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Public Opinion Challenges (and Opportunities?) For Addressing the Uninsured Issue Mollyann Brodie, PhD Vice President, Public Opinion & Media Research, Kaiser Family Foundation Grantmakers in Health January 21, 2004. What do you think are the two most important
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Public Opinion Challenges (and Opportunities?) For Addressing the Uninsured IssueMollyann Brodie, PhDVice President, Public Opinion & Media Research,Kaiser Family FoundationGrantmakers in HealthJanuary 21, 2004
What do you think are the two most important problems for the government to address? Economy War Health care Terrorism/National Security Taxes/Budget Education Crime Note: Adds up to more than 100% because of multiple responses Source: Kaiser Family Foundation Health Poll Report September/October 2003 (conducted Oct. 3-5, 2003)
Americans’ Perceptions of the Most Important Issues for the Government to Address Percent naming health care as one of the two most important issues for the government to address Jun-03 Note: "Don't know" responses were included in the base when percentages were calculated. Source: Harris Interactive Polls, cited in: Blendon, Robert J., John M. Benson, & Catherine M. DesRoches. 2003. Americans’ views of the uninsured: An era for hybrid proposals. Health Affairs, Web Exclusive, W3 :405-414.
Most Important Priority Within Health Care How important do you think it is for the President and Congress to deal with the issue of increasing the number of Americans with health insurance? What do you think is the most important problem in health or health care for the government to address? (OPEN-ENDED RESPONSES*) Costs Seniors’ issues Very important Coverage and access Medical conditions Somewhat important Not too/ Not at all important Insurance issues *Note: Adds up to more than 100% because of multiple responses Source: Kaiser Family Foundation Health Poll Report September/October 2003 (conducted Oct. 3-5, 2003)
Public Often Agrees About Goals… “Everyone--regardless of age, income, health status, or employment --should have access to the same type of health insurance coverage.” (1993) “Health care should be provided equally to everyone just as public education is” (2000) Agree Agree Disagree Disagree No Opinion No Opinion Sources: 1993: Consumers Union/Gallup Survey On Health Care, conducted March 26-April 9, 1993. 2000: Newshour with Jim Lehrer/Kaiser Family Foundation National Survey on the Uninsured, conducted Jan. 10 – Feb. 9, 2000.
… But Not on the Best Solution When forced to choose… Percent who say “MOST preferred option” Percent who FAVOR Tax credits for businesses Expanding state government programs such as Medicaid Requiring businesses to offer insurance to employees Tax credits for individuals Expanding Medicare to people under age 65 National single-payer plan Source: Kaiser Family Foundation Health Poll Report January/February 2003
Level of Support for Three Health Reform Plans, 1945 Percent favoring in forced 3-way choice Percent saying “good” or “fair” idea Insurance company plan Federal government plan Doctor organization plan Source: Opinion Research Corporation Poll, 1945, cited in: Payne, Stanley. 1946. Some opinion research principles developed through studies of social medicine. Public Opinion Quarterly, 10 (1), 93-98.
Willingness to Pay to Help the Uninsured Would you be willing to pay more--either in higher health insurance premiums or higher taxes--in order to increase the number of Americans who have health insurance, or not? Yes, willing to pay No, not willing to pay Don’t know/ Refused Source:Kaiser Family Foundation Health Poll Report January/February 2003
Concerns About National Health Insurance Percent saying they would be LESS INCLINED to support national health insurance if they heard the following arguments… Your ability to choose doctors and hospitals could be restricted Some expensive treatments you can get now may be unavailable Might reduce quality of care Most of us will pay higher taxes Source: Robert Wood Johnson Foundation/Harvard School of Public Health, American Attitudes Toward Health Care Reform (conducted Mar. 18-25, 1993)
Knowledge: Who are the Uninsured? Would you say that more uninsured Americans are... employed or from families where someone is employed, or that more of these uninsured Americans are... unemployed or from families where no one is employed? Source: Kaiser Family Foundation Health Poll Report January/February 2003
Health Care Worries Percent saying they are VERY worried over the next six months… The amount you pay for health care or health insurance will increase Your health plan would be more concerned about saving money for the plan than about what is the best treatment for you* You might lose your health insurance coverage* Source: Kaiser Family Foundation Health Poll Report September/October 2003 (conducted Oct. 3-5, 2003) * Asked of insured only.
Trust in the Federal Government to Do the Right Thing Percent saying “always/most of time” Sources: Michigan-American National Election Study (1958-1982), ABC News/Washington Post and NPR/Kaiser/Harvard (1987-2003).
The “Issue-Attention Cycle” Anthony Downs • The pre-problem stage • Alarmed discovery and euphoric enthusiasm • Realizing the cost of significant progress • Gradual decline in public interest • The post-problem stage
Change in Public Support for Clinton Health Reform Plan Over Time Favor Oppose Favor Oppose No opinion No opinion Source: Gallup/CNN/USA Today Polls, Sept. 24, 1993 and April 16, 1994.
Change in Public Support for Truman Health Reform Plan Over Time Oppose Favor Oppose Favor No opinion No opinion Source: Gallup Polls, 1949 and 1950.
Self-Reported Voting in 2000 Presidential Election by Age and Insurance Status Percent saying they voted in the 2000 presidential election Source: Kaiser Family Foundation/Harvard School of Public Health Post-Election Survey: The Public and the Health Care Agenda for the New Administration and Congress (conducted Nov. 13 – Dec. 13, 2000)
Health Care Priorities for the President and Congress by Age Percent choosing as the MOST important health priority… Age 18-64 Age 65+ Increasing number of covered Americans Helping seniors pay for prescription drugs Making Medicare more financially sound Lowering the cost of malpractice insurance Source: Kaiser Family Foundation Health Poll Report September/October 2003
A Graying Electorate – Non-Presidential Elections The 1974 Electorate 18% were younger than 30 17% were 65 and older The 2002 Electorate 10% were younger than 30 23% were 65 and older The 2022 Electorate 8% will be younger than 30 33% will be 65 and older Source: Washington Post/Kaiser Family Foundation/Harvard University – projections based on a statistical model created using U.S. Census Bureau Current Population Surveys conducted after every election since 1972 and official Census population projections.
Opportunities (?) • Goals – public pays attention to news about the issue • When the economy is bad, it’s a good time to talk about this (people feel more insecure) • Combined approaches • Build on current system