More than one-fourth of Americans rate the nation’s health care system “poor,” according to a new report by the Employee Benefit Research Institute.

As employers and employees ponder the future of health benefits, the Supreme Court’s June decision to uphold the constitutionality of the Patient Protection and Affordable Care Act appears to have had little or no impact on Americans’ confidence in their medical care.

“The decision did not change how people view the system,” says Paul Fronstin, author of the report and director of EBRI’s health and education research center. “Public confidence about various aspects of today’s health care system has remained fairly level both before and after the passage of health care reform law.”

Respondents to the EBRI/MGA 2012 Health Confidence Survey offer a diverse perspective when rating the current health care system: 5% say it is “excellent,” 12% rate it “very good,” 28% consider it to be “good,” and another 28% rate it “fair.” However, the survey finds that the percentage of Americans rating the health care system as “poor” doubled between 1998 and 2004.

Dissatisfaction among respondents with the health care system appears to be focused primarily on cost. The survey shows that only 22% are “extremely” or “very satisfied” with the cost of their health insurance plans and 16% are “satisfied” with the costs of health care services not covered by insurance.

The effects of health care inflation appear to be crowding out employee contributions in other areas. Among those experiencing cost increases in their plans in the past year, 31% say they have decreased their contributions to retirement plans while more than half have decreased their contributions to overall savings.

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