Gallup's Pulse of Democracy
Healthcare Costs
|
Guidance for Lawmakers
|
- Healthcare, in general, is a high priority for Americans. It is among the top domestic concerns of Americans. Healthcare costs are among the top financial problems facing American families. Healthcare is listed as one of the top economic problems for the country as a whole. Healthcare costs are volunteered as the top specific health problem facing the country, above and beyond diseases such as cancer.
- Despite these extreme levels of concern, there is little consensus on exactly what Americans want done to curb healthcare costs.
- By substantial majorities, Americans favor various solutions such as these: offering tax deductions to businesses that provide healthcare coverage, expanding low-income federal assistance, expanding Medicare down to 55, tax deductions for the uninsured, requiring businesses to offer health insurance. Importantly, the one option a majority of Americans do not favor is a national healthcare plan.
- One recent "fix," the Medicare drug plan, has not been widely embraced by seniors as of January 2006. Many claim they didn't understand it and well under half say they have or will enroll in it. The majority of seniors say the new plan is not working.
- Importantly, Americans agree that it is the responsibility of the federal government to make sure that all Americans have healthcare coverage. But less than half support the idea of a government-run healthcare system -- although support for this idea has increased. Americans want government help with healthcare, but don't want government running it. This is a significant point in the politics of healthcare reform.
|
|
Fine Print
|
A key to understanding the public's mandate on healthcare is to comprehend that Americans want government intervention that goes just so far. Americans like federal government's involvement in many ways, but balk at the idea of a national healthcare system or plan. A second key is the understanding that almost any plan that forces businesses to provide better healthcare coverage meets with the approval of Americans. A third key is the understanding that Americans' sense of urgency about healthcare depends on the political environment. Worry about healthcare is like potential energy, waiting to be converted to kinetic energy. At the point in which the Clinton administration was proposing a national healthcare fix in 1993 and 1994, the percentage of Americans saying healthcare was the nation's top problem zoomed up, only to fall back with a year. The fact that support for a national healthcare system jumped in 2005 is interesting; future studies will be needed to see if this is a continuing trend.
|
|
Context
|
The issue of "fixing" the healthcare problems in the United States plays out in a context in which the significant majority of Americans are very worried about the issue and in which they assign it a high priority. By many measures, the healthcare system and healthcare costs in particular are the top domestic issue on Americans' minds today.
|
|
Urgency: Overall Importance as Political Issue
|
This is an issue that scores high on the public's agenda -- trailing only Iraq and terrorism, as a priority for Congress to address in early 2006. Healthcare looms as a very important political issue for both the 2004 and 2006 elections. In some ways it may be the key domestic issue. Americans apparently have a great fear of being faced with huge medical bills they are unable to pay.
At the moment Democrats are better positioned to take advantage of this concern over healthcare than are Republicans. Americans give Democrats the decided advantage when asked who can best handle healthcare problems.
|
|
Key Subgroup Differences
|
There is no strong relationship between age and views on the importance of healthcare policy as a political issue. Older Americans are, however, much more likely to be worried about health in general and are much more likely to report having health problems than are those who are younger. The major difference in the perceived importance of healthcare policy is partisan; Democrats are much more likely to rate it as extremely important for Congress and the president than are Republicans. There are major political differences in desire for a national healthcare plan; Democrats favor it while Republicans reject it in large numbers.
|
|
The Bottom Line
|
There is a high level of concern about healthcare access and costs. Americans favor any solution that puts the burden of responsibility on business. There is no consensus on any one specific plan, however. Americans specifically want federal government involvement in making sure Americans have adequate healthcare, but do not want a national healthcare system. Democrats are much more concerned about healthcare as a policy concern than are Republicans.
