Context: Nearly half of adults in the United States have received an unexpected medical bill in recent years. While government, provider, and insurance policies related to unexpected medical expenses are the subject of attention in media, this study focuses on variation in public support.
Methods: The study employs two multi-factor survey vignette experiments to detect how different features of common health care scenarios that result in costly medical expenses influence the public’s sympathy for patient, perceived fairness of the medical costs, and demand for government action.
Findings: The results point to the cost, severity of the treatment, and the patient’s insurance situation as important for public opinion. The public is significantly more supportive of government action when the costs are high and out of the patient’s control; in contrast, respondents are generally less sympathetic toward patients described as uninsured or who seek out more costly providers.
Conclusions: The findings underscore the sensitivity of health care attitudes to framing effects, which may occur when media choose how to cover health care costs. The results also point to a potential mismatch in legislation addressing “surprise billing,” narrowly, with public support for government to address disproportionate costs across a broader range of scenarios.