Americans’ Views on Health Care Policy Robert J. Blendon, Sc.D. Professor of Health Policy and Political Analysis Harvard School of Public Health Kennedy 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 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/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 different answers. August 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 Harris Interactive Polls, % 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/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 Health Issues for Government to Address, 2003 % saying the issue is one of the two most important health issues for government to address HSPH/RWJF/ICR poll (May/June 2003)

General Policy Values on the Roles of Government The government should be smaller, with fewer services a The government has gone too far in regulating business and interfering with the free-enterprise system b The [federal] government should do everything possible to improve the to improve the standard of living of all Americans a 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 need a [Federal] government should assume larger role in assuring access to affordable health care b Making sure that minorities have health care services equal in quality to whites is responsibility of the [federal] government c 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, % saying so much wrong it needs to be rebuilt

Americans’ Dissatisfaction with the State of the Nation 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 Total40% 66%Total

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 Harris Interactive polls July % saying 1st and 2nd priority

Public’s Perception of Reasonableness of Prices of Selected Products and Services Harris Interactive poll, April % saying unreasonable

Public’s Views of Top Reasons for Increased Health Care Spending Harris Interactive polls, April % saying two top contributors to increased spending

Public’s Views on Passing Law to Provide Insurance for Most Uninsured Americans Harvard School of Public Health/Robert Wood Johnson Foundation/ICR poll, May-June, % 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 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 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 Guarantee Health Insurance for More Americans Harvard School of Public Health/Robert Wood Johnson Foundation/ICR poll, May-June, % 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 Harris Interactive polls, April % saying need more regulation

Public Support for [Federal] Government Price Controls of Various Products and Services Harris Interactive polls, April % saying favor

Public’s Perception of US Drug Prices vs. Canada and Western Europe Harris Interactive polls, April % saying 41%

Public Views on Malpractice Reform (a) KFF/HSPH poll, February 2003; (b) Gallup poll, January 2003; (c) Harris Interactive poll, March % saying Very important cause of health costs a Too many lawsuits b Favor limits on non-financial costs b Favor $250,000 limits c Favor expert/medical special courts c