|
What would you say is the most urgent health problem facing this country at the present time? [Open-ended]
|
A
|
B
|
C
|
D
|
E
|
F
|
G
|
H
|
I
|
J
|
OT
|
DK
|
|
%
|
%
|
%
|
%
|
%
|
%
|
%
|
%
|
%
|
%
|
%
|
%
|
|
2007 Nov
|
26
|
30
|
14
|
10
|
2
|
1
|
1
|
*
|
--
|
1
|
7
|
9
|
|
2006 Nov
|
29
|
22
|
14
|
8
|
6
|
3
|
1
|
*
|
*
|
1
|
8
|
8
|
|
2005 Nov
|
25
|
17
|
15
|
9
|
6
|
4
|
10
|
1
|
*
|
1
|
5
|
7
|
|
2004 Nov
|
29
|
29
|
9
|
7
|
5
|
2
|
2
|
*
|
*
|
*
|
9
|
8
|
|
2003 Nov
|
27
|
25
|
13
|
7
|
8
|
3
|
*
|
1
|
1
|
1
|
8
|
6
|
|
2002 Nov
|
25
|
14
|
21
|
7
|
8
|
5
|
1
|
2
|
1
|
*
|
7
|
9
|
|
2001 Nov
|
14
|
8
|
19
|
4
|
7
|
6
|
1
|
1
|
22
|
1
|
9
|
8
|
|
2000 Sep
|
25
|
13
|
20
|
3
|
18
|
3
|
--
|
1
|
--
|
2
|
8
|
7
|
|
1999 Feb
|
13
|
1
|
23
|
1
|
33
|
5
|
--
|
3
|
--
|
2
|
13
|
6
|
|
1997 Oct
|
9
|
13
|
15
|
*
|
29
|
3
|
--
|
2
|
--
|
6
|
18
|
5
|
|
1992 Mar
|
30
|
--
|
5
|
--
|
41
|
2
|
--
|
--
|
--
|
--
|
18
|
4
|
|
1991 Nov
|
20
|
--
|
6
|
--
|
55
|
2
|
--
|
--
|
--
|
--
|
14
|
3
|
|
1991 May
|
10
|
2
|
16
|
1
|
45
|
2
|
--
|
*
|
--
|
5
|
15
|
4
|
|
1987 Oct
|
1
|
--
|
14
|
3
|
68
|
7
|
--
|
1
|
--
|
4
|
8
|
3
|
|
KEY:
A. Health care/insurance costs
B. Access to health care
C. Cancer
D. Obesity
E. Aids
F. Heart Disease
G. Flu
H. Smoking
I. Bioterrorism/anthrax/smallpox
J. Alcohol/drugs
OT. Other
DK. No opinion
|
Overall, how would you rate -- [ROTATED] -- as excellent, good, only fair, or poor?
A. The quality of health care in this country
|
Excellent
|
Good
|
Only fair
|
Poor
|
No opinion
|
|
%
|
%
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
17
|
37
|
29
|
16
|
*
|
|
2006 Nov 9-12
|
16
|
37
|
32
|
14
|
1
|
|
2005 Nov 7-10
|
16
|
37
|
33
|
14
|
*
|
|
2004 Nov 7-10
|
20
|
39
|
28
|
12
|
1
|
|
2003 Nov 3-5
|
18
|
42
|
28
|
12
|
*
|
|
2002 Nov 11-14
|
14
|
41
|
32
|
12
|
1
|
|
2001 Nov 8-11
|
15
|
38
|
34
|
12
|
1
|
B. Health care coverage in this country
|
Excellent
|
Good
|
Only fair
|
Poor
|
No opinion
|
|
%
|
%
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
6
|
21
|
41
|
31
|
1
|
|
2006 Nov 9-12
|
6
|
19
|
41
|
33
|
1
|
|
2005 Nov 7-10
|
2
|
19
|
43
|
35
|
1
|
|
2004 Nov 7-10
|
4
|
26
|
41
|
29
|
*
|
|
2003 Nov 3-5
|
5
|
23
|
42
|
29
|
1
|
|
2002 Nov 11-14
|
4
|
26
|
41
|
27
|
2
|
|
2001 Nov 8-11
|
5
|
25
|
43
|
26
|
1
|
Are you generally satisfied or dissatisfied with the total cost of health care in this country?
