It's no secret that much of what ails the U.S. healthcare system relates to access and cost issues. Costs and other circumstances place private health insurance out of reach for many Americans -- 45 million went without it in 2003, according to Census figures. A slight majority of adults surveyed in a recent Gallup Poll Panel* study are looking to the federal government to solve these problems. When asked whether it's the federal government's responsibility to ensure all Americans have healthcare coverage, 53% of Americans say yes and 36% say no.
Who Wants Federal Responsibility for Healthcare Coverage?
We already know that the lower people's annual household incomes are, the more likely they are to forego medical treatment because of cost (see "Costs Hurt Those Who Need Healthcare Most" in Related Items). Therefore it's not surprising that support for the federal government ensuring healthcare coverage is related to one's household income. Seventy percent of respondents living in households with annual incomes of less than $25,000 think the federal government should guarantee health coverage for all Americans, compared with 49% of those in households with annual incomes of $50,000 or more.
Republicans typically don't favor invoking the federal government to solve problems, and this sentiment is clear on healthcare coverage; 30% of Republicans say healthcare coverage for all Americans is a federal responsibility, compared with 78% of Democrats. However, even within each political party, income level is a factor in Americans' likelihood to say government should be responsible for guaranteeing healthcare coverage. Republicans and Democrats pulling in annual household incomes of less than $25,000 are the most likely to favor a federal role.
There is a relationship between self-reported health status and a desire for the federal government to guarantee healthcare coverage. People who report their own physical health is fair or poor are significantly more likely than those in excellent or good health to feel healthcare coverage for all Americans is a federal responsibility, 62% compared with 51%.
It might be tempting to assume that age would have a similar effect because older people are more likely to suffer from health problems -- but these data suggest older Americans are less likely to feel healthcare coverage should be the purview of the federal government. Sixty-one percent of those between the ages of 18 and 29 support federal responsibility for healthcare coverage, compared with only 45% of those aged 65 years and older.
Is it a strange contradiction that Americans 65 and older, the age group most likely to be covered by federally sponsored insurance (Medicare), are least supportive of federal responsibility for healthcare coverage? There is a possible explanation -- the Medicare system is in trouble and no one knows this better than the seniors who depend on it. Many older Americans must rely on private health insurance to supplement their Medicare coverage. They may see the federal government as more hindrance than help when it comes to providing medical insurance.
Bottom Line
A majority feels the federal government is responsible for making sure all Americans have healthcare coverage. Those most supportive of this concept -- the poor, the young, and those in poor health -- are the groups most frequently identified as being uninsured or underinsured. These groups are looking to the federal government to repair the system. Absent these repairs, disillusionment with the healthcare system will undoubtedly continue to intensify.
*These results are based on telephone interviews with a randomly selected national sample of 4,984 adults in the Gallup Poll Panel of households, aged 18 and older, conducted Nov. 16, 2004 to Jan. 5, 2005. For results based on this sample, one can say with 95% confidence that the maximum error attributable to sampling and other random effects is ±1.5 percentage points. In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.
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