Ask the Scholar

Document scope · 1 page
doc
Scholar
Ask about this object, its catalog metadata, its source description, or the page inventory. For page-specific OCR and visual context, open one of the page chats.

Scholar Source Context

Document identity
localId
26082429
label
Harris Poll Prepared for Healthright February 1992 [binder]
core
doc
dtoType
document
pageCount
1
Source metadata
Source extras
naId
26082429
levelOfDescription
fileUnit
otherTitles
42-t-2124771-20140159S-018-008-2015
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
48ca7bf3aa852bba
ocrText
First Lady Office - Pam Ciccetti jenuifer Klein First Lady Health Care binders to Courtesy Storage - September 23, 1998 # , Box A ENCLOSURES FILED OVERSIZE ATTACHMENTS 12499 NARA 9868 Health Care binders and group materials - 1993-1994 #2 Box B ENCLOSURES FILED OVERSIZE ATTACHMENTS 12500 NARA 9869 Health Care Binders and group materials 1993-1994 #3 Box C ENCLOSURES FILED OVERSIZE ATTACHMENTS 12501 NARA 9870 State-by-State Analysis of Impact of Administration Policies Economic Impact of 1993 Budget #4 Box D ENCLOSURES FILED OVERSIZE ATTACHMENTS 12502 NARA 9871 1993-1994 Health Care Binders 1995 Medicare/Medicaid Budget Briefing Document 1993 Binder on Legal Services Binder on President's Council on Physical Fitness #5 Box E ENCLOSURES FILED OVERSIZE ATTACHMENTS 12503 NARA 9872 Health Care Binders and group materials 1993-1994 5 leopes filed 9/24/98 Tr Mrs. Clinton - Health Care Binders and group materials 1993-1994 HARRIS POLL Prepared for HEALTH RIGHT FEB. 1992 Harris Poll prepared for Heal PHOTOCOPY PRESERVATION THE PUBLIC MANDATE FOR HEALTH CARE REFORM IN AMERICA Prepared for HEALTHRIGHT Conducted by LH RESEARCH February 1992 Study Director: Louis Harris Study 920016 Not Affiliated With Louis Harris and Associates TABLE OF CONTENTS A WORD ABOUT THE STUDY il EXECUTIVE SUMMARY iii THE PUBLIC MANDATE FOR HEALTH CARE REFORM IN AMERICA 2 I The Context 2 II The Nature of the Mandate for Change 30 III Health Care Priorities 49 IV Long Term Care and the American Health Care System 74 CONCLUDING OBSERVATION 78 SURVEY METHOD 96 QUESTIONNAIRE 99 TABLES Table Page 1 OVERALL RATING OF PERSONAL HEALTH 8-9 2 SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR: QUALITY 10-11 3 OCCURRENCE OF A NEED FOR HEALTH CARE THAT WAS NOT ATTENDED TO IN THE PAST 12 MONTHS 12-13 4 MAIN REASON FOR NOT GETTING THE HEALTH CARE NEEDED 14-15 5 SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR - THE AVAILABILITY OF THE KIND OF HEALTH CARE YOU WANT 16-17 6 SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR - THE COST OF THE HEALTH CARE AVAILABLE TO YOU 18-19 7 SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR - THE HEALTH INSURANCE PLAN AVAILABLE TO YOU 20-21 8 WHETHER FAVOR/OPPOSE PRESENT HEALTH CARE SYSTEM 22-23 9 OVERALL VIEW OF THE HEALTH CARE SYSTEM IN THIS COUNTRY 24-25 10 PRIORITY CLINTON ADMINISTRATION SHOULD GIVE TO HEALTH CARE REFORM 26-27 11 WHETHER HEALTH CARE IS A FUNDAMENTAL RIGHT 28-29 12 WHETHER FAVOR/OPPOSE NATIONAL HEALTH INSURANCE 35-36 13 WHETHER FAVOR/OPPOSE "EMPLOYER PLAY OR PAY" 37-38 14 WHETHER FAVOR/OPPOSE "MANAGED CARE" 39-40 15 WHETHER FAVOR/OPPOSE "HMO SPONSOR" 41-42 15 WHETHER FAVOR/OPPOSE "MEDICARE EXPANSION" 43-44 16 PREFERENCE FOR THE BRITISH NATIONAL HEALTH CARE SYSTEM OR THE HEALTH CARE SYSTEM WE NOW HAVE IN THIS COUNTRY 45-46 17 PREFERENCE FOR THE CANADIAN SYSTEM OF NATIONAL HEALTH INSURANCE OR THE HEALTH CARE SYSTEM WE NOW HAVE IN THIS COUNTRY 47-48 18 PRIORITY OF HEALTH CARE ISSUES - HOSPITALS THAT REALLY CARE ABOUT THE PATIENTS 54-55 19 PRIORITY OF HEALTH CARE ISSUES - PREVENTIVE HEALTH CARE 56-57 Tables (continued) Table Page 20 PRIORITY OF HEALTH CARE ISSUES - FAST, CONVENIENT OUTPATIENT CARE 58-59 21 PRIORITY OF HEALTH CARE ISSUES - LONG-TERM HOME CARE 60-61 22 PRIORITY OF HEALTH CARE ISSUES - LONG-TERM NURSING HOME CARE 62-63 23 PRIORITY OF HEALTH CARE ISSUES - LONG OR EXTENDED HOSPITAL STAYS 64-65 24 PRIORITY OF HEALTH CARE ISSUES - UNLIMITED AVAILABILITY OF SUCH CARE AS KIDNEY DIALYSIS, ORGAN TRANSPLANTS, AND PLASTIC SURGERY 66-67 25 PRIORITY OF HEALTH CARE ISSUES - EXTENSIVE TESTING OF PATIENTS 68-69 26 MOST IMPORTANT HEALTH CARE ISSUE 70-71 27 FIRST/SECOND MOST IMPORTANT HEALTH CARE ISSUE 72-73 28 EXPERIENCE WITH THE NEED FOR LONG-TERM CARE BECAUSE OF CHRONIC DISEASE, BIRTH DEFECT, OR A PERMANENT DISABILITY 80-81 29 PREFERENCE FOR NURSING HOME OR OWN HOME FOR LONG-TERM CARE 82-83 30 ABILITY TO AFFORD LONG-TERM CARE ($15,000 TO $60,000 A YEAR/$40 TO $160 A DAY) 84-85 31 WHETHER FAVOR/OPPOSE A FEDERAL PROGRAM PROVIDING LONG-TERM CARE IN THE HOME FOR CHRONICALLY ILL OR DISABLED - FOR ELDERLY PEOPLE 65 AND OVER 86-87 32 WHETHER FAVOR/OPPOSE A FEDERAL PROGRAM