Health Care for All Information Project: New Polls on Health Care (US & CA)
Health Care for All Information Project: New Polls on Health Care (US & CA)
IN THIS ISSUE
1) Health Care and 2008 : Country Ready for 'Universal Health Care' Debate
By Democracy Corps
Greenberg Quinlan Rosner Research
Democracy Corps and Greenberg Quinlan Rosner have completed a
comprehensive study of the most important domestic issue of the cycle, health
care. The survey was conducted May 29-31, 2007, among 1,000 likely voters and
finds Americans deeply frustrated with the current health care system, ready to
move beyond narrow debates over issues like the cost of prescription drugs and
waiting for big, bold reform. The new research shows that, above almost anything
else, Americans want security in their health care delivery, health care that
can never be taken away from them. As such a guarantee is impossible absent a
universal system, it shows universal health care, both as policy goal and
normative value, as a powerful political asset.
In their latest strategy memo, Stan Greenberg, James Carville,
and Anna Greenberg argue that Democrats should drive the health care debate and
make Republicans' timid overtures on this issue irrelevant. We hope you find
this material helpful in your work. If you have any questions or comments,
please contact us at 202-478-8300.
2) World's Best Medical Care?
By New York
Late Edition - Final, Section
WK, Page 9, Column , 1294 words
Many Americans are under the delusion that we have "the best
health care system in the world," as President Bush sees it, or provide the
"best medical care in the world," as Rudolph
Giuliani declared last week.
That may be true at many top medical centers. But the disturbing truth is that
this country lags well behind other advanced nations in delivering timely and
Michael Moore struck a nerve in his new documentary, "Sicko,"
when he extolled the virtues of the government-run health care systems in
France, England, Canada and even Cuba while deploring the failures of the
largely private insurance system in this country. There is no question that Mr.
Moore overstated his case by making foreign systems look almost flawless. But
there is a growing body of evidence that, by an array of pertinent yardsticks,
the United States is a laggard not a leader in providing good medical care.
Seven years ago, the World Health Organization made the first
major effort to rank the health systems of 191 nations. France and Italy took
the top two spots; the United States was a dismal 37th. More recently, the
highly regarded Commonwealth Fund has pioneered in comparing the United States
with other advanced nations through surveys of patients and doctors and analysis
of other data. Its latest report, issued in May, ranked the United
last or next-to-last compared with five other nations - Australia, Canada,
Germany, New Zealand and the United Kingdom - on most measures of
performance, including quality of care and access to it. Other comparative
studies also put the United States in a relatively bad light.
Insurance coverage. All other major industrialized nations
provide universal health coverage, and most of them have comprehensive benefit
packages with no cost-sharing by the patients. The United States, to its shame,
has some 45 million people without health insurance and many more millions who
have poor coverage. Although the president has blithely said that
people can always get treatment in an emergency room, many studies have shown
that people without insurance postpone treatment until a minor illness becomes
worse, harming their own health and imposing greater costs.
Access. Citizens abroad often face long waits before they can
get to see a specialist or undergo elective surgery. Americans typically get
prompter attention, although Germany does better. The real barriers here are the
costs facing low-income people without insurance or with skimpy coverage. But
even Americans with above-average incomes find it more difficult than their
counterparts abroad to get care on nights or weekends without going to an
emergency room, and many report having to wait six days or more for an
appointment with their own doctors.
Fairness. The United States ranks dead last on almost all
measures of equity because we have the greatest disparity in the quality of care
given to richer and poorer citizens. Americans with below-average incomes
are much less likely than their counterparts in other industrialized nations to
see a doctor when sick, to fill prescriptions or to get needed tests and
Healthy lives. We have known for years that America has a high
infant mortality rate, so it is no surprise that we rank last among 23 nations
by that yardstick. But the problem is much
broader. We rank near the bottom
in healthy life expectancy at age 60, and 15th among 19 countries in deaths from
a wide range of illnesses that would not have been fatal if treated with timely
and effective care. The good news is that we have done a better job than other
industrialized nations in reducing smoking. The bad news is that our
obesity epidemic is the worst in the world.
