of Life survey that was first conducted in 2000. (December 2010)
A Survey of Providers was also conducted to learn their opinions about a range of issues including employment, health care, quality assurance, housing, and self advocacy.
MarketResponse International also prepared a meta analysis of the customer research studies that have been conducted over the past ten years, studies among people with developmental disabilities and families, businesses, and the general population in Minnesota, and provided recommendations for future research. (October 2010)
Awareness, Attitudes and Impact of the Americans with Disabilities Act Among Minnesota Businesses
MarketResponse International has conducted a survey of 500 Minnesota businesses, including retail stores, restaurants, hotels, banks, grocery stores, and vehicle dealerships; and interviewed architects and engineers, and commercial building contractors, to determine their awareness about the Americans with Disabilities Act (ADA), the impact of the ADA on design and building projects, enforcement of accessibility provisions, and accommodations made and accommodations anticipated to meet accessibility requirements and improve access for people with disabilities. Survey results are available in several formats. (April 2010)
Information Technology Customer Research Study 2009
MarketResponse International has conducted a survey of 382 Minnesota households that have members with and without disabilities. The purpose of this survey was to obtain measures about access to; and adoption, use and the perceived benefits of information technologies; satisfaction with state government websites; and attitudes about information technologies among people with disabilities compared with the general population in the state of Minnesota. This survey is available in several formats. (April 2009)
Flash (PowerPoint) PDF Text Only Executive Summary (HTML)
Innovative Employers in Minnesota Presentation
MarketResponse International conducted a nominations process to identify Minnesota businesses that are using innovative employment practices in hiring people with developmental disabilities and promoting an inclusive work environment. Forty-five nominations were received and 11 businesses were selected. On October 1, 2008, these employers and their employees were recognized. Profiles of the businesses are available in several formats. (April 2009)
Flash (PowerPoint)PDF Text Only Press Release (PDF)
Employment Honorees Photo Presentation: Flash (PowerPoint) PDF
Document Imaging Presentation: PDF
News Segment from Cable Channel 12 Business Beat on Noble Parkway Mobil
News Segment from Cable Channel 12 Business Beat on Golden Valley Byerly's
Information Technology Insights Focus Groups
In May 2008, six focus groups were conducted by Bill Harreld, Quality Culture Institute, to learn how youth with and without disabilities are accessing and using technology, and their perspectives on the future of technology based on predictions that Bill Gates made in 2007. A total of 88 young adults participated in the focus groups. (July 2008) More...
1962-2007 Public Opinion Poll Results
In 1962, the Minnesota Department of Public Welfare contracted with Social Issues Research, Inc. to conduct 900 face to face interviews with a sample of Minnesotans that was in close approximation to the 1960 Census.
The purpose of the study was to "determine what salience does the problem of mental retardation have for the people of Minnesota?" The Arc of Minnesota was a major partner in this effort. The results were intended to be used to design a community education program to alter misconceptions about people with mental retardation.
Forty five years later, the staff of the Minnesota Governor's Council on Developmental Disabilities discovered a copy of the study while creating an online archive, Parallels in Time, Part 2. The original study, "Survey of Information and Attitudes Regarding Mental Retardation In Minnesota" may be downloaded here. (PDF)
The Council then contracted with MarketResponse International to conduct a similar study – 800 phone interviews were made with a sample of Minnesotans that was in close approximation to the 2005 Census. The purpose of the study was to measure attitudinal changes of the general population in Minnesota during the past 45 years.
The Arc of Minnesota, The Autism Society of Minnesota, Self Advocates of Minnesota, The State Council on Disability, and United Cerebral Palsy of Minnesota are major partners in this effort.
This is the final version of the 1962-2007 Public Opinion Poll and includes the Attitudinal Segmentation Analysis. (Flash format. Also available as PDF and text-only.
The Minnesota Governor's Council on Developmental Disabilities is in the process of developing a new Five-year State Plan. The direction of the Plan will reflect what people with developmental disabilities and their families, service providers and front line staff believe are the important issues to be addressed and where positive changes can be made in services and service delivery systems over the next five years. Two surveys were conducted to assist with this process – The Individual Survey (PDF) (Text version) was based on the Quality of Life survey conducted in 2000; and measured levels of independence, productivity, self determination, integration and inclusion among people with developmental disabilities. The Provider Survey (PDF) (Text version) collected input from service providers on areas of emphasis and levels of satisfaction with those areas of emphasis. The surveys are supported by qualitative statements (PDF) (Text version), input and the personal quotes intended to supplement the quantitative results that are presented in the reports.
In addition to the input from the Individual and Provider surveys conducted by MarketResponse International, visits were scheduled in eight regions of the state to talk with people with developmental disabilities, families, advocates, program managers, and front line staff. The purpose of these meetings was to listen to the people who are receiving and providing services, to learn about the issues that are important to them, and to gather their ideas and suggestions on where and how services and supports could be improved. The notes taken during these meetings and interviews – the qualitative statements (PDF) (Text version) – were then organized into categories. This input and the personal quotes are intended to supplement the quantitative results that are presented in the report prepared by MarketResponse International. (January 2006)
Employer Survey (PDF) (text version) The Minnesota Governor's Council on Developmental Disabilities has completed a survey of 600 Minnesota employers across a broad range of organizations and businesses. The purpose of the survey was to identify and measure issues and perceptions that are barriers to increasing the employment of people with disabilities. (May 2005)
Minnesota Health Care Opinion Poll (PDF) (Text Version) The Minnesota Governor's Council on Developmental Disabilities and the Minnesota Board on Aging commissioned MarketResponse International to gather opinions from Minnesotans regarding their current feelings on many key issues related to health care. (January 2004)
Electronic Government Services Survey (PDF) (Text Version) The Minnesota Governor's Council on Developmental Disabilities wants to support the advancement of Electronic Government Services (EGS), and increase the number of their primary customers who use EGS. From the government's viewpoint, EGS improves efficiency, accountability and responsiveness of government agencies while reducing costs. From the customer's viewpoint, EGS gives the citizen choice, convenience and control over relationships with government.
The objective of this study is to evaluate the current state of EGS, and develop an understanding of the needs, requirements, expectations and desires of customers related to EGS. (September 2003)
Consumer Directed Community Supports Survey (PDF) (Text Version) In April, 2002, MarketResponse International conducted a survey of the Consumer Directed Community Supports (CDCS) program offered by the Minnesota Department of Human Services (DHS). Survey results indicate the program has been successful and appreciated by participants with a total of 93% giving CDCS a satisfaction rating of 5, 6, or 7 on a seven point scale. (April 2002)
Quality of Life Survey (PDF) (Text Version) The Minnesota Governor's Council on Developmental Disabilities conducted a quality assessment in 2000, to determine how people with developmental disabilities evaluate the quality of services they receive from the array of service providers, and what obstacles they may face in their day to day living. (January 2001)