Only half of Americans trust the U.S. healthcare system to act in patients' best interests, and more than a third actively distrust it.
So finds an inaugural report from SachsHEALTH, a newly launched nonpartisan healthcare policy and communications division of Sachs Media, shared with Fierce Healthcare. The findings are based on a national survey of 2,500 American adults conducted in February. The report aimed to understand the disconnect between who Americans consider influential in healthcare and who they wish had greater influence.
The delta was greatest among clinicians: only a quarter of Americans believe they have influence over the public healthcare narrative, while 58% believe they should have it. Half of respondents identified their personal doctor or clinician as the source most likely to change their mind about a new health policy proposal.
Yet despite clinicians being the most trusted party in healthcare, the survey found 42% of Americans deliberately act against their clinician's recommendations, like skipping treatment or stopping medication early. This suggests a perception that clinicians are susceptible to outside influence.
“Everything we’ve really heard up till now has been focused mostly on people’s attitudes. This was the first time we really saw data that showed the behavioral implications of distrust,” Ryan Cohn, chief strategy officer at Sachs Media, told Fierce Healthcare. “People want more information, they want more communication and they want receipts.”
In contrast to perceptions of clinician influence, half of Americans believe payers have influence, but only 15% think they should have it. The single group that was seen as having the most influence overall was payers (22%), followed by elected officials (16%) and pharma (15%).
The question of influence came up industry-wide during Trump’s One Big Beautiful Bill Act last year. “There were a lot of industry players that were surprised by some of the outcomes,” Cohn said. “It’s forced a lot of industry players to reexamine the landscape and the role of influence.”
When asked to name the three groups with the most influence, 20% of respondents chose influencers and podcasters in their top three, ahead of journalists (14%) and independent scientists (11%). When asked to narrow it to a single most influential group, public health agencies barely edged influencers and podcasters, 9% to 8%.
The report also traced how Americans learn about healthcare. Nearly two-thirds (63%) say they regularly encounter confusing or conflicting health information. This affects trust: 71% of those who distrust the system say they have encountered conflicting or confusing health information, compared to 58% of those who trust it.
Among those who distrust the healthcare system, the ability to check evidence is a top driver of whether they trust a health message (54%). Overall, the most trusted sources of information are providers (48%) and the ability to verify evidence independently (48%).
Trust in public health agencies hovers around half of Americans and is about the same among liberals and conservatives. Respondents were asked about their confidence that the agencies base decisions on science rather than politics, listen to community concerns and are transparent about uncertainty.
RELATED: Patients less confident than ever about health choices: survey
Trust in institutions in times of crisis is even lower. Respondents were asked, when a serious problem happens in healthcare, which two groups are most trustworthy: Providers ranked the highest, at only 34%, followed by hospitals (28%), patient advocacy groups (27%) and public health agencies (22%).
When asked to name their top three health concerns, affordability was named by 54% of respondents. A third chose insurance denials and coverage gaps, 29% chose Medicare and Medicaid sustainability and 28% chose mental health access.
The survey also touched on artificial intelligence, finding opinions divisive. About 44% of respondents trust clinicians to use AI for imaging or lab interpretation, while 45% distrust the use case. Men were nearly 20 percentage points more likely to trust a clinician using AI than women. Generational differences were minimal.
In a similarly close split, 47% are willing to use AI chatbots for general health questions, with those willing skewing younger, while 45% are not. “Americans may need some time or bigger explanation around how it all works to build their comfort level with it before it’s widely trusted and embraced,” Cohn said.