PROVIDING LONG-TERM CARE IN THE HOME FOR CHRONICALLY ILL OR DISABLED - FOR PEOPLE 20 TO 64 YEARS OF AGE 88-89 33 WHETHER FAVOR/OPPOSE A FEDERAL PROGRAM PROVIDING LONG-TERM CARE IN THE HOME FOR CHRONICALLY ILL OR DISABLED - FOR CHILDREN 19 YEARS OF AGE OR UNDER 90-91 34 WHETHER FAVOR/OPPOSE EXTENDING MEDICARE TAX ON ALL INCOME EARNED OVER $130,200 TO FUND A FEDERAL LONG-TERM CARE PROGRAM 92-93 35 PRIORITY A LONG-TERM CARE PROGRAM SHOULD HAVE IN A NATIONAL HEALTH INSURANCE SYSTEM 94-95 A Word About This Study This study looks at the attitudes of Americans toward their own health, the quality of health care they received, their view of the major options for reform of the health care system, and their priorities for health care. It looks in depth at public opinion on long term care with a special focus on home care - in terms of their experience with it, its cost, a greater federal role in providing it, and the priority the public would give it. The study was conducted between December 23, 1992, and January 3, 1993, among a random cross-section of 1250 Americans 18 years old and above. The details of the sample are discussed in "Sample Method" at the end of the report. Its project director was Louis Harris, Chairman of LH Research, who has had wide experience in health care research as well as in all forms of public opinion research. Mr. Harris was assisted by Robert F. Wagner, Jr., Vice Chairman of LH Research. Mr. Wagner has had experience with health care issues, particularly during his four years as Chairman of New York City's Health and Hospitals Corporation which is the second largest public hospital system (after the Veterans Administration) in the country. The study's findings put the national debate over health care in a new light. It also highlights the real importance attached to long term care, particularly home care, in the context of that debate. What this study attempts to do, as its title states, is look overall at The Public Mandate for Health Care Reform in America. i LH Research is particularly grateful for the great help of the National Association of Home Care, and of the Foundation for Hospice and Homecare, which made the project possible. ii Executive Summary The Public Mandate for Health Care Reform in America What this study shows is a pattern in terms of American attitudes toward health care: a general satisfaction with the quality of care; a general dissatisfaction with the way health care is financed; a desire to go beyond the answers commonly suggested for reform; and a real commitment to long term care, especially home care, preventive medicine and hospitals that provide a more caring atmosphere. What all of this adds up to is a mandate for basic change in the country's health care system, change that builds on existing quality but fundamentally alters the way services are delivered and financed. Here are some of the major findings: Context - Quality of Health Care: Quite High: Overall 37% rate their health as "excellent", 46% as "pretty good", 13% "only fair", and 4% "poor". When the excellent and pretty good are combined, 83% of Americans consider themselves to be generally healthy. On actual health care experience 84% say they are either "very satisfied" or "somewhat satisfied" with the quality of service they received in the last year, with 45% saying "very satisfied". On the question of "the availability of the kind of health care you want" the results are somewhat less positive than when it comes to the "quality of the service you received in the last year", with 74% saying they are either "very satisfied" or "somewhat satisfied". - Cost of Health Care: A Problem: By a 53-43%, the respondents say they are satisfied with "the cost of health care available to you." However only 24% take the position that they are "very satisfied" with 26% saying they are "very dissatisfied". The groups that are most dissatisfied are those 65 and over (35% "very dissatisfied"), those earning less than $15,000 a year (34% "very dissatisfied"), who voted for Perot (35% dissatisfied), and those who rate their own health negative (38% "very dissatisfied"). - Status Quo in Health Care Overwhelmingly Rejected: By 67% to 24%, a majority takes the view that the current health care system needs to be overhauled. The survey asked the public to choose between three different points of view about health care. "On the whole, the health care system works pretty well and only minor changes are necessary to make it work better"; "There are some good things about our health care system, but fundamental changes are needed to make it work better"; and "Our health care system has so much wrong with it that we need to completely rebuild it." Only 10% gave the first