Quality. In a comparison with five other countries,
the Commonwealth Fund ranked the United States first in providing the
'right care' for a given condition as defined by standard
and gave it especially high marks for preventive care, like Pap smears and
mammograms to detect early-stage cancers, and blood tests and cholesterol checks
for hypertensive patients. But we scored poorly in coordinating the care of
chronically ill patients, in protecting the safety of patients, and in meeting
their needs and preferences, which
drove our overall quality rating down to
last place. American doctors and hospitals kill patients through surgical and
medical mistakes more often than their counterparts in other
Life and death. In a comparison of five countries, the United
States had the best survival rate for breast cancer, second best for cervical
cancer and childhood leukemia, worst for kidney
transplants, and almost-worst
for liver transplants and colorectal cancer. In an eight-country comparison, the
United States ranked last in years of potential life lost to circulatory
diseases, respiratory diseases and diabetes and had the second highest death
rate from bronchitis, asthma and emphysema. Although several factors can affect
these results, it seems likely that the quality of care delivered was a
Patient satisfaction. Despite the declarations of their
political leaders, many Americans hold surprisingly negative views of their
health care system. Polls in Europe and North America seven to nine years ago
found that only 40 percent of Americans were satisfied with the nation?s health
care system, placing us 14th out of 17 countries. In recent Commonwealth Fund
surveys of five countries, American attitudes stand out as the most negative,
with a third of the adults surveyed calling for rebuilding the entire
system, compared with only 13 percent who feel that way in Britain and 14
percent in Canada.
That may be because Americans face higher out-of-pocket costs
than citizens elsewhere, are less apt to have a long-term doctor, less able to
see a doctor on the same day when sick, and less apt to get their questions
answered or receive clear instructions from a doctor. On the other hand, Gallup
polls in recent years have shown that three-quarters of the respondents in
the United States, in Canada and in Britain rate their personal care as
excellent or good, so it could be hard to motivate these people for the
wholesale change sought by the disaffected.
Use of information technology. Shockingly, despite our vaunted
prowess in computers, software and the Internet, much of our health care system
is still operating in the dark ages of paper records and handwritten scrawls.
American primary care doctors lag years behind doctors in other advanced nations
in adopting electronic medical records or prescribing medications
electronically. This makes it harder to coordinate care, spot errors and adhere
to standard clinical guidelines.
Top-of-the-line care. Despite our poor showing in many
international comparisons, it is doubtful that many Americans, faced with a
life-threatening illness, would rather be treated elsewhere. We tend to think
that our very best medical centers are the best in the world. But whether this
is a realistic assessment or merely a cultural preference for the home team
is difficult to say. Only when better measures of clinical excellence are
developed will discerning medical shoppers know for sure who is the best of the
With health care emerging as a major issue in the presidential
campaign and in Congress, it will be important to get beyond empty boasts that
this country has ?the best health care system in the world? and turn instead to
fixing its very real defects. The main goal should be to reduce the huge number
of uninsured, who are a major reason for our poor standing globally. But there
is also plenty of room to improve our coordination of care, our use of
computerized records, communications between doctors and patients, and dozens of
other factors that impair the quality of care. The world's most powerful economy
should be able to
provide a health care system that really is the best.
3) Health care system slammed Poll: 69 percent of voters displeased with current
By Peter Hecht
Wednesday, August 22, 2007, Published 12:00 am PDT
In a dramatic shift in public attitudes, more than two-thirds
of California voters now say they are unhappy with the health care system and
increasing numbers favor a government-run system covering all state residents, a
new Field Poll revealed Tuesday.
The survey of 536 registered voters showed that 69 percent are
dissatisfied with the health care system in California, with 42 percent saying
they are "very dissatisfied" and 28 percent
saying they are content with the
Those numbers -- in a poll taken Aug. 3-12 -- contrast starkly
with responses to a similar Field Poll last December. Then, 51 percent of voters
said they were satisfied with the way the health care system was functioning,
compared with 44 percent who were dissatisfied.
