American Thoughts on Health Reform
Cedric K. Dark, MD, MPH
July 8, 2009
Last month’s CBS News/New York Times poll on “The Debate over Health Care” provides useful information on the public’s view about several reform components being considered by Congress this summer.
At Policy Prescriptions, we have advocated for the following options for health reform: universal healthcare, individual mandates, guaranteed issue, community rating, subsidies for the poor, and a public not-for-profit option for health insurance. This recent poll explores the public’s views about these and other options for health reform.
A large majority of Americans (including majorities of Republicans - 54%, Democrats - 64%, and Independents -73%) view the uninsured as a “very serious” problem for the country. Fifty-seven percent of Americans would be willing to pay higher taxes in order to ensure that all Americans had health insurance that they could not lose. Sixty-four percent think that the the federal government should guarantee health insurance for all Americans.
Overwhelming majorities of Americans across party lines think that the government should require health insurance companies to cover all patients regardless of preexisting medical conditions. Overall seventy-five percent of respondents approve of guaranteed issue (64% among Republicans, 88% among Democrats, and 70% among Independents)
The Public Plan
When asked about who would do a better job providing health care, fifty percent of the public thinks government would do better than the private sector (led predominantly by Democratic respondents). Seventy-two percent of Americans (led by Democrats and Independents) favor a government administered health insurance plan that could compete with private insurers. In contrast to the political rhetoric
, one of every two Republican respondents favors a public plan.
Read more on Universal Healthcare
The RAND Health Insurance Experiment represent the best evidence available to determine the behavior of patients based on cost sharing in health plans. Following the publishing of data from this study, many private insurance companies adopted these cost-sharing strategies. The researchers estimated price elasticities for medical care in the range of -0.1 to -0.2. What is concerning about this data is that all patients - healthy or sick - decrease utilization equally based on financial reasons. While cost sharing can help reduce unnecessary health utilization, it very well reduces necessary care as well. As the Obama Administration and Congress work towards health reform this summer, the lessons from this landmark study should remain in the minds of policy makers.