answer, while 53% say they agree with the second and 36% with the third. - Health Care a Top Priority: Among adult Americans 47% believe it should have the "highest priority", and another 47% say it should have a "somewhat high priority". Only 5% say it should not have a high priority at all. Even more positive is the responseto the question of whether health care is a "fundamental right". Here by an 85-10% margin Americans believe it is. iii The Nature of the Mandate For Change - Wide Support For Single Payer Plan With Choice: On a national single payer health insurance plan, with government establishing fees, and a choice of doctor, a full 70% say they would support such a national health system, with 20% opposed and 10% not sure. - On the "Play or Pay" Option: The "play or pay" approach to health care found 33% in favor, compared to 56% against, with 11% undecided. - On Managed Competition: 29% favor, 59% oppose - On Managed Care Through HMO: 59% are opposed, 30% in favor. - On Universal Medicare Coverage: Nearly two-thirds (66%) favor such a system while 26% are opposed and 8% undecided. - On the British System Compared to the American: Some 35% say they would favor the British system while 58% say they would "favor the system we have here." - On the Canadian System: Here the results are very different with 66% preferring the Canadian system and 30% "the system we have here". Health Care Priorities - Priorities: On a scale of one to five, the public was asked to rate the importance of a variety of services in our health care system. On top, with 67% rating it a "one" very important, is "hospitals that really care about the patients", followed by "long term care at home or in a nursing home" (66%), preventive care (51%), "fast, convenient outpatient care" (46%), "unlimited availability of such care as kidney dialysis, organ transplants, and plastic surgery" (33%), "long or extended hospital stays," (30%) and extensive testing of patients (23%). Interestingly, if home care and nursing home care are combined, long term care, with 66%, would rank second to "hospitals that really care about the patients." People were than asked which one or two of these items they would give the highest priority. In this context the order shifts somewhat with preventive care clearly coming out first with 69% mentioning it either as a first or second priority; this followed by "hospitals that really care about people" (43%), "fast, convenient outpatient care" (29%), and "long term nursing home care" (26%). When home care and nursing home care are combined, long term care would actually come in second, at 51%. iv Long Term Care and the American Health Care System - Experience: Some 50% of the American public say that they, a member of their family, or someone they have known have needed long term care, while 50% say this has not been the case. However, experience does not seem to radically alter attitudes on issues involving health care, even long term care, as a result of having had an experience with long term care. LH Research ran a special cross tabulation comparing the answers of those with experience and those without. The results showed almost no significant difference in responses. - Strong Preference For Home Care Over Nursing Home Care: By an overwhelming 79-14% the American public says it prefers long term home care to long term nursing home care. - Deep Concern About the Cost of Long Term Care: By 91% to 7% Americans say they could not afford long term care. This is even greater than the 82-16% margin recorded in 1988. - Strong Support For Federal Programs to Long Term Care for the Chronically III in All Age Groups: For those 65 years old and above, 88% say they favor such a program, for those 20 to 64 years old 83%, and for those 19 and under 86%. - Support For Extending Medicare Tax to Earnings Over $130,200: By 81-15% the public favors such an approach to fund a program for long term care. - High, But Not Highest Priority For Long Term Health Care: Some 31% say long term health care should get the highest priority, while 54% say it should get a high but not top priority, only 11% say it should get a lower priority. All in all the American people are way ahead of their political leaders on health care. They are not looking for piecemeal change. They want fundamental reform - with a choice of doctor and hospital but based on national health insurance not managed care, a "play or pay" plan, or managed competition. Long term care, with home care the preferred form of assistance, has strong support, along with preventive medicine and the need for caring hospitals, in a revised health care system. V THE PUBLIC MANDATE FOR HEALTH CARE REFORM IN AMERICA What this study shows