May 13, 2009 -- Americans are evenly split on how to reform the U.S. health care system, according to a new poll.
Congress is readying bills to try and slow the growth of health care costs, expand access to health insurance, improve the quality of care, and promote disease prevention. President Barack Obama said last week that he wants to sign a bill "by the end of the year."
But Wednesday's results suggest that Washington is getting no clear direction from voters on how to fix the system.
About 40% of registered voters polled by the Center on Longevity at Stanford University said they favor one proposal: expanding government programs like the State Children's Health Insurance Program (SCHIP) and Medicaid to give more people access to coverage. But a roughly equal number, 37%, opposed it.
Researchers polled nearly 2,000 registered voters, roughly split between Democrats, Independents, and Republicans and also split between self-identified liberals and conservatives.
Before asking their views, pollsters gave voters briefings on the pros and cons of several reform options now floating around Washington. And a pattern of ambivalence was evident throughout, researchers said.
The results show that voters understand "there is no such thing as a perfect solution to any of this," says Geoff Garin, president of Peter Hart Research, which helped conduct the poll.
Here's how voters came down on a variety of options for reforming health care:
- Requiring everyone to have health insurance, either individually or through an employer, while delivering subsidies to help pay for coverage if people can't afford it: 43% were in favor, 40% opposed, 17% undecided. Six in 10 said they like the fact that a so-called "individual mandate" would expand access to coverage, but four in 10 worried that it would increase taxes.
- Changing how health care is paid for, so that doctors and hospitals are paid for episodes of care or for quality care, instead of being paid separately for every test and treatment they order: 38% viewed that option positively, 40% negatively, and 28% were evenly divided between advantages and disadvantages.
- Forming an independent board to compare the effectiveness of different treatments, tests and procedures, and encouraging that only the best be used widely: 36% were positive, 40% were negative, 20% were undecided. "People like the idea of identifying the most effective treatments," Garin said. "There is some concern that once you create this body of information that insurers or Medicare will not cover treatments" that are deemed less effective.
Laura Carstensen, PhD, director of the Stanford Center on Longevity, said the results show there is no single policy that will solve the problem and that voters know it.
Carstensen said she was encouraged that voters don't seem to swing wildly on reform options according to their political affiliation. "When voters hear about possible reforms, they're hearing it form someone who either wants to sell them something or wants them to be afraid of it."