americans’ views on health care policy robert j. blendon, sc.d. professor of health policy and...
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Americans’ Views on Health Care Policy
Robert J. Blendon, Sc.D.
Professor of Health Policy and Political Analysis
Harvard School of Public HealthKennedy School of Government
States Ideology and Health Policy
Most Conservative Most Liberal
(1) Mississippi (1) Vermont
(2) North Dakota (2) Massachusetts
(3) Oklahoma (3) Rhode Island
(4) Utah (4) New York
(5) South Carolina (5) New Jersey
J. McIver, R. Erikson, and G Wright, “Public Opinion and Public Policy in Temporal Perspective: A View from the States.” Presented at State Politics and Policy Conference, College Station, TX (March 2001).
Public Views on Health Care Policy
• Priorities
• Values
• Changing the health system
• Spending
• Costs
• Taxes
• Uninsured
• Regulations
Most Important Issues for Government to Address
Percent saying issue is one of two most important:
1. Economy/Jobs 39%
2. War/Defense 33%
3. Terrorism 13%
4. Health care 11% (excluding Medicare)
5. Education 8%
6. Taxes 7%
December 2001
Note: May sum to more than 100% because each respondent was asked to give up to two different answers.
August 2003
1. War/Defense 48%
2. Economy/Jobs 39%
3. Terrorism 31%
4. Education 12%
5. Taxes 6%
6. Health Care 5%
Harris Interactive polls, December 2001, August 2003.
Americans’ Perceptions of the Most Important Issues for the Government to Address
0%
10%
20%
30%
40%
50%
60%
Jan-93
Jul-93
Jan-94
Jul-94
Jan-95
Jul-95
Jan-96
Jul-96
Jan-97
Jul-97
Jan-98
Jul-98
Jan-99
Jul-99
Jan-00
Jul-00
Jan-01
Jul-01
Jan-02
Jul-02
Jan-03
Jul-03
Harris Interactive Polls, 1982-2003.
% naming health care as one of the two most important issues
55%
11%
Aug-03
Most Important Issues in Deciding 2002 Congressional Vote, by Party
(Open-ended question/verbatim responses recorded)
1. Economy/Jobs 26%
2. Education 14%
3. Health care/Medicare 10%
4. Terrorism/War 6%
5. Taxes 4%
Republicans Democrats
1. Economy/Jobs 18%
2. Taxes 16%
3. Education 14%
4. Terrorism/War 9%
5. Health Care/Medicare 8%
Source: NPR/Kaiser Family Foundation/Kennedy School of Government poll, October 2002 (likely voters).
Most Important Health Care Issue
Cost
Uninsured
Quality
Don’t know
44%
38%
16%
2%
Source: Harvard School of Public Health/Robert Wood Johnson Foundation/ICR poll, May-June 2003.
Americans’ Views of the Most Important Health Issues for Government to Address, 2003
% saying the issue is one of the two most important health issues for government to address
3%
4%
4%
5%
5%
15%
19%
Smoking
Obesity/beingoverweight
Diabetes
SARS
Heart disease
HIV/AIDS
Cancer
HSPH/RWJF/ICR poll (May/June 2003)
General Policy Values on the Roles of Government
The government should be smaller, with fewer servicesa
The government has gone too far in regulating business and interfering with the free-enterprise systemb
The [federal] government should do everything possible to improve the to improve the standard of living of all Americansa
46%
62%
56%
Source: Washington Post/Kaiser Family Foundation/Harvard University polls: (a) August-September 2002, (b) October 2000 (registered voters).
Health Policy Values
The government should do whatever is necessary to see that everyone gets the medical care they needa
[Federal] government should assume larger role in assuring access to affordable health careb
Making sure that minorities have health care services equal in quality to whites is responsibility of the [federal] governmentc
69%
73%
62%
Source: (a) Harris Interactive poll, February/March 2003; (b) NPR/Kaiser Family Foundation/Kennedy School of Government poll, May-June 2000; (c) Washington Post/Kaiser Family Foundation/Harvard University poll, March-April 2001.
Public Attitudes Towards the Health Care System
Harris Interactive pols, 1982-2003.
% saying so much wrong it needs to be rebuilt
31%32%
29%30%30%
33%
29%28%
25%
21%
19%
24%
42%
35%31%
24%
0%
10%
20%
30%
40%
50%
60%
1982
1983
1984
1987
1988
1990
1991
1993
1994
1996
1998
1999
2000
2001
2002
2003
Americans’ Dissatisfaction with the State of the Nation in Two Areas
34%
28%
32%
12%
Not too satisfied Not at all satisfied
The nation’s system of improving and protecting the public’s health
The availability and affordability of health care
Total
Source: Harvard School of Public Health/Robert Wood Johnson/ICR poll, May-June 2003.