is a fascinating pattern in terms of American attitudes toward health care: a general satisfaction with the quality of care; a general dissatisfaction with the way health care is financed; a desire to go beyond the answers commonly suggested for reform; and a real commitment to preventive medicine, long term care, especially home care, and hospitals that provide a more caring atmosphere. What all of this adds up to is a mandate for basic change in the country's health care priorities and its health care system, change that builds on existing quality but fundamentally alters the way service are delivered and financed. I The Context In general, Americans consider themselves by and large healthy, satisfied with the quality of the services they receive, but dissatisfied with the way health care is delivered and concerned, in many cases deeply concerned, about the cost involved. Quality of Health Care: Quite High - Before discussing American attitudes on health care issues it is useful to look at how Americans rate their own health. Overall 37% rate their health as "excellent", 46% as "pretty good", 13% "only fair", and 4% "poor". When the excellent and pretty good categories are combined, 83% of Americans consider themselves to be generally healthy. - with the most positive being those 18 to 29 (90%), those earning $25,000 and above (91%), and the college educated (94%). When the "only fair" and "poor" categories are pulled together, the percentage is 17% for the country as a whole. However, certain groups show significantly greater concern - blacks (26%), Hispanics (21%), those 65 and over (36%), those earning under $15,000 (28%). (Table 1 - Q.8) Overall 84% say they are either "very satisfied" or "somewhat satisfied" with the quality of service they received in the last year, with 45% saying "very satisfied". The level of satisfaction (using the "very satisfactory" category as the key indicator) is highest among those earning more than $50,000 (54%), Republicans (54%), those with a postgraduate education (59%), and those who voted for President Bush (55%). It is lowest among blacks (36%), Hispanics (40%), those earning under $15,000 (40%), and those covered by an employer "play or pay" plan (39%). In terms of expressing actual dissatisfaction, three groups stand out - those earning less than $25,000 (17% either "somewhat" or "very dissatisfied"), those who rate their own health as negative (24%) are satisfied, and those who supported Ross Perot (18%). (Table 2, Q.1a) The survey also asked the cross-section of 1250 adults about whether there was any time in the last twelve months "when you or a member of your family needed or thought you needed health care and could not get it?" A full 90% say there was not such a time. Although the differences among key groups was fairly insignificant, a number of groups do say there was such a time more often than others: 15% in the West, 13% in the 18-29 age group, 14% of those earning under $15,000, and 17% of those who rate their own health negatively. (Table 3, Q.2a) Of the 10% who answer the question positively (that they or a family member could not get the health care they thought they needed): 7 out of 10 cite cost in one way or another. (Table 4, Q.2b) However the overall positive results do not mean the public is completely satisfied with the availability of health care. On the question of "the availability of the kind of health care you want" (Q.1b) the results are somewhat less positive, than 3 LH RESEARCH, INC. when it comes to the "quality of the service you received in the last year", with 74% saying they are either "very satisfied" or "somewhat satisfied", with only 38% saying they are "very satisfied". Again the level of those "very satisfied" is highest among those earning over $50,000 (52%), Republicans (51%), those voting for Bush (48%), and those with a postgraduate education (53%). The groups reporting the lowest "very satisfied" levels are blacks (28%), Hispanics (22%), those earning under $15,000 (28%), and those who rate their health negative. This last group has among the highest level of actual dissatisfaction (with 36% saying either "somewhat" or "very dissatisfied"), along with those earning below $15,000 (38%), and Hispanics (35%). (Table 5 - Q.1b) Cost of Health Care: A Problem: - When it comes to the cost of health care, the picture is quite different. By 53% to 43% the respondents say they are satisfied with "the cost of health care available to you." However, only 24% take the position that they are "very satisfied" with 26% saying they are "very dissatisfied". Interestingly blacks and Hispanics are somewhat more positive than the rest of the population (58% and 56% "very" or "somewhat