|
|
Satisfied
|
Dissatisfied
|
No opinion
|
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
17
|
81
|
2
|
|
2006 Nov 9-12
|
19
|
79
|
2
|
|
2005 Nov 7-10
|
20
|
79
|
1
|
|
2004 Nov 7-10
|
21
|
78
|
1
|
|
2003 Nov 3-5
|
20
|
79
|
1
|
|
2002 Nov 11-14
|
22
|
75
|
3
|
|
2001 Nov 8-11
|
28
|
71
|
1
|
|
1993 May 10-12 ^
|
8
|
90
|
2
|
|
|
|
|
|
^
|
WORDING: Now, thinking about health care in the country as a whole, are you generally satisfied, or dissatisfied, with ... Next, … The quality of health care in this country.
|
Which of these statements do you think best describes the U.S. health care system today -- [ROTATED: it is in a state of crisis, it has major problems, it has minor problems, (or) it does not have any problems]?
|
State of
crisis
|
Major problems
|
Minor problems
|
Does not have any problems
|
No
opinion
|
|
%
|
%
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
17
|
56
|
24
|
2
|
1
|
|
2006 Nov 9-12
|
16
|
55
|
25
|
3
|
1
|
|
2005 Nov 7-10
|
18
|
52
|
28
|
1
|
1
|
|
2004 Nov 7-10
|
14
|
53
|
31
|
2
|
*
|
|
2003 Nov 3-5
|
14
|
54
|
30
|
1
|
1
|
|
2002 Nov 11-14
|
11
|
54
|
32
|
2
|
1
|
|
2001 Nov 8-11
|
5
|
44
|
47
|
2
|
2
|
|
2000 Sep 11-13
|
12
|
58
|
28
|
1
|
1
|
|
1994 Sep 6-7 ^
|
17
|
52
|
29
|
1
|
1
|
|
|
|
|
|
|
|
^
|
WORDING: Which of these statements do you think best describes the U.S. health care system today--the health care system is in a state of crisis, it has major problems, it has minor problems, or it does not have any problems?
|
Do you think it is the responsibility of the federal government to make sure all Americans have health care coverage, or is that not the responsibility of the federal government?
|
Yes, government
responsibility
|
No, not government responsibility
|
No
opinion
|
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
64
|
33
|
3
|
|
2006 Nov 9-12 ^
|
69
|
28
|
3
|
|
2005 Nov 7-10 ^
|
58
|
38
|
4
|
|
2004 Nov 7-10 ^
|
64
|
34
|
2
|
|
2003 Nov 3-5 ^
|
59
|
39
|
2
|
|
2002 Nov 11-14
|
62
|
35
|
3
|
|
2001 Nov 8-11 ^
|
62
|
34
|
4
|
|
2000 Sep 11-13
|
64
|
31
|
5
|
|
2000 Jan 13-16
|
59
|
38
|
3
|
|
|
^
|
Asked of a half sample.
|
Which of the following approaches for providing health care in the United States would you prefer -- [ROTATED: replacing the current health care system with a new government run health care system, (or) maintaining the current system based mostly on private health insurance]?
|
|
Replacing the
current system
|
Maintaining the
current system
|
No
opinion
|
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
41
|
48
|
11
|
|
2006 Nov 9-12
|
39
|
51
|
10
|
|
2005 Nov 7-10
|
41
|
49
|
10
|
|
2004 Nov 7-10
|
32
|
63
|
5
|
|
2003 Nov 3-5
|
38
|
57
|
5
|
|
2001 Nov 8-11
|
33
|
61
|
6
|
Do you currently have medical coverage through Medicare or [Medicaid/Medi-Cal]?
|
|
Yes
|
No
|
No opinion
|
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
31
|
69
|
1
|
|
2006 Nov 9-12
|
33
|
67
|
*
|
|
2005 Nov 7-10
|
30
|
69
|
1
|
|
2004 Nov 7-10
|
30
|
70
|
*
|
|
2003 Nov 3-5
|
26
|
73
|
1
|
|
2002 Nov 11-14
|
27
|
72
|
1
|
|
2001 Nov 8-11
|
26
|
73
|
1
|
Do you currently have medical coverage through some other form of health insurance?
