Public Supports Healthcare Reform, But Not Willing to Pay For It

John Commins, for HealthLeaders Media , June 16, 2009

A new poll finds that most Americans continue to support the idea of healthcare reform, even though they don't want to pay more for it, and they are easily swayed by arguments on all sides of the issue.

A Kaiser telephone tracking poll of 1,205 adults, conducted in the first week of June and released today, finds that 61% of Americans believe health reform is more important than ever, given the country's economic problems. The results are in line with similar bimonthly Kaiser polls dating back to October 2008.

The latest poll also found that:

  • 69% support employer coverage mandates, while 71% back individual mandates.
  • 65%-67% support the public plan option, depending upon the wording.
  • Only 41% of the public say they're willing to pay more for healthcare reform.
  • 40% support taxing employer-based health insurance.

Those public sentiments run afoul with some of the stated positions of key special interest groups in the healthcare reform debate. The American Medical Association, America's Health Insurance Plans, and the U.S. Chamber of Commerce, for example, have all voiced opposition to the public plan.

All might not be lost for those special interests, however, because the poll found that the public is easily swayed, and can shift by as much as 40 percentage points when arguments are tested.

Kaiser President and CEO Drew Altman says the malleable state of public opinion means that Congress must quickly get a health reform bill on President Barack Obama's desk "so that a protracted debate and a Harry-and-Louise-style ad war do not undermine the high level of public support we see today."

The poll suggests that a majority of Americans' support for health reform comes from personal experiences, with 55% of respondents saying they or a member of their household have delayed or foregone medical care or prescription drugs within the past year because of cost concerns.

A narrow majority of the public (53%) supported limiting future increases in how much doctors and hospitals are paid under Medicare to help pay for health reform (37% opposed). A majority (56%) of those under 65 supported this while only four in 10 of those age 65 or older did.

A large majority (70%) liked the idea of insurance exchanges to help people purchase insurance on their own.

While the public clearly favors some sort of healthcare reform, they are very much divided on how to pay for it, the poll found. A slight majority (54%) say they are not personally willing to pay more to expand coverage to the uninsured, while 60% say the healthcare system can be reformed without spending more money if policymakers do it correctly.

Roughly two-thirds (67%) oppose across-the-board increases on income taxes, but a narrow majority supports taxing soda (53%) and unhealthy snack foods (55%).  Clear majorities support increased taxes on the wealthy (68%), cigarettes (68%), and alcohol (67%) as a way to pay for health reform.

"With all the talk of inefficiencies in the system and achieving future savings, the public may confuse the potential for long-term savings with the need for short-term outlays and think that healthcare can be reformed for free," Altman says. "This could make policymakers' jobs tougher when the price tag for the legislation comes out."

While a clear majority of Americans favor health reform, the poll found large areas of disagreement reflected by partisan politics. Nearly three-quarters (74%) of Democrats and 59% of independents say the nation's economic straits make health reform more important than ever, while 56% of Republicans say we can't afford it right now. A slim majority of Democrats (53%) are willing to pay more for providing coverage, while 38% of independents and 29% of Republicans say the same.

John Commins is a senior editor with HealthLeaders Media.

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