As economic conditions remain poor, a majority of the public continues to say that they or a member of their household have delayed or skipped health care in the past year, according to the Kaiser Family Foundation's April health tracking poll.Perhaps because Americans continue to struggle with the cost of medical care in their own lives, the country's overall economic problems have not dampened their interest in pursuing health care reform: a solid majority of the public (59%) believes health care reform is more important than ever, compared with the thirty-seven percent who say we can't afford health reform because of economic problems. "Our polls suggest strong general support for health reform, but the public can be swayed on the key details," said Kaiser President and CEO Drew Altman. "There is still a tremendous opportunity for leadership but also for interest groups to define the direction of the health reform debate." The most common actions taken due to costs were substituting home remedies or over-the-counter drugs for doctors visits (42%) and skipping dental care or check ups (36%). Additionally, three in ten (29%) did not fill a prescription for medicine and two in ten (18%) cut pills in half or skipped doses. Not everyone can forgo care, and overall one in four (26%) Americans say someone in their household has had trouble paying medical bills in the past year. Support for Some Methods to Pay for Health Reform, Others Less Popular One of the crucial challenges for health reform is the financing of the plan. Seven in 10 (71%) Americans strongly or somewhat favor increasing income taxes for those in families making more than $250,000 per year, but there is much less support for increasing income taxes on all taxpayers (28%). The poll indicates some support for taxing unhealthy behaviors, sometimes called "sin" taxes. When asked if they would favor or oppose increasing taxes on a package of items including soda, alcohol, junk food, and cigarettes to pay for health reform and provide coverage for the uninsured, six in ten (61%) favor such taxes while roughly four in ten (37%) are opposed. Asked about each of these items specifically, the poll suggests there is somewhat more support for increasing taxes on cigarettes, wine and beer than on snack foods or soda. Another tax change that has been discussed by some policymakers as a financing option is changing the tax treatment of employer-based health insurance. Roughly half (52%) of the public is opposed to changing the law so workers with the most generous health benefits would pay taxes on the money their employer puts towards their coverage, while 41 percent are in favor. Those who currently have employer-sponsored health insurance are even more likely to oppose the proposal (62 percent oppose, 33 percent favor). One other potential area of revenue discussed by policymakers for health reform comes from changes to the Medicare program. When asked about making changes to the program as a way to keep Medicare financially sound, reducing payments to managed care plans and other private insurers is "strongly" or "somewhat" supported by two-thirds (66%) of the public. Two-thirds (65%) also support reducing Medicare payments to doctors and hospitals. Ideological Divide in Support for Public Plan There has already been an ongoing debate about whether a public plan option should be included in health reform. Generally, two-thirds of the public (67%) "strongly" or "somewhat" favor creating a public option "similar to Medicare." More than eight in ten Democrats and six in ten political independents "strongly" or "somewhat" favor having a public plan, but just about half (49%) of Republicans agree. Another way to measure Americans' views on the public plan debate is giving the public a choice of two methods and asking which would better encourage price competition among health plans. When asked whether private plans competing with just each other or with a government-administered public insurance plan similar to Medicare would do a better job of lowering costs and improving quality, Democrats favor including a public plan by more than 3 to 1 (71% to 19%), and political independents back this approach 53 percent to 40 percent. A majority of Republicans, on the other hand, prefer having private plans compete without a public plan (54% to 39%).
********** Published: April 24, 2009 - Volume 8 - Issue 1