In the survey, respondents were asked to rate their perceptions of the importance of each of 16 government actions related to health care and to rate their perceptions of the government’s performance on each of those actions. Actions with the largest gap between importance and performance are the areas in which the government has the greatest opportunity for improvement. Actions with the smallest gap between importance and performance are the areas in which government is strongest.

Outcomes

• On average, just fewer than six in 10 U.S. respondents rated Outcomes actions as essential or very important.

• They placed the most importance on government ensuring that health providers coordinate efforts with different public services to address wider health needs.

• That is also the Outcomes action with the largest performance gap.

Balance

• U.S. respondents assigned the most emphasis to government ensuring that support is provided to respondents who may have difficulties so they can gain easier access to care.

• Yet, only about one in five think government is performing that action well.

Engagement

• U.S. respondents identified Engagement as the most important component of their relationship with government.

• More than six in 10 rate each of the actions as essential or very important.

• However, government is falling short in a number of areas—especially seeking respondents’ views when determining priorities for health and health services.

Accountability

• U.S. respondents perceive government performance is weakest in this component.

• They placed heavy emphasis on government provide clear explanations of how spending priorities are determined.

• They also called for government to provide evidence of how health care policies are improving respondents' health and to take prompt, effective action to resolve issues that respondents experience with health services.

The radar chart above provides a visual depiction of how respondents in the United States rated the importance and performance of the 16 government actions listed below.

Outcomes

• Focus on delivering real improvements in the overall health of the nation.
• Target health services to help people with the highest level of need.
• Coordinate their efforts with different public services (e.g., social services, schools) to ensure that people’s wider health needs are met.
• Coordinate their efforts with different nongovernment organizations to ensure that people’s wider health needs are met.

Balance

• Provide fair and equal access to health services for everyone in the country.
• Provide people with treatment and care that is more tailored to their individual health needs.
• Make health information and services easily available to people through a variety of different methods, such as telephone and Internet, as well as in person.
• Help people who may have difficulties using health care services, e.g., the elderly, to gain easier access.

Engagement

• Provide reliable and trustworthy information and advice about health and health services.
• Provide a clear and easy way for people to access health information and information on health services quickly and easily.
• Seek people’s views when deciding on the priorities for health services.
• Encourage and educate people to take more personal responsibility for improving their health and that of their families.

Accountability

• Provide clear explanations of how spending priorities on health services are decided.
• Provide the public and patients with clear evidence of how health care policies are improving people’s health.
• Take prompt and effective action to resolve problems or difficulties that patients and the public experience with health services.
• Create regular opportunities for patients and the public to take part in discussions about the quality of health services.