Report finds little faith in US healthcare system

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More people attributed those decisions to cost in this year's survey than in previous years. Nearly half said cost motivated their decision to not see a doctor in the 2011 survey, compared with 35 percent in 2009.

Unsurprisingly, cost pressures are most severe for the uninsured, who also use fewer healthcare services. Less than half of the uninsured population has a primary care physician, compared with 87 percent of insured consumers. More than one-third of people without a primary-care doctor say they can't afford primary care — up 11 percentage points from two years ago.

Supporters of expanded health coverage often argue that bringing uninsured patients into the system will ultimately drive down the number of people who don't seek care until they get sick — and who do so through costly and often unnecessary emergency-room visits.

According to the Deloitte report, only 20 percent of uninsured patients reported having an imaging test in the past year, compared with 43 percent of insured patients.