To
probe for answers to these and other questions about how Americans view health care, WorldPublicOpinion.org and the
Brookings Institution conducted a poll among 1400 Americans. The size of the sample answering each question
varied, though all had over 800 respondents. The margin of error varied from +/- 2.6 to 3.5 percentage points.
The survey was fielded September 26-October 5, 2009 by Knowledge Networks, a polling, social science, and market
research firm in Menlo Park, California, with a stratified random sample of its large-scale nationwide research
panel. This panel itself has been randomly recruited from the national population of households having telephones;
households without internet access are subsequently provided with free web access and an internet appliance. Thus
the panel is not limited to those who already have home internet access. The distribution of the sample in the
Web-enabled panel closely tracks the distribution of United States Census counts for the US population on age,
race, Hispanic ethnicity, geographical region, employment status, income, education, etc. Upon survey completion,
the data were weighted by gender, age, education, and ethnicity. For more information about the online survey
methodology, please go to:
www.knowledgenetworks.co
m/ganp.
Key findings were:
1. The Role of Government in Health Care
Three in five Americans
believe that the government has the responsibility to ensure that citizens can meet their basic need for health
care; however, this number has declined significantly over the last year, and is no longer bipartisan,
presumably in response to the current debate.
Three in five also see health care as a right, not a
privilege. Views are roughly divided as to whether the government should generally provide health care services
directly.
2. Assessments of Current Situation
Two out of three Americans, including clear majorities
of all parties, believe that the US government is doing a poor job of ensuring that people can meet their basic
needs for health care. A majority thinks that the present health care system is not viable because costs are
rising while more people are going onto Medicare. Large majorities are concerned about whether they and Americans
in general will be able to get health insurance at a price they can afford. However, there is less concern about
the quality of health care: views are divided as to whether, on its present trajectory, health care will worsen.
3. Reaction to Health Care Debate
As the partisan debate has grown more intense, far more people have
become less supportive of both parties’ ideas than have become more supportive of the ideas of one party. People
express substantial levels of anxiety about the subject of health care. More express fear that the government
action will make the health care system worse than express confidence that government action will help. People are
divided as to whether the government can afford to reform health care in the current economic environment.
4.
Specific proposals
Nearly all of the specific proposals for health care reform are endorsed by a majority.
Large majorities favor a public option limited to those who are not receiving insurance through their employer,
cross-state purchasing and requiring insurance companies to accept every applicant and to not drop sick people for
making a mistake in their original application form. More modest majorities favor tort reform, a public option
for all who wish it, an employer mandate, and an individual mandate. A modest majority opposes the government
directly providing health care.
4a. Public Option
A majority favors a public option available to all,
while three-quarters favor one limited to those who cannot get insurance through their employers. Interestingly, a
modest majority of Republicans, as well as large majorities of Democrats and Independents, favors a limited public
option.
4b. Cross-State Purchasing
Two-thirds favor the idea of cross-state purchasing, including
large majorities of all parties. A large majority finds the argument in favor of cross-state purchasing
convincing, while a substantial majority finds the argument against it unconvincing.
4c. Insurance Company
Regulation
Overwhelming majorities of all parties favor the government requiring insurance companies to
accept every applicant for coverage and prohibiting insurance companies from dropping a sick person because of a
minor mistake in his or her application form.
4d. Tort Reform
A modest majority favors the idea of tort
reform, including a plurality of Democrats. The argument in favor of tort reform is found convincing by a large
majority, while the argument against it elicits a divided response.
4e. Employer mandate
A large majority
is convinced by the argument against a proposed requirement that all but the smallest businesses either provide
health insurance to all their workers or pay into a public fund to cover the uninsured, but a strong majority also
finds the argument for such a requirement convincing. A modest majority favors such a requirement.
4f.
Individual Mandate
A modest majority favors requiring all people to have health insurance for themselves and
their children, with a subsidy for those who could not afford it and a penalty for those who refuse. Views break
along party lines. Interestingly, majorities of both parties find convincing arguments both for and against an
individual mandate.
5. Cutting Health Care Costs
An overwhelming majority thinks that it is possible to
cut waste, fraud and abuse in the health care system without denying people the treatment they need. Estimates of
the magnitude of waste, fraud, and abuse are substantial and approximately equal for private and public health
care.
6. Impact of Health Care Reform on Taxes and the Deficit
Six in ten believe that health care
reform will lead to at least somewhat higher taxes and that the deficit will increase at least somewhat. Those who
believe that taxes and the deficit will go up are less supportive of reform, but only those who believe that their
taxes and the deficit will become a lot greater depart from majority positions in support of major health care
reforms.
7. Perceptions of US Health Care System
Contrary to frequent assertions in the health care
debate that the American health care system is the best in the world, most Americans have more modest and
realistic assumptions about how the American health care system compares to other highly developed countries.
Most Americans have a good understanding about which health care programs are government sponsored and which are
private.
8. Older Americans
Older Americans are generally less supportive than younger people of the
government taking on new obligations (obligations that could potentially compete with Medicare). However a
majority, albeit a relatively smaller one, does support the idea that the government is responsible for ensuring
access to health care, a slight majority favors a generally available public option, and a large majority supports
a limited public option. Older Americans report that they are following the health care debate more closely than
do persons of other ages; they also express more worry about the issues of health care.
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