Total 40%
66%Total
45%
22%
32%
0%
20%
40%
60%
80%
100%
1993 2001 2003
Dissatisfaction with the Availability and Affordability of Health Care
Source: Gallup/CNN/USA Today poll (January 1993) Harvard School of Public Health/Robert Wood Johnson Foundation/ICR polls (2001, 2003).
% saying not at all satisfied
Americans’ Views on Spending to Improve and Protect the Nation’s Health
Spending too little
Spending about right amount
Spending too much
Don’t know
74%
21%
2%
1%
Source: General Social Survey, 2002.
Top Priorities for Future Economic Growth
1%
2%
6%
7%
13%
46%
53%
67%
Clothes
Leisure andentertainment
Automobile andtransportation
Food
Housing
Defense
Education
Health care
Harris Interactive polls July 2003.
% saying 1st and 2nd priority
Public’s Perception of Reasonableness of Prices of Selected Products and Services
10%
16%
36%
43%
54%
57%
Package foods
Clothing
Automobiles
Doctors bills
Hospital charges
Prescription drugs
Harris Interactive poll, April 2003.
% saying unreasonable
Public’s Views of Top Reasons for Increased Health Care Spending
8%
12%
18%
20%
23%
24%
28%
37%
Increased use of medical services
New medical technology and newdrugs
Aging of the population
Higher hospital fees
Increased fraud, waste and abuse
Increased profits in health carecompanies
Medical malpractice and insurance
Higher prices of prescription drugs
Harris Interactive polls, April 2003.
% saying two top contributors to increased spending
Public’s Views on Passing Law to Provide Insurance for Most Uninsured Americans
74%
Harvard School of Public Health/Robert Wood Johnson Foundation/ICR poll, May-June, 2003.
% saying extremely/very important to pass a law in next year to provide health insurance to most Americans
The Government Should Do Whatever Is Necessary, Whatever It Costs in Taxes, To See
That Everyone Gets the Medical Care They Need
43%
3%
28%
69%
Agree if substantialtax increase
required
Not sure
Disagree
Agree
Harris Interactive (2003).
% saying
Americans’ Views on What Government Should Do About the Uninsured
Make a major effort to provide insurance, may require a tax increase to pay for it
Make limited effort to provide insurance for some of the uninsured, would mean more government spending
Keep things the way they are
Don’t know/Refused
47%
37%
13%
3%
Source: Harvard School of Public Health/Robert Wood Johnson Foundation/ICR poll, May-June 2003.
Percent saying the government should...
15%
35%
50%
Public Views on the New Tax Cut
New tax cut was a good thing
New tax cut was a bad thing
Not sure
Source: Harris Interactive poll, June 2003.
Public’s Views on Different Ways to Guarantee Health Insurance for More Americans
46%
73%
77%
80%
Harvard School of Public Health/Robert Wood Johnson Foundation/ICR poll, May-June, 2003.
% favoring
Expanding state government programs for low-income people
Requiring businesses to offer private health insurance for employees
Offering uninsured tax deductions, credits, other assistance
National health care plan, financed by taxpayers, insurance from single government plan
Public’s Views of Government Regulation of Various Industries
10%
11%
21%
30%
31%
35%
44%
52%
57%
60%
Supermarkets
Computer software companies
Banks
Telephone companies
Airlines
Hospitals
Tobacco companies
Oil companies
Pharmaceutical and drug companies
Managed care companies such as HMOs
Harris Interactive polls, April 2003.
% saying need more regulation
Public Support for [Federal] Government Price Controls of Various Products and Services
17%
23%
27%
43%
48%
56%
Clothing
Packaged foods
Automobiles
Doctors bills
Hospital charges
Prescription drugs
Harris Interactive polls, April 2003.
% saying favor
Public’s Perception of US Drug Prices vs. Canada and Western Europe
42%
2%
7%
8%
16%
25%
Not sure
Much lower here
Somewhat lowerhere
About the same
Somewhat higherhere
Much higher here
Harris Interactive polls, April 2003.
% saying
41%
Public Views on Malpractice Reform
62%
48%
64%
57%
60%
(a) KFF/HSPH poll, February 2003; (b) Gallup poll, January 2003; (c) Harris Interactive poll, March 2003.
% saying
Very important cause of health costsa
Too many lawsuitsb
Favor limits on non-financial costsb
Favor $250,000 limitsc
Favor expert/medical special courtsc