Survey of health care opinion leaders
The Commonwealth Fund
Health Care Opinion Leaders Survey
Harris Interactive, Inc.
Dates: November 22, 2004 - December 8, 2004
The Commonwealth Fund Health Care Opinion Leaders Survey was conducted
by Harris Interactive on behalf of the Fund, with a broad group of more than
300 opinion leaders in health policy and innovators in health care delivery and finance. The survey focused on health policy priorities for Congress over the next five years.
There is broad consensus among leaders that expanding coverage to the uninsured is the top priority that should be addressed by Congress. This is the top priority for all groups represented in this study, with a large majority of academic/research institutions, health care delivery, business/insurance/other health care industry, and government/labor/advocacy identifying this issue as the top priority. There is also considerable agreement about the reforms that should be enacted in order to achieve this priority. Allowing individuals and small businesses to buy into the Federal Employees Health Benefits Program or similar federal group option receives the highest support overall and a majority of votes across all groups.
Also, expanding existing state-based public insurance programs, Medicaid and
the State Children’s Health Insurance Program, is supported by more than half of leaders overall and across groups, except for the health care delivery sector. This suggests a more incremental approach, with a national health system (universal coverage) receiving very little attention as a priority now.
http://www.cmwf.org/surveys/surveys_show.htm?doc_id=254281
From the survey:
Q700 Below is a list of possible reforms to expand coverage for the uninsured. Which of the following should be the top priorities for action?
(Please select up to five priorities.)
65% - Allow individuals and small businesses to buy into the Federal Employees Health Benefits program or similar federal group option
55% - Expand existing state-based public insurance programs, Medicaid and SCHIP
48% - Let near-elderly adults buy into Medicare
45% - Single-payer system of health insurance through a new program or Medicare-for-all
43% - Incentives or requirements to expand employer-based health insurance
37% - Reinsurance for small business insurance plans
31% - Eliminate two-year waiting period for the disabled for Medicare
22% - Create new tax credits for the uninsured to purchase insurance in the individual insurance market
22% - Expand tax-free health savings accounts
20% - Create new tax credit for the uninsured but limit to purchase of group
coverage through state public programs or employers
04% - Other
01% - Mandate
01% - Not Sure
http://www.cmwf.org/usr_doc/Opinion_leaders_topline.pdf
Note that the single payer result was skewed downward by a 29% response of the Business/Insurance/Other Health Care Industry sector - Table 4a:
http://www.cmwf.org/usr_doc/CMWF_Opinion_Leaders_summary.pdf
Comment: Another interesting result is that the Government/Labor/Consumer
Advocacy sector expressed 63% support of a single payer system as compared
to 57% support for expanding eligibility for the Federal Employees Health Benefits Program (FEHBP). It appears that some of those who have “the coverage that members of Congress have” would rather be covered under a single payer system.
The good news is that tax credits and HSAs bombed as choices for expanding
coverage.
The unfortunate news is that The Commonwealth Fund continues to characterize
the results as representing support of incremental approaches, with a national health system “receiving very little attention.” Although there is support for FEHBP, simultaneously there is opposition to tax credits that would make FEHBP premiums affordable for the individual (but with a greater tax burden). And correcting for the insurance/business bias against single payer, brings the support to 51%, making it one of the leading options for reform.
The only real conclusion that can be reached from this survey of health care
opinion leaders is that they do want universal health care coverage, but that they are divided over whether that should be through a single payer system or through private health plans with a safety-net public program.
We need to further expand the dialogue.
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Message: 2
Date: Fri, 7 Jan 2005 16:55:23 -0800
Subject: qotd: Karen Davis on the survey of health care opinion leaders
In my comment on the health care opinion leaders survey, I stated, “The unfortunate news is that The Commonwealth Fund continues to characterize the
results as representing support of incremental approaches, with a national health system ‘receiving very little attention.’” Although that comment was taken from their release and from their report, I believe that the comments of Karen Davis present a much more objective assessment of the survey. This is an excerpt from her message.
Karen Davis, President of The Commonwealth Fund:
“Although tapped as the top policy priority for Congress, there was only limited consensus among opinion leaders on the best way to address this difficult problem, but the top two approaches were clearly allowing individuals and small businesses to buy into the Federal Employees Health Benefits Program (FEHBP), and expanding Medicaid/CHIP. Opinion leaders within the health insurance industry appear to prefer Medicaid/CHIP expansions and find the FEHBP buy-in notion less attractive, as do consumer and advocacy group leaders. Allowing the uninsured to buy into Medicare and implementing some kind of “Medicare-for-all” system had a surprising degree of support, not just in the academic/research sector but also in the health care delivery sector, although an incremental approach to reducing the number of Americans lacking health coverage seems far more likely than a more basic overhaul of the system. Perhaps the most surprising finding, again given the amount of public and political attention the concept has received, is the lack of enthusiasm in this survey for health savings
accounts or tax credits to buy individual health insurance.”
And…
“We fully expect some of our results, especially those that may seem surprising at first blush, to be parsed, questioned, and criticized. And that’s fine. The goal here is to expand and inform a healthy public and professional debate, not reinforce established notions or limit useful options.”
http://www.cmwf.org/aboutus/aboutus_show.htm?doc_id=254655