Public Opinion : Health Care Coverage, Costs, and Financing

1. Public Opinion: Health Care Coverage, Costs, and Financing

2. 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

3. Most with employment-based coverage are satisfied with their health insurance benefits Gallup Poll conducted August 8-11, 2005. Results reported for adults aged 18 or older employed full or part time.

4. But the broader view is that health care in America is in trouble The Gallup Poll, conducted November 7-10, 2006. 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.

5. 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 2005. • 82% 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).

6. 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).

7. Who types of organizations do Americans think should own, provide or run most health insurance? 32% prefer government 21% Unsure 22% prefer for-profit companies 25% prefer non-profit organizations SOURCE: Wall Street Journal Online/Harris Interactive Health-Care Poll, 2003

8. 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)

9. 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).

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

11. 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

12. … This trend is true even for people who are chronically ill. Most people with employer-sponsored insurance are willing to have fewer choices of providers in order to reduce out-of-pocket costs . . . 2001 50% 2003 400+ 54% Chronically ill 51% 59% Income as % of Federal Poverty Level 200-399 62% 60% 66% 0-199 67% 68% 55% All 59% 56% 0 10 20 30 40 50 60 70 80 Center for Studying Health System Change, 2005