Americans’ Views onHealth 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 ConservativeMost 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 theStates.” 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 forGovernment to Address
Percent saying issue is one of two most important:
1. Economy/Jobs 39%
2. War/Defense33%
3. Terrorism13%
4. Health care11% (excluding Medicare)
5. Education8%
6. Taxes7%
December 2001
Note: May sum to more than 100% because each respondent was asked to give up to two differentanswers.
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 ImportantIssues for the Government to Address
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 2002Congressional Vote, by Party
(Open-ended question/verbatim responses recorded)
1. Economy/Jobs26%
2. Education14%
3. Health care/Medicare10%
4. Terrorism/War6%
5. Taxes4%
Republicans
Democrats
1. Economy/Jobs18%
2. Taxes16%
3. Education14%
4. Terrorism/War9%
5. Health Care/Medicare8%
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 HealthIssues for Government to Address, 2003
% saying the issue is one of the two most importanthealth issues for government to address
HSPH/RWJF/ICR poll (May/June 2003)
General Policy Values on the Roles ofGovernment
The government should be smaller,with fewer servicesa
The government has gone too far inregulating business and interferingwith the free-enterprise systemb
The [federal] government should doeverything possible to improve theto improve the standard of living ofall 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 isnecessary to see that everyone gets the medicalcare they needa
[Federal] government should assume larger rolein assuring access to affordable health careb
Making sure that minorities have health careservices equal in quality to whites isresponsibility of the [federal] governmentc
69%
73%
62%
Source: (a) Harris Interactive poll, February/March 2003; (b) NPR/Kaiser Family Foundation/Kennedy School ofGovernment poll, May-June 2000; (c) Washington Post/Kaiser Family Foundation/Harvard University poll, March-April2001.
Public Attitudes Towards theHealth Care System
Harris Interactive pols, 1982-2003.
% saying so much wrong it needs to be rebuilt
Americans’ Dissatisfaction with the State of theNation in Two Areas
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
Dissatisfaction with the Availability andAffordability 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 Improveand 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
Harris Interactive polls July 2003.
% saying 1st and 2nd priority
Public’s Perception of Reasonableness ofPrices of Selected Products and Services
Harris Interactive poll, April 2003.
% saying unreasonable
Public’s Views of Top Reasons forIncreased Health Care Spending
Harris Interactive polls, April 2003.
% saying two top contributors to increased spending
Public’s Views on Passing Law to ProvideInsurance for Most Uninsured Americans
Harvard School of Public Health/Robert Wood Johnson Foundation/ICR poll, May-June, 2003.
% saying extremely/very important to pass a law in nextyear to provide health insurance to most Americans
The Government Should Do Whatever IsNecessary, Whatever It Costs in Taxes, To SeeThat Everyone Gets the Medical Care They Need
Harris Interactive (2003).
% saying
Americans’ Views on What GovernmentShould Do About the Uninsured
Make a major effort to provideinsurance, may require a taxincrease to pay for it
Make limited effort to provideinsurance for some of theuninsured, would mean moregovernment 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...
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 GuaranteeHealth Insurance for More Americans
Harvard School of Public Health/Robert Wood Johnson Foundation/ICR poll, May-June, 2003.
% favoring
Expanding state government programs for low-incomepeople
Requiring businesses to offer private health insurance foremployees
Offering uninsured tax deductions, credits, otherassistance
National health care plan, financed by taxpayers,insurance from single government plan
Public’s Views of Government Regulationof Various Industries
Harris Interactive polls, April 2003.
% saying need more regulation
Public Support for [Federal] Government PriceControls of Various Products and Services
Harris Interactive polls, April 2003.
% saying favor
Public’s Perception of US Drug Prices vs.Canada and Western Europe
Harris Interactive polls, April 2003.
% saying
41%
Public Views on Malpractice Reform
(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