We want to hear from you.
Tell us where you stand:
1. What concerns you more: The quality of health care you and your family receive or how much health care costs you and your family today?
Quality
Cost
2. Have you or a member of your family decided not to fill a prescription for a medication because of cost?
Yes
No
If you answered yes above, please share your story:
3. What action, if any, would you like to see your state or federal government take to lower prescription drug costs?
4. To the best of your knowledge, what is the biggest factor behind increased health care costs?
Fees charged by doctors, hospitals and other providers
Pharmaceutical companies
An aging population
5. Do you think Americans should be able to buy prescription drugs from Canada or other countries?
Yes
No
Please comment on why:
6. Has your local hospital or physician’s practice recently become part of a larger health care system?
Yes
No
If so, what changes have you seen?
7. What kind of health insurance do you have?
Medicare
Medicaid
Privately purchased insurance
None
8. Have you ever received an unexpected bill from a hospital or other health care provider outside your insurance network?
Yes
No
If you answered yes, please explain:
9. Were you able to resolve this billing issue?
Yes
No
10. Do you think your state or federal government should protect consumers from these so-called “surprise” medical bills?
Yes
No
Please explain why:
First Name
Last Name
Email
*
Cell Phone Number
Zip
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