satisfied"), probably because of Medicaid. The groups that are most dissatisfied are those 65 and over (35% "very dissatisfied"), those earning less than $15,000 a year (34% "very dissatisfied"), those who voted for Perot (35% "very dissatisfied"), and those who rate their own health negative (38% "very dissatisfied"). Interestingly, men are more dissatisfied with the cost of health care than are women (31% "very dissatisfied" compared to 22%). By region, the Midwest and South are the most dissatisfied (29% and 27% "very dissatisfied" respectively). Those earning over $35,000 (59% are either "very" or "somewhat satisfied"), and those with a postgraduate education (58% are either "very" or "somewhat satisfied"). However, 4 LH RESEARCH, INC. it needs to be emphasized that high percentages among many groups show real dissatisfaction with the cost of health care and that more people are "very dissatisfied" than are "very satisfied". (Table 6 - Q.1c) The results are somewhat more positive when it comes to "the health insurance plan available to you." Some 67% say they are either "very" or "somewhat satisfied." The most satisfied are the elderly (71%), the more affluent (72% among those earning $35,000 - $50,000 and 78% for those over $50,000), Republicans (73%), and those with college or postgraduate education (75% and 78% respectively). The least satisfied are those earning under $15,000 (52%) and those who rate their health negative (54%). (Table 7 - Q.1d) Observation: In general, when it comes to the quality and availability of health care, the public is positive. In fact, this bears out other Harris findings, which indicate that Americans and Canadians tend to be far more positive about the quality of care than residents of other industrial countries. However, there is clearly a disturbing gap in terms of income, education, race, and ethnicity - with blacks, Hispanics, and those earning under $15,000 far more critical than more affluent Americans. On health care costs, the response is very different and much more negative. On health insurance, the response is more positive, but still a significant 28% say they are either "very" or "somewhat dissatisfied". Consistently, those who believe they have the most health problems - those who rate their health negative - are the least satisfied with the care and coverage they receive. Status Quo in Health Care Overwhelmingly Rejected: - However, despite the generally positive views of care received, the public overwhelmingly opposes the system as it now exists. By 67% to 24%, a majority takes the view that the current health care system needs to be overhauled. This feeling is strongest in the West (71%), and among Hispanics (70%), those 30-49 years old (71%), those earning $35,000 to $50,000 (73%), Democrats (70%), Independents (73%), and Clinton and 5 LH RESEARCH, INC. Perot voters (75% and 73% respectively). Interestingly enough, the group most satisfied with existing health care - those with a post graduate education - are the most opposed to the existing system with better than three out of four (76%) taking that view. Only among those who oppose national health insurance do less than a majority hold this view, and even there a plurality (47-43%) oppose the present system. (Table 8 - Q.3a) The survey asked the public to choose between three different points of view about health care: "On the whole, the health care system works pretty well and only minor changes are necessary to make it work better"; "There are some good things in our health care system, but fundamental changes are needed to make it work better;" and "Our health care system has so much wrong with it that we need to completely rebuild it." Only 10% give the first answer, while 53% say they agree with the second and 36% with the third. That means 89% of the public opts for the idea of fundamental reform. In 1987, 29% agreed with the first, 47% with the second, and 19% with the third; In five years the number saying the system should be completely rebuilt nearly doubled, and the number supporting fundamental reform has gone up by 23 percentage points. The results are fairly uniform across the board, though fewer of those 18-29 years old (25%) opt for the third answer and more of those 65 and older (48%) do. One other interesting difference is a comparison of Clinton and Bush voters; among the former 42% take the more extreme position while only 25% of the latter do the same. (Table 9 - Q.5) Health Care a Top Priority: - When it comes to the issue of what kind of priority health care reform should get from President Clinton, the public is overwhelmingly 6 LH RESEARCH, INC. convinced that it should be a very high priority. Among adult Americans 47% believe it