[BASED ON ADULTS NOT INSURED BY MEDICARE OR MEDICAID]
|
|
Yes
|
No
|
No opinion
|
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
83
|
16
|
1
|
|
2006 Nov 9-12
|
84
|
15
|
1
|
|
2005 Nov 7-10
|
81
|
19
|
*
|
|
2004 Nov 7-10
|
84
|
16
|
*
|
|
2003 Nov 3-5
|
87
|
13
|
*
|
|
2002 Nov 11-14
|
83
|
17
|
*
|
|
2001 Nov 8-11
|
84
|
16
|
*
|
[SUMMARY TABLE: HEALTH INSURANCE COVERAGE]
|
Private
insurance
|
Medicare/ Medicaid
|
No
insurance
|
No
opinion
|
|
%
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
57
|
31
|
11
|
*
|
|
2006 Nov 9-12
|
57
|
33
|
10
|
*
|
|
2005 Nov 7-10
|
57
|
30
|
13
|
*
|
|
2004 Nov 7-10
|
59
|
30
|
11
|
*
|
|
2003 Nov 3-5
|
63
|
27
|
10
|
*
|
|
2002 Nov 11-14
|
61
|
27
|
12
|
--
|
|
2001 Nov 8-11
|
62
|
26
|
11
|
1
|
Who pays the cost of premiums on your health insurance? Do you or someone in your household pay the total cost, does an employer pay the total cost, or is the cost shared between the employer and you or someone in your household?
[BASED ON ADULTS WITH PRIVATE HEALTH INSURANCE]
|
Self/ household
|
Employer pays all
|
Costs are shared
|
None/other (vol.)
|
No
opinion
|
|
%
|
%
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
18
|
15
|
64
|
2
|
1
|
|
2006 Nov 9-12
|
20
|
15
|
62
|
2
|
*
|
|
2005 Nov 7-10
|
18
|
14
|
65
|
2
|
1
|
|
2004 Nov 7-10
|
18
|
17
|
64
|
1
|
*
|
|
2003 Nov 3-5
|
23
|
16
|
59
|
2
|
*
|
|
2002 Nov 11-14
|
21
|
19
|
57
|
2
|
1
|
|
2001 Nov 8-11
|
19
|
24
|
54
|
2
|
1
|
Over the past year, has the amount YOU paid for your and your family's health insurance - [ROTATED: gone up a lot, gone up a little, not changed, gone down a little, (or) gone down a lot]?
[BASED ON ADULTS WHO PAY ALL OR PART OF THEIR HEALTH PREMIUMS]
|
|
Gone up
a lot
|
Gone up
a little
|
Not changed
|
Gone down
a little
|
Gone down
a lot
|
No
opinion
|
|
2006 Nov 9-12
|
29%
|
46
|
19
|
3
|
1
|
3
|
|
2005 Nov 7-10
|
28%
|
46
|
23
|
2
|
*
|
1
|
|
2004 Nov 7-10
|
28%
|
48
|
17
|
5
|
1
|
1
|
|
2003 Nov 3-5
|
31%
|
43
|
23
|
*
|
1
|
2
|
Within the last twelve months, have you or a member of your family put off any sort of medical treatment because of the cost you would have to pay?
|
|
Yes
|
No
|
No opinion
|
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
30
|
70
|
*
|
|
2006 Nov 9-12
|
30
|
69
|
1
|
|
2005 Nov 7-10
|
28
|
71
|
1
|
|
2004 Nov 7-10
|
26
|
74
|
*
|
|
2003 Nov 3-5
|
24
|
76
|
*
|
|
2002 Nov 11-14
|
25
|
75
|
*
|
|
2001 Nov 8-11
|
19
|
81
|
*
|
|
1991 Jan 3-6
|
22
|
77
|
1
|
When you put off this medical treatment, was it for a condition or illness that was -- very serious, somewhat serious, not very serious, or not at all serious?
