Any Healthcare Reform Plan Will Do for Americans

PRINCETON, NJ -- Americans consistently rank healthcare as one of the top domestic issues they want the president and Congress to focus on, and, perhaps accordingly, nearly all of the leading 2008 presidential candidates have put forth position papers or plans for reforming the nation’s healthcare system. These include various Democratic proposals for government-funded healthcare programs as well as various Republican proposals for making private health insurance more affordable and accessible. Gallup recently evaluated public support for 12 of these and, remarkably, found majority support for all of them.

The implication? Americans may be receptive to almost any remedy for improving the nation’s healthcare system.

The poll was conducted Sept. 24-27, 2007, and included 1,006 adults, aged 18 and older, drawn from the nationally representative Gallup Panel.

The Details

Americans generally support all of the healthcare proposals tested, ranging from a national healthcare system akin to the Canadian and European systems, to government deregulation of healthcare aimed at increasing competition among private healthcare providers. However, support levels span a wide range from 53% to 94%. Additionally, some of the plans are more controversial than others, with a majority of Democrats favoring them, and a majority of Republicans opposed.

The broadest support levels are generally seen for proposals aimed at expanding Americans’ access to private health insurance, with relatively modest levels of government funding.

• There is near-universal support (94% in favor) for giving tax breaks to small businesses to allow them to provide health insurance for their employees.
• Nearly as many (86%) favor allowing American workers to keep the same medical insurance when they change jobs.
• About four in five Americans (81%) favor requiring large companies either to offer health insurance coverage to their employees or to pay into a pool that would be used to pay for health insurance.
• Along the same lines, 77% favor reducing government regulation to allow more health insurance providers to compete in the system.
• Seventy-six percent favor providing government subsidies to help lower-income Americans buy health insurance.

An additional proposal favored by about 8 in 10 Americans is providing incentives in health insurance plans for those who can demonstrate they live healthy lifestyles (81% in favor).

Three proposals are favored by approximately two-thirds of Americans. These vary in nature, with two involving significant federal funding, either for tax credits or state-run healthcare programs. The third involves reducing healthcare costs by passing so-called “tort reform” laws that would limit the amount of money awarded in malpractice suits against doctors.

• Nearly 7 in 10 (69%) favor introducing reforms to the legal system that would place limits on the amount of money awarded in malpractice suits against doctors.
• Sixty-eight percent favor providing American families with a $15,000 tax credit to allow them to buy private health insurance.
• The same percentage (68%) favors having the federal government help fund state programs that attempt to address the health insurance situations of each state.

The three least-favored approaches, though still supported by a majority of Americans, include the following:

• Establishing a national healthcare system funded by the government, similar to the ones in Canada and Europe (54% in favor).
• Repealing the federal income tax cuts passed in 2001 and 2002 and using that money to pay for new healthcare programs (54%).
• Requiring every American to carry some form of health insurance (53%).

Notably, these three proposals -- favored by just 53% or 54% of Americans -- are the only proposals measured that do not receive bipartisan public support. They are each supported by a majority of Democrats, but fewer than half of Republicans.

By contrast, the most popular programs on the list receive broad bipartisan support, with nearly equal levels of Republicans and Democrats saying they favor them.

The proposals can also be arrayed on a government-private continuum, where a national health system run by the federal government is the most extreme government solution, and reducing government regulation of healthcare to allow for more competition among health insurance providers is the most extreme private solution. (See the accompanying table.)

Despite the general sequence of these proposals along ideological lines, there is no clear pattern in support levels. Whereas only 54% of Americans favor a national healthcare system, 68% favor another approach that also sounds “government heavy” -- state-run programs paid for in part by the federal government. That is roughly the same level of support as seen for one of the most popular private reforms – placing limits on the amount of money awarded in medical malpractice suits (69%).

Bottom Line

Previous Gallup polling has shown that most Americans who have health insurance say they are satisfied with their own healthcare coverage and are even satisfied with the costs they pay. However, Gallup has documented that healthcare is viewed as one of the nation’s top domestic problems and is also one of the top three issues Americans say will be the basis for their vote in the coming presidential election. Additionally, healthcare is cited near the top of the list when Americans are asked to name the top financial problems facing their families.

For these reasons, healthcare presents itself as an attractive issue for political candidates to champion. Indeed, as found in the most recent poll, Americans are amenable to a broad array of proposals aimed at improving the nation’s healthcare system. And they are not especially ideological in their preferences.

Policy-makers eager to make some progress on healthcare reform might consider focusing their efforts on expanding access to private health insurance, as these proposals tend to receive the highest and most bipartisan support. There is likely to be much more push-back -- particularly from Republicans -- when it comes to major government expenditures or a government takeover of healthcare. Still, even establishing a national healthcare plan is currently favored by more than half the U.S. public.

Results for this panel study are based on telephone interviews with 1,006 national adults, aged 18 and older, conducted Sept. 24-27, 2007. Respondents were randomly drawn from Gallup’s nationally representative household panel, which was originally recruited through random selection methods. The final sample is weighted so it is representative of U.S. adults nationwide.

For results based on the total sample of national adults, one can say with 95% confidence that the maximum margin of sampling error is ±4 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.

10. Do you think each of the following presidential candidates does or does not have good ideas about how to address the healthcare system in the United States? How about -- [RANDOM ORDER]?

Still thinking about healthcare,

11. Please tell me whether you would favor or oppose each of the following as a way of reforming the U.S. healthcare system. How about -- [RANDOM ORDER]?

6. Next, how important is it to you that the president and Congress deal with each of the following issues in the next year -- is it -- extremely important, very important, moderately important, or not that important? How about -- [RANDOM ORDER]?