should have "the highest priority", and another 47% say it should have a "somewhat high priority". Only 5% say it should not have a high priority at all. The strongest in the view that it should have the highest priority are blacks (54%), Hispanics (58%), those 50-64 years of age (62%), those 65 and over (57%), those earning less than $15,000 a year (58%), those who rate their own health in negative terms (54%), and those who voted for Clinton (56%). In no case, not even among Bush voters, do more than 11% say it should not be a priority at all. (Table 10 - Q.7g) Even more positive is the response to the question of whether health care is a "fundamental right". Here by an 85-10% margin Americans believe it is. Strongest feelings are among blacks (93%), 18-29 year old (90%), those earning less than $15,000 (93%), and Clinton voters (91%). Women are more in agreement (89%) than men (81%). (Table 11 - Q.7h) Observation: All of this amounts to an overwhelming commitment to changing the existing system, with 89% supporting "fundamental change". In terms of the priority it is given, fully 94% gives it either a top or near-top priority. And, 85% of the public says that health care should be a "fundamental right". That the "quality of care received" during the last year is rated positively, as is "the availability of the kind of health care you want", does not mean the public is at all satisfied with the existing system. In fact, the situation is that while personally quite happy about the quality of their own care, Americans are profoundly committed to change, in no small measure because of the cost of health care. This feeling is strongest among the poor, blacks, Hispanics, and Clinton voters, but support for basic change runs through virtually all groups. 7 LH RESEARCH, INC. TABLE 1 - QUESTION 8 OVERALL RATING OF PERSONAL HEALTH PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE To- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% EXCELLENT/ 83% 87% 81% 81% 84% 85% 75% 79% 90% 85% 82% 64% 71% 78% 91% 91% 91% 88% 79% 80% PRETTY GOOD EXCELLENT 37% 39% 35% 39% 36% 39% 28% 34% 47% 41% 28% 20% 25% 29% 40% 42% 52% 46% 31% 36% PRETTY GOOD 46% 49% 45% 42% 48% 46% 47% 45% 42% 44% 55% 43% 46% 49% 51% 49% 39% 42% 48% 43% ONLY FAIR/POOR 17% 13% 19% 19% 14% 15% 26% 21% 9% 15% 18% 36% 28% 22% 10% 8% 9% 11% 21% 20% ONLY FAIR 13% 9% 14% 16% 13% 11% 18% 20% 7% 14% 12% 26% 21% 18% 8% 8% 6% 7% 16% 17% POOR 4% 4% 5% 3% 1% 3% 7% 2% 2% 1% 6% 11% 8% 4% 2% * 3% 3% 5% 3% NOT SURE * 2% * 1% 1% 1% * 1% * NO ANSWER 8 LH RESEARCH, INC. TABLE 1 - QUESTION 8 OVERALL RATING OF PERSONAL HEALTH HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% EXCELLENT/ 83% 82% 84% 94% 89% 84% 85% 83% 86% 80% 82% 77% 84% 81% 85% 86% 85% 81% 82% PRETTY GOOD EXCELLENT 37% 39% 35% 53% 53% 38% 34% 43% 41% 34% 36% 36% 36% 43% 39% 42% 42% 35% 37% PRETTY GOOD 46% 43% 48% 42% 35% 46% 50% 41% 45% 46% 46% 41% 47% 38% 45% 45% 43% 46% 45% ONLY FAIR/POOR 17% 18% 16% 5% 10% 15% 15% 17% 14% 100% 20% 18% 23% 16% 18% 15% 13% 15% 18% 17% ONLY FAIR 13% 15% 11% 5% 8% 12% 11% 14% 12% 78% 17% 14% 16% 14% 15% 13% 11% 13% 14% 13% POOR 4% 3% 4% 1% 2% 4% 5% 3% 2% 22% 2% 4% 6% 3% 4% 2% 3% 2% 4% 4% NOT SURE * * * 1% * 1% * * * * * * NO ANSWER 9 LH RESEARCH, INC. TABLE 2 - QUESTION 1A SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR - THE QUALITY OF THE SERVICE YOU RECEIVED PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% VERY/SOMEWHAT 84% 88% 80% 83% 85% 83% 85% 79% 81% 84% 85% 85% 79% 77% 88% 88% 90% 86% 85% 78% SATISFIED VERY SATISFIED 45% 47% 42% 44% 47% 46% 36% 40% 35% 44% 55% 48% 40% 41% 48% 44% 54% 54% 45% 39% SOMEWHAT 39% 41% 38% 39% 38% 37% 48% 38% 45% 40% 31% 37% 39% 36% 40% 43% 36% 32% 41% 39% SATISFIED SOMEWHAT/VERY 13% 11% 14% 12% 12% 12% 14% 12% 16% 12% 9% 14% 17% 17% 11% 9% 8% 8% 13% 16% DISSATISFIED SOMEWHAT 7% 8% 9% 5% 8% 8% 7% 9% 10% 7% 3% 9% 7% 8% 8% 8% 6% 6% 8% 7% DISSATISFIED VERY 5% 3% 6% 7% 4% 4% 7% 4% 5% 5% 6% 5% 10% 9% 3% 2% 2% 2% 5% 8% DISSATISFIED NOT SURE 4% 2% 5% 4% 3% 5% 1% 10% 3% 5% 5% 1% 5% 6% 3% 3% 1% 5% 2% 6% NO ANSWER 10 LH RESEARCH, INC. TABLE 2 - QUESTION 1A SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR - THE QUALITY OF THE SERVICE YOU RECEIVED HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% VERY/SOMEWHAT 84% 80% 87% 89% 91% 85% 86% 87% 77% 74% 81% 83% 83% 83% 88% 84% 87% 83% 84% 84% SATISFIED VERY SATISFIED 45% 41% 48% 53% 59% 46% 43% 55% 38% 45% 41% 44% 45% 42% 53% 39% 47% 43% 43% 45% SOMEWHAT 39% 39% 39% 35% 31% 39% 43% 32% 40% 28% 40% 39% 38% 41% 35% 45% 40% 40% 41% 38% SATISFIED SOMEWHAT/VERY 13% 16% 9% 8% 8% 12% 12% 10% 18% 24% 14% 13% 13% 13% 9% 13% 10% 13% 13% 13% DISSATISFIED SOMEWHAT 7% 8% 7% 6% 4% 7% 6% 7% 9% 13% 7% 8% 8% 8% 6% 7% 5% 6% 7% 