1. The Kitchen Sink: What consumers think about a variety of healthcare topics… Presented by: 4th Quarter, 2009

2. Introduction Page 2

3. research for your brand’s health Introduction Page 3 Background and Purpose  The purpose of this quantitative survey was to understand consumers’ current thinking on a wide range of healthcare-related topics. Topics included: Concerns with the healthcare system Hospital safety Traveling for care Swine flu Transparency/Price shopping Interest in new information sources Seeking healthcare services Charging for white papers Health and health behaviors Physician relationship Advertising Methodology  A national online survey was conducted among 400 heads of household, 21 or older who are involved in the healthcare decisions for the household. The interviewing was conducted from October 10-18, 2009 by our research partner The Dieringer Research Group (DRG) in Milwaukee. The sample frame used was e-Rewards’ online consumer panel. The final data set was weighted by state, age, education, and income.  The total sample size of 400 yields a sample error of +/-4% at the 90% Confidence Level (CL). For example, if this study were repeated 100 times, in 90 times out of that 100 (i.e., 90% confidence level) we would find a total sample statistic of 50% to fall within 46% and 54%.  In the charts, letters (e.g., A, B, C) and arrows indicate a statistically significant difference at the 90% Confidence Level. Colors and bolding are used to highlight interesting patterns and/or findings.

4. research for your brand’s health Demographic profile Responsible for making healthcare decisions for a parent13% Female 71%Median household income$50,600 Political Party Affiliation Republican Independent Democrat 20% 41 24 Education Level Up to high school Some college College grad (undergrad) Graduate degree 43% 29 18 10 Age 21-34 35-54 55+ Median age 26% 40 33 47 Health Insurance Provided by work/union Purchased individually Medicare Medicaid No health insurance 47% 8 22 5 11 Page 4

5. ...and now the rest of the story Page 5

6. research for your brand’s health Right direction/wrong track? Page 6 Q1: Do you feel things in the country are generally going in the right direction, or do you feel things have pretty seriously gotten off on the wrong track? Concerns vary greatly by political affiliations: Democrats – 40%; Independents – 65%; Republicans – 94%. Concerns vary greatly by political affiliations: Democrats – 40%; Independents – 65%; Republicans – 94%.

7. research for your brand’s health Issues of most concern to Americans Page 7 Q2: Which of the following issues is MOST important to you? Not too surprisingly, issue importance varies greatly by political party affiliation: Democrats Economy and healthcare Republicans Taxes/spending, immigration, and terrorism Not too surprisingly, issue importance varies greatly by political party affiliation: Democrats Economy and healthcare Republicans Taxes/spending, immigration, and terrorism

8. research for your brand’s health Is our system broken? Page 8 Q3: Which one of the following statements best reflects how you feel about our entire healthcare system?

9. research for your brand’s health Experienced financial hardship due to medical bills Page 9 Q4: Have you experienced a significant financial hardship in the past year due to medical bills? More likely: Independents, younger, less educated, lower income, and caregivers.

10. research for your brand’s health Will I benefit from healthcare reform? Page 10 Q5: If you currently have health insurance, do you think there will or will not be a specific benefit to you if healthcare reform passes?

11. research for your brand’s health Healthcare reform and cost control Page 11 Q6: Do you expect to see lower healthcare costs for you if health reform passes in Washington? Q7: Do you think the Federal government needs to play a larger role in healthcare today in terms of lowering the costs and providing health insurance to those who don’t have it?

12. research for your brand’s health Payor preference Page 12 Q8: If you had a choice to buy health insurance from the federal government or from a private insurance company, which do you think you would prefer?

13. research for your brand’s health Reactions to the “public option” Page 13 Q9a: How important do you think it is for any health care reform to have what is called the “public option” that will allow people to buy health insurance from the federal government if they can’t get health insurance elsewhere? Q9b: Do you think it is a good idea or a bad idea for the federal government to offer what is called a “public option” that will allow people to buy health insurance from the federal government if they can’t get health insurance elsewhere?

14. research for your brand’s health Hospital safety Page 14 Q10: Do you perceive there to be a problem at hospitals today regarding patient safety in terms of preventable medical errors? Q11: In the past 3 years, have you personally or someone in your immediate household experienced any serious quality issues or medical errors while being treated at a hospital? About one in six (16%) people say they have experienced a serious quality issue or medical error at a hospital in the past 3 years.

