Californians shift views on reform
Californians Express Greater Dissatisfaction with the State’s Health Care System, but Are Skeptical about Prospects for Health Reform This Year.
By Mark DiCamillo and Mervin Field
The Field Poll
August 22, 2007
In its latest statewide survey, The Field Poll asked California voters about their overall views of the health care system and prospects for reforming the state’s health care system. Some of the questions were identical to those asked in a previous Field Poll completed last December.
Questions Asked (Responses for August 2007, with December 2006 in parentheses)
How satisfied are you with the way the health care system is working in California? Are you very satisfied, somewhat satisfied, somewhat dissatisfied or very dissatisfied?
7% (13%) - Very satisfied
21% (38%) - Somewhat satisfied
27% (24%) - Somewhat dissatisfied
42% (20%) - Very dissatisfied
Which of the following statements is closer to your view of what California should do to improve the state’s health care system: (1) Rely on free market competition to improve the current health insurance system; (2) Make reforms within the framework of the current health insurance system, by encouraging shared responsibilities by employers, government and individuals; or, (3) Replace the current system with a new system administered entirely by state government and covering all Californians.
36% (24%) - Replace current system with a new state government-run system covering all Californians
33% (52%) - Make reforms within framework of current health insurance system through shared responsibilities by employers, government and individuals
14% (18%) - Rely on free market competition to improve health insurance system
8% (2%) - None/other (volunteered)
9% (4%) - No opinion
Big differences in health reform preferences across subgroups
There is a direct relationship between dissatisfaction with the health care system and support for creating a new government-run system. Among voters very dissatisfied with the way the health care system is working, nearly half (48%) favor replacing it with a new state government-run system that would cover everyone. This compares to just 19% support for a government-run system among voters who are very satisfied with the current system.
There are partisan and ideological differences in the health reform preferences of voters. Pluralities of Democrats, non-partisans and liberals favor replacing the current system with a government-run system that would cover everyone. By contrast, creating a government-run system is the least attractive of the three alternatives to Republicans and conservatives. They favor either taking a shared responsibilities approach or relying on the free market system. Voters who identify themselves as politically moderate are evenly split between creating a new government-run health care system (34%) and reforming the system by sharing responsibilities among employers, government and individuals within the existing health insurance system (34%).
http://www.field.com/fieldpollonline/subscribers/Rls2239.pdf
Comment:
By Don McCanne, MD
This poll does demonstrate a significant increase in the perceived dissatisfaction with the health care system in California in the past eight months, with the total dissatisfied increasing from 44% to 69%.
From a policy perspective, the most dramatic change has been in the opinions of what we should do about it. In December, twice as many thought that we should reform the current health insurance system, whereas now more believe that we should “replace the current system with a new system administered entirely by state government and covering all Californians.”
Since our health care system has not changed that much in the past eight months, what could account for this shift in opinion? Simply stated, Californians have put into place the fundamentals of citizen action: grassroots, education, coalitions - in various combinations. Just a few of those involved include the California Nurses Association, Health Care for All, the OneCareNow campaign, League of Women Voters, California Physicians Alliance/PNHP, advocates for Sen. Sheila Kuehl’s SB 840, activities around Sicko, community forums, op-eds and letters in support of public insurance and in opposition to flawed policies of other publicized political approaches to reform, etc, etc. Thousands of organizations and hundreds of thousands of individuals have been involved in organizing grassroots coalitions and educating the public on the actual issues and options.
In real numbers, the support for public insurance has increased from only one-fourth to slightly over one-third. Although that represents a plurality of those polled, it falls far short of a political mandate.
We can’t let up. The issues are complex. The public needs to be educated on the fundamentals of health policy if we are to counter the misinformation campaign spewing from the non-think rhetoric tanks. We have a lot more work ahead of us, but we can do it. But it will take all of us. Start thinking now about what else you can do.