7% DISSATISFIED VERY 5% 8% 3% 2% 4% 5% 5% 3% 9% 11% 7% 6% 5% 5% 4% 6% 5% 7% 5% 5% DISSATISFIED NOT SURE 4% 4% 4% 3% 1% 3% 2% 4% 5% 2% 5% 4% 4% 4% 2% 3% 3% 4% 4% 4% NO ANSWER 11 LH RESEARCH, INC. TABLE 3 - QUESTION 2A OCCURRENCE OF A NEED FOR HEALTH CARE THAT WAS NOT ATTENDED TO IN THE PAST 12 MONTHS PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% WAS SUCH A TIME 10% 7% 10% 8% 15% 9% 14% 10% 13% 10% 8% 8% 14% 10% 16% 7% 7% 7% 10% 13% NO SUCH TIME 90% 92% 90% 91% 85% 90% 85% 91% 87% 90% 92% 91% 86% 90% 85% 93% 93% 93% 90% 87% NOT SURE * 1% 1% * 1% 1% 1% 1% * 1% 1% 1% 1% NO ANSWER 12 LH RESEARCH, INC. TABLE 3 - QUESTION 2A OCCURRENCE OF A NEED FOR HEALTH CARE THAT WAS NOT ATTENDED TO IN THE PAST 12 MONTHS HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% WAS SUCH A TIME 10% 10% 10% 6% 8% 10% 11% 8% 12% 17% 11% 10% 10% 11% 6% 10% 11% 7% 10% 10% NO SUCH TIME 90% 90% 90% 94% 92% 89% 89% 91% 88% 83% 88% 90% 89% 88% 94% 90% 88% 93% 89% 89% NOT SURE * 1% * 1% * 1% 1% * 1% 1% * 1% 1% 1% * NO ANSWER 13 LH RESEARCH, INC. TABLE 4 - QUESTION 2B MAIN REASON FOR NOT GETTING THE HEALTH CARE NEEDED PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% WAS SUCH A TIME 10% 7% 10% 8% 15% 9% 14% 10% 13% 10% 8% 8% 14% 10% 16% 7% 7% 7% 10% 13% LACK OF MONEY 4% 2% 4% 4% 9% 4% 5% 3% 6% 5% 2% 5% 6% 5% 6% 4% 3% 5% 2% 6% COULDN' T AFFORD IT NO INSURANCE 2% 2% 3% 3% 1% 2% 6% 1% 3% 4% 1% 4% 2% 3% 1% 2% 1% 3% 2% COVERAGE FOR THE CONDITION COULDN'T GET 1% * 1% 3% 1% 5% 2% 1% * 1% 3% 1% * 1% 1% 2% DOCTOR'S APPOINTMENT COULDN'T GET INTO * * * * 1% 1% 1% 1% 1% HOSPITAL TOLD BY DOCTOR/ * 1% * * 1% 1% * 1% HOSPITAL CONDITION DIDN'T REQUIRE MEDICAL HELP DIDN'T HAVE * * * * 1% * 1% * * TRANSPORTATION TO DOCTOR/HOSPITAL DIDN'T KNOW WHERE * * * * * 1% * * * OR FROM WHOM TO GET MEDICAL HELP HAD INSURANCE BUT 1% * 1% * * 1% 1% * 1% 2% 1% 2% * * 1% 1% IT PAID ONLY PART OF THE BILL OTHER 1% 3% * 1% 1% 3% 1% 3% 1% 2% 1% * 1% 1% 1% NOT SURE * * * * 1% * 1% 1% 1% * * NO ANSWER NO SUCH TIME 90% 92% 90% 91% 85% 90% 85% 91% 87% 90% 92% 91% 86% 90% 85% 93% 93% 93% 90% 87% NOT SURE * 1% 1% * 1% 1% 1% 1% * 1% 1% 1% 1% NO ANSWER 14 LH RESEARCH, INC. TABLE 4 - QUESTION 2B MAIN REASON FOR NOT GETTING THE HEALTH CARE NEEDED HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% WAS SUCH A TIME 10% 10% 10% 6% 8% 10% 11% 8% 12% 17% 11% 10% 10% 11% 6% 10% 11% 7% 10% 10% LACK OF MONEY 4 % 5% 4% 3% 1% 4% 4% 4% 6% 7% 5% 4% 4% 5% 2% 5% 7% 3% 4% 5% COULDN' T AFFORD IT NO INSURANCE 2% 2% 2% 1% 3% 3% 3% 2% 2% 4% 3% 2% 2% 3% 2% 1% 2% 1% 3% 3% COVERAGE FOR THE CONDITION COULDN'T GET 1% 1% 1% 1% 1% 1% 1% 1% 2% * 1% 1% 1% 1% 1% 1% * 1% 1% DOCTOR'S APPOINTMENT COULDN'T GET INTO * 1% * 1% 1% * * * 1% * 1% * * HOSPITAL TOLD BY DOCTOR/ * * * * * 1% * * * * * * * HOSPITAL CONDITION DIDN'T REQUIRE MEDICAL HELP DIDN'T HAVE * * * * * * * * 1% * * * TRANSPORTATION TO DOCTOR/HOSPITAL DIDN'T KNOW WHERE * * * * * * * * * * OR FROM WHOM TO GET MEDICAL HELP HAD INSURANCE BUT 1% * 1% 1% 1% 1% 1% 2% 1% 1% 1% 1% 1% * * 1% * 1% * IT PAID ONLY PART OF THE BILL OTHER 1% 1% 1% 1% 1% 1% 1% 2% * 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% NOT SURE * * * 1% * * * 1% * * 1% * * * * * * * NO ANSWER NO SUCH TIME 90% 90% 90% 94% 92% 89% 89% 91% 88% 83% 88% 90% 89% 88% 94% 90% 88% 93% 89% 89% NOT SURE * 1% * 1% * 1% 1% 1% 1% * 1% 1% 1% * NO ANSWER 15 LH RESEARCH, INC. TABLE 5 - QUESTION 1B SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR - THE AVAILABILITY OF THE KIND OF HEALTH CARE YOU WANT PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% VERY/SOMEWHAT 74% 77% 75% 73% 72% 76% 73% 58% 71% 76% 78% 69% 55% 74% 77% 81% 86% 81% 74% 73% SATISFIED VERY SATISFIED 38% 41% 35% 41% 37% 41% 28% 22% 33% 38% 44% 40% 28% 33% 37% 43% 52% 51% 33% 35% SOMEWHAT 36% 36% 40% 32% 36% 35% 45% 36% 39% 38% 34% 29% 27% 42% 40% 37% 35% 30% 41% 38% SATISFIED SOMEWHAT/VERY 22% 19% 21% 23% 25% 20% 26% 35% 25% 21% 18% 24% 38% 21% 20% 18% 13% 17% 23% 23% DISSATISFIED SOMEWHAT 11% 9% 10% 12% 13% 11% 12% 17% 18% 12% 5% 7% 14% 11% 13% 11% 9% 8% 11% 12% DISSATISFIED VERY 11% 10% 10% 11% 12% 9% 14% 17% 7% 10% 13% 17% 24% 10% 7% 7% 4% 9% 12% 11% DISSATISFIED NOT SURE 4% 4% 5% 3% 2% 4% 1% 8% 4% 2% 5% 7% 7% 4% 4% 1% 1% 2% 4% 4% NO ANSWER 16 LH RESEARCH, INC. TABLE 5 - QUESTION 1B SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR - THE AVAILABILITY OF THE KIND OF HEALTH CARE YOU WANT HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% VERY/SOMEWHAT 74% 73% 76% 85% 88% 77% 74% 82% 75% 61% 70% 74% 73% 73% 83% 76% 81% 76% 73% 75% SATISFIED VERY SATISFIED 38% 37% 40% 49% 53% 40% 36% 48% 38% 26% 35% 37% 37% 35% 52% 35% 40% 35% 36% 39% SOMEWHAT 36% 36% 36% 37% 34% 36% 38% 34% 37% 35% 34% 37% 36% 38% 31% 42% 41% 40% 38% 36% SATISFIED SOMEWHAT/VERY 22% 24% 