PULSE CHECK: New Report Identifies Root Causes of Mistrust in Health Care

United States of Care’s latest insights report reveals where mistrust in health care stems from and outlines clear steps to rebuild patient confidence

Washington, DC — Today, United States of Care (USofCare) released its first Pulse Check report on trust in the health care system. The report finds that high costs, confusing billing practices, perceived corporate greed, and mistreatment leave people skeptical of the health care system and reluctant to seek care when they need it. These insights point to deep cracks in how people experience health care – and reveal what must change to restore faith. 

Key Insights on Mistrust in Health Care Include:

• Trust differs between “system” and “care.” People’s lack of trust in “systems” and system actors like insurance companies, CEOs, and pharmaceutical companies is separate and distinct from their trust in the “care” they associate with doctors and nurses, due to the personal relationships they develop. 
• Health care is seen as expensive and profit-driven, with seven in 10 people feeling that costs are too high. Corporate and institutional greed is perceived as the primary driver of steep health costs. 
• Complexity fuels mistrust. People are frustrated by nontransparent costs, surprise bills, and confusing coverage that make the health care system feel profit-driven instead of patient-focused. The confusion of navigating the system feels intentionally designed.
• Fee-for-service drives negative perceptions, with 65% of survey respondents saying that this model does not work well – citing concerns like unnecessary tests and prescriptions, rushed appointments, and high care costs. 
• Racial disparities deepen mistrust. People of color report lower levels of trust due to mistreatment, stereotyping, language barriers, and a lack of representation in health care settings.
• Artificial intelligence raises new concerns, with 77% of people feeling concerned, skeptical, or uncertain about the use of AI in health care, and most reporting no experience with or awareness of the technology being used in their most recent health visit. 

“Our conversations with people across the country prove that trust in health care is deeply broken and it’s having dire consequences,” said Venice Haynes, Senior Director of Research and Community Engagement at USofCare. “This report reflects what people have told us about the barriers they face – and the steps needed to rebuild confidence in the system: Lower costs, greater transparency, patient-centered care models, and care approaches tailored to individual communities. We cannot create a system that is both trusted and effective without implementing these strategies.”

Over the last six years, USofCare has conducted more than 30,000 listening sessions across all 50 states to better understand people’s real experiences with health care. These insights are analyzed into a series of Pulse Check reports that highlight key themes shaping the future of healthcare. As the first in this series, the Pulse Check: Trust report provides a timely look at where trust in health care stands today and what must change to strengthen it.

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