Almost every election cycle, public health advocates trot out poll after poll showing that Americans want to expand coverage to the uninsured. Pundits from liberal news media organisations (often the ones funding the polls) invariably use these polls in an attempt to gain support for universal health care.
Interestingly, health care never quite seems to become a voter's issue, although health care reform usually makes most politicians' platforms, and many polls will claim it swung the vote their way.
Recently, a study based on a health care poll was published in the journal Health Affairs. The study found 80 per cent of Americans are dissatisfied with the health care system, but it also illustrates the contradictions in Americans' opinions on health coverage.
For instance, the poll found widespread agreement on the need to expand coverage to the uninsured. Yet there was no clear consensus on how this should work. Nearly nine out of ten people favoured working with employers to expand coverage. But many of the same people (61 per cent) also agreed government, not employers, should provide coverage for all.
Almost as many (55 per cent) thought the government's role should be limited to providing coverage for low-income people. Fifty-four per cent agreed that we should not rely on employers. Rather, individuals should be responsible and government should only help low-income families. If this all sounds contradictory and confusing, well, it is.
According to the authors "Americans seem to be hoping for a better deal
" There was little evidence of willingness for self-sacrifice. Individuals wanted to retain choice and control of plans. They largely did not want insurance to pay more out-of-pocket.
This is typical of polls. People want lavish health benefits with little cost-sharing that is affordable to all. In other words, people want universal coverage paid for by other people's money.
Yet in this poll the same people apparently changed their minds from one question to the next about whose money should be used. The authors correctly interpret the results as interesting, but concede that there is no clear consensus. Health reform acceptable to a majority of people remains an elusive goal.
Read the Health Affairs article: http://content.healthaffairs.org/cgi/reprint/25/6/w596
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FMF Policy Bulletin/ 28 November 2006