15. research for your brand’s health Traveling for care Page 15 Q12: In the past couple of years have you or has someone in your immediate household traveled outside your area for medical care? Q13: In the past couple years have you or has someone in your immediate household traveled outside the country for medical care? 17% have traveled outside their immediate area for medical care in the past couple of years. 4%* have traveled outside the US for medical care in the past couple of years. *3% a year ago

16. research for your brand’s health Swine Flu Page 16 Q14: Thinking about Swine Flu, how concerned are you about contracting Swine Flu? Q15: Do you feel that Swine Flu is a serious health threat to Americans or more media hype? A serious health threat (17%) Totally media hype (10%) A threat but made bigger by the media (70%) Not sure (3%) Is Swine Flu…

17. research for your brand’s health Transparency/Price shopping Page 17 Q16: Within the past year, did you or did a member of your immediate household contact any healthcare organization, hospitals, or physician offices to ask about the price for a specific visit, test, treatment, or surgery? IF YES IN Q16  Q17: What type of health service did you ask about pricing for? IF YES IN Q16  Q18: Did you end up choosing the least expensive provider? 4 th Qtr 2008 4 th Qtr 2009 Households that have contacted a healthcare organization to ask the price for a specific visit, test, treatment, or surgery 33%32% Chose the least expensive provider for one of these healthcare cases 36%41% % of the total patient market  12%13%

18. research for your brand’s health Information source credibility Page 18 Q19: Next, if you had to be hospitalized and you wanted to gather information about which hospital you should choose, which of the following sources of information are most credible to you (whether you have used them or not) and which ones have you actually used? Average credibility = 21% Average used = 14% Percent

19. research for your brand’s health Information sources Page 19 Q20: Next, which of the following online health-related activities have you participated in over the past few years?

20. research for your brand’s health Healthcare behavior changes Page 20 Q21: Has the debate over healthcare reform caused you to change any of your healthcare behavior? Q22: Has the economic downturn caused you to delay seeking any medical care that you normally would have sought out? More than a quarter (27%) of Americans say the economic downturn has caused them to delay seeking certain medical care that they normally would have sought out (but not the debate).

21. research for your brand’s health Elective procedures Page 21 Q23: Which of the following elective or cosmetic procedures have you had in the past 2 years and which ones are you considering having in the next 2 years? Especially among 35-54 year olds

22. research for your brand’s health Purchasing a health-related white paper Page 22 Q24: Say you are seeking information on a specific medical condition and you came across a white paper written by researchers at a well known and respected academic medical center such as Johns Hopkins or a Mayo Clinic or an MD Anderson, for example. And assume this publication was of interest of you. This particular publication cost $9 to download off the internet or to have emailed to you. You also found other articles online from other academic medical centers that you were familiar with on this topic that were free. Would you…. College – 6% < College – 1%

23. research for your brand’s health Personal health conditions Page 23 Q25: Please check any of the following medical or health situations that relate to you personally? Increases with age Increases with age, < college Decreases with age < college Decreases with age, < college Older, < college, < $55k < college < college, < $55, $55k+

24. research for your brand’s health Physician relationship Page 24 Q26: Do you have a primary care or personal physician? Q27: When you chose your primary care doctor which of the following factors had the biggest influence on which doctor you chose? 83% of folks have a primary care physician.

25. research for your brand’s health Physician “hassle factors” Page 25 Q28: Please agree or disagree with the following statements.

26. research for your brand’s health Social media sites’ influence on physician relationships Page 26 Q29: Have you ever gone online to a social networking site (such as Facebook or Angie’s List or a Blog, etc.) and shared your experiences (good or bad) about a doctor or a hospital you recently visited? Q30: Has your doctor ever asked you to sign an agreement that you will not go online and share your experiences on some social networking site such as Facebook or Angie’s List or a Blog?

27. research for your brand’s health Communicating with physician via email Page 27 Q31: How comfortable would you be in communicating with your physician via email for certain routine activities such as scheduling an appointment, changing an appointment, getting prescription refills, getting test results, etc? e-mail must be old technology! 21-34: 36% 35-54: 60% 55+: 56% e-mail must be old technology! 21-34: 36% 35-54: 60% 55+: 56%

28. research for your brand’s health Changing doctors Page 28 Q32: Have you changed primary care physicians in the past few years? Q33: Why have you changed primary care physicians? [Among the 83% that have a primary care physician] 24% of patients have recently changed PCPs

29. research for your brand’s health TV advertising “themes” Page 29 Q34: All TV ads try to convey their message using a variety of themes or story-telling methods. If you saw a TV ad for a local hospital, which of the following themes would cause you to pay the most attention?

30. research for your brand’s health Additional information If you would like additional information regarding this study, please contact: Rob Klein President Klein & Partners, Inc. 412 Ashbury Dr. Hinsdale, IL 60521 [630] 455-1773 rob@kleinandpartners.com Page 30