Mark DiCamillo, director of the California Field Poll, said the
shift in attitudes seems to reflect reactions to a political drumbeat led by
Gov. Arnold Schwarzenegger and state lawmakers insisting the state health care
system needs fixing.
Schwarzenegger has advanced a $12 billion plan to cover some
6.5 million uninsured Californians. His proposal would expand the state's health
insurance program for the poor -- Medi-Cal -- and require employers that don't
provide coverage to pay 4 percent of payroll costs to help subsidize residents
who can't afford insurance.
But the Republican governor has strenuously rejected a
single-payer health care bill, Senate Bill 840 by Sen. Sheila Kuehl, D-Santa
Monica, calling the legislation to abolish private health care insurance
"government-run health care."
"At one level, the public is taking his message that the health
care system is broken and needs to be fixed," DiCamillo said. "The public pretty
much takes him (Schwarzenegger) at his word, and more and more they are
dissatisfied with the system.
"But as more people get dissatisfied ... the more likely they
are to support a state government-run health care system."
Some 36 percent of voters in the most recent poll say they now
support replacing the current health care system in California with a state
government-run system covering all residents.
That's up from 24 percent who supported a government-run system
in December 2006.
In the December poll, 52 percent of California voters said they
favored a plan to overhaul health care by making changes within the existing
framework of health insurance and by sharing responsibility among employers, the
state and individuals.
In the latest poll, support for this so-called "shared
responsibilities" approach dropped to 33 percent of voters -- 3 percentage
points less less than the support for a government-run system.
Meanwhile, the percentage of voters who support relying on
free-market competition to improve the health care insurance system dropped from
18 percent last December to 14 percent in the recent poll.
"If anything, the poll says the Legislature should think
broadly about health care reform, and the cynicism will only increase if nothing
gets done," said Anthony Wright, executive director of Health Access California,
a group advocating expanding health care through both government and employer
"Clearly, voters are in the mood for broad change."
If so, they don't have much confidence in the ability of state
leaders to come up with a solution.
Some 58 percent of Field Poll respondents said they doubt the
Legislature and the governor will be successful in passing significant health
care reform this year. Thirty-six percent said they expect state government will
enact some meaningful legislation.
"I think the results tell us that we need to have affordable
coverage for all Californians and there's a strong sense of urgency for doing
that," said Chris Ohman, CEO of the California
Association of Health Plans,
which represents 39 private and public health plans covering 21 million state
Ohman said the voter attitudes -- and Tuesday's passage of the
state budget -- could force the Legislature to undertake a "serious discussion"
of health coverage.
Besides Schwarzenegger's health care plan and Kuehl's
single-payer proposal, Assembly Speaker Fabian N±ez and
Senate President Pro Tem Don Perata are backing a plan to impose a higher
threshold on employers. Assembly Bill 8 would require them to spend 7.5 percent
of payroll toward employee health coverage or pay the money into a government
health insurance pool.
"There is really no consensus within the voting public in how
to best reform the system," DiCamillo said.
But he said rising support for a government-run program may
have been influenced by Michael Moore's recent documentary, "Sicko." The movie
assails private, for-profit health care.
"When you calculate the numbers from the box office, the movie
wasn't all that huge," DiCamillo said. "But the publicity it generated certainly
raised the level of anxiety about the
(health care) system."
The (health care) system." The percentage of state voters
saying they were "very dissatisfied" with health care jumped from December,
soaring from 27 percent to 50 percent among Democrats, from 11 percent to 34
percent among Republicans, and from 20 percent to 37 percent among nonpartisans.
But while 47 percent of Democrats and 39 percent of
independents favor a government-run system, only 19 percent of Republicans
"There is no question that people are frustrated with the high
cost of health care and are concerned about getting and keeping insurance," said
Vince Sollitto, spokesman for the California Chamber of Commerce. "But turning
over health care to the same government bureaucracy that brought us the
Department of Motor Vehicles ... is not the answer, and Californians know