A painful, pre-existing condition – obsession over the cost of medical care and health insurance – makes the latest announcements of rising insurance rates a potent political issue, according to a survey that polled patients throughout New York state this year.

The 2016 Empire State Healthcare Survey, conducted by the Cornell Institute for Healthy Futures through the university’s Survey Research Institute, polled 800 New Yorkers of all backgrounds and political inclinations between February and April 2016. Overall, two-thirds thought the cost of care (39 percent of respondents) and the American health insurance system and policy (27 percent) were the “most important problems in U.S. health care.”

“If that’s what worried people before the latest round of insurance premium increases for 2017, it’s not surprising that Obamacare costs have so much political currency,” said Rohit Verma, executive director of the Cornell Institute for Healthy Futures and one of three authors of the report, Empire State Healthcare Survey 2016.

Most people aren’t worried about the quality of American health care (more than 70 percent gave a positive rating to their most recent hospital visit experience, and only 7 percent were dissatisfied), “but they’re clearly telling us where they’re hurting – in the pocketbook,” said Verma, the Singapore Tourism Board Distinguished Professor in Asian Hospitality Management at the School of Hotel Administration and dean of external relations of Cornell's College of Business. “They’re blaming that pain on two causes: hospital and doctor bills, and the regulatory policies that govern health insurance in this country.”

Other so-called problems weren’t keeping many patients up at night. Access to health care worried only 6 percent in the survey, and about the same number expressed concern over the efficiency of health care delivery. A contented 4 percent saw “no problem” at all.

The survey analyzed responses based on political affiliation, with 77 percent of self-identified Republicans or conservatives saying they were somewhat satisfied or very satisfied with their latest hospital experience, according to a summary of responses. Younger patients were a little harder to please; 54 percent of under-30s reported a positive experience, but 85 percent of patients age 65 and above did.

Upstate residents had slightly higher levels of satisfaction than downstate residents in the 2016 survey.

As for bedside manner, 66 percent of patients were not put off by doctors wielding computers (laptops, smartphones or tablets) during their visits. Self-identified liberals were more accepting (75 percent) of computerized health care, compared with conservatives (61 percent). Then a generational divide emerged: Those below age 30 have the lowest portion of positive reaction to physicians’ computer use (60 percent very positive or somewhat positive) compared to respondents 30 years or older.

Stereotypes were further defied when the survey asked about health care delivery in the future. Suppose, for instance, you could get help with minor problems like the flu or a rash via smartphone? Compared with other age groups, the youngest (below 30) has the lowest level of interest in using their smartphone at home to receive outpatient care and the highest level of preference in going to a hospital clinic.

But government policy regarding health care, the 2016 New York survey revealed, is most worrisome issue for young to mid-age patients (18-49 years old). Men are more concerned with cost of care and government policy than women, according to survey analyses, whereas women are more concerned with specialized treatment, insurance policy-specific issues, quality of service, efficiency and access.

H. Roger Segelken is a freelance writer for the College of Human Ecology.