Access and Affordability: Rural Nebraskans’ View of Health Care

The availability, cost and quality of health care services are important issues to rural Nebraskans. How available are these services and how satisfied are they with them? Do they have health insurance? Have they experienced any medical hardships during the past year? This report details 2,915 responses to the 2004 Nebraska Rural Poll, the ninth annual effort to understand rural Nebraskans’ perceptions. Respondents were asked a series of questions about health care services. For all questions, comparisons are made among different respondent subgroups, i.e., comparisons by age, occupation, region, etc. Based on these analyses, some key findings emerged: • The health care services most accessible to rural Nebraskans are a pharmacy, doctor/health clinic and dentist. Seventy-six percent report having to drive less than 15 miles to reach a pharmacy, 68 percent drive less than 15 miles for a doctor/health clinic and 66 percent drive that distance to reach a dentist. Twenty-four percent report driving more than 60 miles for specialized health care. • Persons living in the North Central region are more likely than persons living in other regions of the state to have to drive more than 60 miles to access each health care service listed. Forty-nine percent of the residents of this region have to drive more than 60 miles for specialized health care. However, only 21 percent of the South Central residents have to drive that distance for this care. • Rural Nebraskans are most satisfied with the following aspects of medical and mental health care services: the condition of medical facilities, care provided by their medical doctor and the variety of medical services available to them. • Rural Nebraskans are most dissatisfied with the cost of health insurance, the cost of medical services and the coverage of health insurance. • Younger persons are more likely than older persons to be dissatisfied with the cost of medical services. At least 70 percent of the persons under the age of 65 report being dissatisfied with the cost of medical services. However, only 56 percent of the persons age 65 and older are dissatisfied with the cost. • Seven percent of rural Nebraskans do not have health insurance. Over one-half (54%) have health insurance through job benefits. Thirty percent have insurance through a government program such as Medicare or Medicaid and 21 percent purchased their health insurance on their own. Sixty percent of the persons with health insurance coverage through a government program also purchased supplemental insurance on their own. • Persons living in or near larger communities are more likely than persons living in or near smaller communities to have health insurance through job benefits. Sixty-two percent of the persons living in or near communities with populations of 10,000 or more have health insurance through job benefits. However, only 44 percent of the persons living in or near communities with less than 500 people have this benefit. • Younger persons are less likely than older persons to have health insurance. Eighteen percent of the persons age 19 to 29 report not having health insurance, compared to only two percent of the persons age 65 and older • Males are more likely than females to have health insurance through job benefits. Fifty-eight percent of males have health insurance through job benefits, compared to only 46 percent of females. • Over one-quarter of rural Nebraskans have experienced the following during the past year: had great difficulty paying the cost of necessary medical care (28%), not seen a doctor when needed because of the cost (28%) and had great difficulty paying for prescription drugs (28%). Nineteen percent have reduced the recommended dosage of prescription drugs to save money and 16 percent quit taking prescription drugs because of the cost. • Younger persons are more likely than older persons to have not seen a doctor when needed because of the cost. Forty-four percent of the persons age 19 to 29 did not see a doctor when needed because of the cost. Only 10 percent of the persons age 65 and older shared this experience. • Older persons are more likely than younger persons to have had great difficulty paying for prescription drugs during the past year. Thirty-three percent of the persons age 65 and older had difficulty paying for their prescriptions, compared to 24 percent of the persons age 30 to 39