POLITICO, Harvard T.H. Chan School of Public Health, March 2019
PART I: REASONS FOR THE NATION’S HIGH HEALTH CARE COSTS
The Public’s Views about the Reasons for High Health Care Costs in the Nation – % saying each of the following is a “major reason”:
- 79% – High prices charged by drug companies
- 75% – High prices charged by insurance companies
- 74% – High prices charged by hospitals
- 66% – High prices charged by doctors and other health professionals
- 64% – Actions taken by the federal government that raise health care prices
- 58% – People not taking good enough care of their own health
- 56% – Waste in the health care system
- 55% – Fraud in the health care system
- 52% – Administrative costs in handling insurance claims
- 51% – The American population is aging and needs more medical care
- 49% – Unnecessary use of expensive new drugs, treatments, and medical technology
- 46% – Too many malpractice lawsuits
- 45% – People are receiving more advanced medical treatments and prescription drugs
- 43% – Doctors recommending health care that patients often do not need
- 41% – The American population is getting sicker, regardless of age
- 33% – Patients seeking health care that they often do not need
- 31% – Patients not taking responsibility to find the lowest-cost health care
The Public’s Views on Whether High Prices or Overuse Is the More Important Cause of High Health Care Costs:
- 60% – Prices too high for health care services and drugs
- 23% – Americans are getting more health care and Rx drugs then they need
- 11% – Both
- 3% – Neither
- 2% – Don’t know/ Refused
PART II: REDUCING THE NATION’S HIGH HEALTH CARE COSTS
The Public’s Views About Proposed Ways to Reduce the Nation’s Health Care Costs:
- 84% – Make greater efforts to prevent future diseases and to have people live healthier lives.
- 67% – Have the government making it easier for health care professionals and for hospitals to compete with each other based on price and quality.
- 65% – Have the government establish limits on what health care professionals and hospitals can charge.
- 61% – Allow people age 50 to 64 to buy into Medicare.
- 52% – Change our health care system so that most people have Medicare and there is little or no private health insurance.
- 70% Democrats
- 30% Republicans
- 37% – Have government and private health insurance plans NOT pay for some high-cost prescription drugs and medical or surgical treatments, which have been shown to be safe and effective, but whose high cost many experts feel is not justified by the amount of benefit they provide.
- 37% – Give individuals tax incentives to buy high-deductible health plans. High-deductible plans require consumers to spend several thousand dollars out of pocket before their insurance kicks in to help cover the cost of drugs and services. Some think these plans would encourage consumers to shop for lower-priced health care and use fewer unnecessary tests and treatments.
The Public’s Views About the Effectiveness of Proposed Ways to Reduce the Nation’s Health Care Costs:
- 41% – Make greater efforts to prevent future diseases and to have people live healthier lives.
- 36% – Change our health care system so that most people have Medicare and there is little or no private health insurance.
- 51% Democrats
- 20% Republicans
- 34% – Have the government establish limits on what health care professionals and hospitals can charge.
- 32% – Have the government making it easier for health care professionals and for hospitals to compete with each other based on price and quality.
- 25% – Allow people age 50 to 64 to buy into Medicare.
- 19% – Give individuals tax incentives to buy high-deductible health plans. High-deductible plans require consumers to spend several thousand dollars out of pocket before their insurance kicks in to help cover the cost of drugs and services. Some think these plans would encourage consumers to shop for lower-priced health care and use fewer unnecessary tests and treatment.
- 18% – Have government and private health insurance plans NOT pay for some high-cost prescription drugs and medical or surgical treatments, which have been shown to be safe and effective, but whose high cost many experts feel is not justified by the amount of benefit they provide.
The Public’s Views About Whether Government or Private Health Insurance Plans Would Do a Better Job at Reducing the Nation’s Health Care Costs:
- 47% – Government
- 65% – Democrats
- 25% – Republicans
- 38% – Private health insurance plans
- 25% – Democrats
- 61% – Republicans
Comment:
By Don McCanne, M.D.
This POLITICO/Harvard T.H. Chan School of Public Health poll reveals the public’s views on what they believe are the reasons for the nation’s high health care costs and the ways they believe we can reduce those costs and how effective that would be. Let’s see how well they understand the issues.
Regarding the reasons for high health care costs, they certainly understand correctly that high prices are the greatest factor, blaming especially the drug and insurance companies, though hospitals and physicians rank up there. They place too much blame on patients not taking care of themselves. They do not place enough blame on the high administrative costs in our system, indicating the need for us to increase our emphasis on the structural reform that we need in health care financing. They seem to understand that Americans are not seeking more health care than they need. They also do not believe that patients should do more shopping for lower health care prices, which suggests that we should put the consumer-driven health care movement to rest.
How about the ways they believe that we could reduce our high health care costs? They place the greatest emphasis on prevention, which is certainly recommended, but there is not a lot of data that would suggest that there is much in the way of savings there. Yes, prevent, but look elsewhere to reduce our excessive spending. Their second choice is to encourage competition within the health care delivery system. No, markets do not work in health care. We need to get real here. They do believe correctly that government price controls would help. They do not believe that we should restrict appropriate health care and drugs, nor do they believe that we should use high deductibles as a barrier to health care access. On the most effective method – replacing private health insurance with Medicare for all – there is a sharp partisan divide, with 70 percent of Democrats but only 30 percent of Republicans in agreement.
So how effective do they believe these methods of reducing health care costs would be? Across the board, less than half of the public believe that these methods would be effective, with the sole exception that 51 percent of Democrats believe that replacing private insurance with Medicare would be effective.
When asked which entity would do a better job at reducing health care costs, 65 percent of Democrats said the government and 61 percent of Republicans said private health insurance plans. In fact, our government Medicare program has been far more effective than private insurers.
So the nation does have more to learn if they want a truly affordable health care system that works for all of us. Let’s teach them the basics.
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