Public Opinion : Health Care Coverage, Costs, and Financing

Poll Data Data divided into 3 groups: Broad values and preferences Opinions on health care costs Views on tradeoffs Emphasis on recent poll data Data from national surveys using sound polling techniques

Most with employment-based coverage are satisfied with their health insurance benefits Gallup Poll conducted August 8-11, Results reported for adults aged 18 or older employed full or part time.

But the broader view is that health care in America is in trouble The Gallup Poll, conducted November 7-10, Wording (rotated) : Which of these statements best describes the U.S. health care system today – It is in a state of crisis, it has major problems, it has minor problems,, (or) it does not have any problems.

Values and Preferences The majority believe that it is the responsibility of the federal government to make sure all Americans have health care coverage Gallup polls show this percent within the range of 58% to 64% (+/- 3%) in 7 polls taken between January 2000 and November % say it’s the government’s responsibility to help pay for healthcare for people who cannot afford to pay for it themselves (Kaiser, 2005). Results are somewhat mixed about willingness to finance government- sponsored insurance coverage that would be available to all Americans: 2 different national polls: 65% favored a government guarantee of health insurance for all citizens, even if it would mean raising taxes (Pew, 2005). Of the 64% who said it’s the government’s responsibility to ensure coverage for all Americans, only 45% said they would be willing to pay higher taxes or premiums to pay for the coverage (Public Agenda/ Gallup/Kaiser, 2004).

Broad Values and Preferences: Private Insurance A 2004 post-election survey compared perceptions of private and public sector to solve health care issues: 49% of respondents trusted the private sector more 40% trusted the government more However, trust in employer-sponsored insurance may be waning: 7 percentage-point decline in percentage of respondents who would prefer to get health insurance through an employer (48% in 2002 to 41% in 2003) 9 percentage-point increase in who would prefer to get insurance from government rather than employer (25% in 2002, 36% in 2003) (EBRI, 2003).

Who types of organizations do Americans think should own, provide or run most health insurance? 21% Unsure SOURCE: Wall Street Journal Online/Harris Interactive Health-Care Poll, % prefer for-profit companies 32% prefer government 25% prefer non-profit organizations

Health Care Costs “Health care/insurance costs” was cited more than any other problem as the most urgent health problem facing America (Gallup, 2005). 23% of Americans had trouble paying medical bills 18% say medical bills are biggest monthly expense (USA Today/Kaiser Family Foundation/Harvard School of Public Health, 2005) Americans believe several factors contribute to high costs: 89% cite high profits made by drug and insurance companies 84% cite the aging population 77% cite the use of high-tech medical equipment and expensive new drugs 63% cite the lack of incentive for the insured to look for lower-priced services (Kaiser/Harvard, 2004)

Health Insurance Tradeoffs 61% of adults with employer-provided insurance said they would choose not to get a pay increase in order to maintain their current health insurance (Wall Street Journal/Harris Interactive, 2005). 57% somewhat or strongly agree that they would stay with a job they dislike because of their need to maintain health/prescription drug coverage (Zogby, 2005).

Paying more for services not covered by insurance Percentage Willing to Pay Out-of-Pocket for Particular Services Get Specialized Services See a doctor outside normal hours Spend more time with a doctor Get top priority for appointments 42% 33% 23% 21% SOURCE: Harris Interactive, 2005

Tradeoffs to Control Costs 59% of adults with employer-provided coverage indicated they would be willing to sacrifice some provider choice in exchange for lower out-of- pocket costs (Community Tracking Survey, 2003). If health care costs increase significantly: 55% would be willing to sacrifice choice of hospitals to obtain lower costs 64% would sacrifice choice in prescription drugs to obtain lower costs 52% would sacrifice choice in physicians to obtain lower costs 20% would not sacrifice ANY restrictions on choice

Most people with employer-sponsored insurance are willing to have fewer choices of providers in order to reduce out-of-pocket costs... Income as % of Federal Poverty Level All % 54% 59% 62% 66% 67% 55% 59% … This trend is true even for people who are chronically ill. 51% 60% 68% 56% Center for Studying Health System Change, 2005 Chronically ill