[BASED ON WHO PUT OFF MEDICAL TREATMENT DUE TO COSTS]
|
Very
serious
|
Somewhat
serious
|
Not very serious
|
Not at all serious
|
No
opinion
|
|
%
|
%
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
15
|
45
|
28
|
10
|
2
|
|
2006 Nov 9-12
|
10
|
48
|
32
|
9
|
2
|
|
2005 Nov 7-10
|
18
|
37
|
31
|
13
|
1
|
|
2004 Nov 7-10
|
16
|
44
|
30
|
10
|
*
|
|
2003 Nov 3-5
|
6
|
42
|
44
|
8
|
1
|
|
2002 Nov 11-14
|
16
|
43
|
31
|
9
|
1
|
|
2001 Nov 8-11
|
15
|
47
|
23
|
13
|
2
|
|
1991 Jan 3-6
|
15
|
37
|
37
|
10
|
1
|
[COMBINED RESPONSES]
|
Put off treatment for serious condition
|
Put off treatment for non-serious condition
|
Did not
put off
treatment
|
No
opinion
|
|
%
|
%
|
%
|
%
|
|
2007 Nov 11-14
|
18
|
11
|
70
|
1
|
|
2006 Nov 9-12
|
18
|
12
|
69
|
1
|
|
2005 Nov 7-10
|
16
|
12
|
71
|
1
|
|
2004 Nov 7-10
|
16
|
10
|
74
|
*
|
|
2003 Nov 3-5
|
12
|
13
|
75
|
*
|
|
2002 Nov 11-14
|
15
|
10
|
75
|
*
|
|
2001 Nov 8-11
|
12
|
7
|
81
|
*
|
|
1991 Jan 3-6
|
11
|
11
|
77
|
1
|
As you may know, Congress is considering a bill that would increase the number of children eligible for government subsidized health insurance, but the Democrats in Congress and President Bush disagree on how much to increase the program. How closely have you been following the news about this -- very closely, somewhat closely, not too closely, or not at all?
|
|
Very
closely
|
Somewhat
closely
|
Not too
closely
|
Not
at all
|
No
opinion
|
|
2007 Oct 12-14
|
17%
|
34
|
30
|
19
|
*
|
(Asked of a half sample) Based on what you have heard or read about this bill, who do you have more confidence in to handle this issue -- [ROTATED: George W. Bush (or) the Democrats in Congress]?
|
Bush
|
Democrats
|
Neither (vol.)
|
No opinion
|
|
2007 Oct 12-14
|
32%
|
52
|
10
|
5
|
(Asked of a half sample) As you may know, the Democrats want to allow a family of four earning about $62,000 to qualify for the program. President Bush wants most of the increases to go to families earning less than $41,000. Whose side do you favor?
|
Bush
|
Democrats
|
Neither (vol.)
|
No opinion
|
|
2007 Oct 12-14
|
52%
|
40
|
3
|
4
|
(Asked of a half sample) How concerned are you that expanding this program would create an incentive for middle class Americans to drop private health insurance for a public program, which some consider to be a step toward socialized medicine? Are you -- very concerned, somewhat concerned, not too concerned, or not concerned at all?
|
|
Very concerned
|
Somewhat concerned
|
Not too concerned
|
Not concerned
at all
|
No
opinion
|
|
2007 Oct 12-14
|
22%
|
33
|
25
|
17
|
2
|
(Asked of a half sample) For each of the following health conditions, please say whether you think it is a very serious problem around the world, a somewhat serious problem, or not a serious problem? How about - [RANDOM ORDER]?
A. HIV or AIDS
|
Very
serious
|
Somewhat serious
|
Not
serious
|
No
opinion
|
|
%
|
%
|
%
|
%
|
|
2007 Jun 11-14
|
82
|
16
|
2
|
*
|
|
2006 Dec 8-10
|
89
|
10
|
1
|
*
|
B. Cancer
|
2007 Jun 11-14
|
79
|
20
|
1
|
1
|
|
2006 Dec 8-10
|
87
|
11
|
1
|
--
|
C. Tuberculosis
|
2007 Jun 11-14
|
24
|
51
|
23
|
2
|
|
2006 Dec 8-10
|
31
|
48
|
17
|
3
|
D. Malaria
|
2007 Jun 11-14
|
24
|
50
|
22
|
3
|
|
2006 Dec 8-10
|
28
|
47
|
20
|
4
|
E. Poor nutrition
|
2007 Jun 11-14
|
75
|
22
|
3
|
1
|
|
2006 Dec 8-10
|
80
|
18
|
1
|
1
|