20% 13% 13% 21% 23% 16% 24% 36% 26% 22% 24% 23% 15% 21% 16% 19% 23% 21% DISSATISFIED SOMEWHAT 11% 11% 11% 6% 7% 9% 11% 6% 11% 13% 10% 11% 11% 12% 8% 12% 10% 8% 12% 10% DISSATISFIED VERY 11% 13% 9% 6% 4 % 11% 12% 10% 13% 23% 17% 11% 13% 11% 7% 9% 6% 11% 11% 11% DISSATISFIED NOT SURE 4% 3% 4% 2% 1% 3% 4% 3% 2% 2% 4% 4% 3% 4% 2% 3% 3% 5% 4% 4% NO ANSWER 17 LH RESEARCH, INC. TABLE 6 - QUESTION 1C SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR - THE COST OF THE HEALTH CARE AVAILABLE TO YOU PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% VERY/SOMEWHAT 53% 61% 49% 50% 57% 53% 58% 56% 55% 51% 55% 51% 48% 51% 51% 59% 58% 57% 58% 46% SATISFIED VERY SATISFIED 24% 24% 26% 25% 21% 25% 23% 22% 22% 20% 31% 33% 22% 22% 22% 28% 29% 30% 27% 18% SOMEWHAT 29% 37% 23% 26% 36% 27% 35% 34% 34% 32% 24% 17% 27% 29% 30% 31% 29% 28% 32% 28% SATISFIED SOMEWHAT/VERY 43% 37% 46% 45% 41% 43% 38% 38% 39% 46% 40% 45% 46% 45% 46% 39% 38% 41% 37% 50% DISSATISFIED SOMEWHAT 16% 12% 16% 18% 18% 18% 12% 14% 18% 18% 15% 11% 12% 16% 17% 17% 21% 17% 15% 16% DISSATISFIED VERY 26% 24% 29% 27% 22% 25% 26% 23% 22% 28% 24% 35% 34% 29% 29% 22% 17% 24% 23% 34% DISSATISFIED NOT SURE 4% 3% 6% 4% 2% 4% 4% 8% 5% 3% 6% 5% 6% 5% 3% 2% 4% 2% 4% 5% NO ANSWER 18 LH RESEARCH, INC. TABLE 6 - QUESTION 1C SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR - THE COST OF THE HEALTH CARE AVAILABLE TO YOU HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% VERY/SOMEWHAT 53% 47% 58% 55% 58% 50% 51% 55% 41% 48% 47% 52% 54% 51% 62% 55% 54% 51% oto 54% 53% SATISFIED VERY SATISFIED 24% 21% 27% 26% 26% 24% 25% 27% 17% 23% 22% 23% 25% 22% 32% 23% 25% 21% 23% 24% SOMEWHAT 29% 26% 31% 28% 32% 26% 26% 28% 23% 25% 26% 29% 29% 29% 31% 31% 29% 30% 31% 28% SATISFIED SOMEWHAT/VERY 43% 49% 38% 43% 41% 46% 45% 43% 53% 48% 49% 44% 43% 45% 34% 41% 42% 44% 42% 44% DISSATISFIED SOMEWHAT 16% 17% 16% 23% 23% 18% 19% 16% 19% 10% 13% 17% 14% 17% 18% 18% 17% 19% 15% 17% DISSATISFIED VERY 26% 31% 22% 19% 17% 28% 26% 28% 35% 38% 35% 27% 28% 28% 17% 23% 25% 25% 26% 27% DISSATISFIED NOT SURE 4% 4% 4% 2% 2% 3% 4% 2% 6% 5% 4% 4% 3% 5% 3% 4% 3% 4% 5% 4% NO ANSWER 19 LH RESEARCH, INC. TABLE 7 - QUESTION 1D SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR - THE HEALTH INSURANCE PLAN AVAILABLE TO YOU PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- - $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% VERY/SOMEWHAT 67% 73% 62% 67% 68% 68% 69% 63% 67% 66% 66% 71% 52% 63% 70% 72% 78% 73% 69% 60% SATISFIED VERY SATISFIED 32% 34% 31% 31% 30% 34% 26% 23% 30% 29% 33% 40% 26% 31% 30% 31% 42% 40% 32% 28% SOMEWHAT 35% 39% 31% 36% 38% 34% 43% 40% 37% 37% 32% 30% 26% 33% 41% 41% 36% 33% 37% 33% SATISFIED SOMEWHAT/VERY 28% 24% 32% 29% 24% 27% 30% 28% 25% 30% 29% 27% 40% 33% 28% 25% 19% 23% 26% 35% DISSATISFIED SOMEWHAT 13% 10% 13% 15% 11% 13% 14% 8% 11% 14% 13% 11% 11% 12% 14% 15% 12% 9% 13% 15% DISSATISFIED VERY 15% 14% 19% 15% 13% 14% 16% 20% 13% 16% 16% 16% 29% 21% 14% 9% 7% 14% 13% 20% DISSATISFIED NOT SURE 5% 2% 6% 3% 8% 5% 1% 9% 7% 4% 5% 2% 8% 4% 3% 4% 3% 4% 5% 5% NO ANSWER 20 LH RESEARCH, INC. TABLE 7 - QUESTION 1D SATISFACTION WITH HEALTH CARE SERVICES USED IN THE PAST YEAR - THE HEALTH INSURANCE PLAN AVAILABLE TO YOU HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% of 100% or 100% oto 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% VERY/SOMEWHAT 67% 67% 68% 75% 77% 67% 66% 72% 62% 54% 59% 65% oto 66% 66% 74% oto 67% 71% 66% 65% 66% SATISFIED VERY SATISFIED 32% 29% 34% 36% 34% 32% 31% 38% 24% 23% 29% 30% 31% 29% 41% 30% 32% 33% 30% 32% SOMEWHAT 35% 37% 33% 39% 43% 35% 35% 34% 38% 32% 31% 35% 35% 37% 33% 36% 39% 33% 35% 34% SATISFIED SOMEWHAT/VERY 28% 30% 26% 23% 22% 29% 30% 24% 34% 41% 36% 30% 30% 29% 22% 27% 25% 29% 30% 29% DISSATISFIED SOMEWHAT 13% 13% 13% 12% 15% 13% 14% 11% 15% 12% 15% 14% 11% 14% 11% 14% 12% op 11% 13% 14% DISSATISFIED VERY 15% 17% 14% 11% 7% 16% 16% 14% 19% 29% 21% 16% 18% 15% 11% 13% 13% 18% 17% 15% DISSATISFIED NOT SURE 5% 3% 6% 2% 1% 4% 4% 4% 5% 4% 5% 5% 4% 5% 4% 7% 4% 6% 6% 5% NO ANSWER 21 LH RESEARCH, INC. TABLE 8 - QUESTION 3A WHETHER FAVOR/OPPOSE PRESENT HEALTH CARE SYSTEM PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 24% 25% 25% 26% 19% 24% 30% 19% 32% 23% 23% 17% 25% 25% 22% 22% 28% 34% 22% 18% OPPOSE 67% 69% 66% 64% 71% 67% 62% 70% 60% 71% 68% 67% 66% 69% 68% 73% 66% 56% 70% 73% NOT SURE 9% 6% 9% 10% 10% 10% 8% 10% 8% 7% 9% 16% 9% 7% 11% 5% 6% 10% 8% 9% NO ANSWER 22 LH RESEARCH, INC. TABLE 8 - QUESTION 3A WHETHER FAVOR/OPPOSE PRESENT HEALTH CARE SYSTEM HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 24% 28% 20% 26% 18% 22% 16% 32% 20% 27% 16% 22% 21% 20% 44% 26% 27% 25% 22% 23% OPPOSE 67% 66% 67% 67% 76% 69% 75% 58% 73% 64% 76% 69% 67% 73% 47% 68% 67% 67% 70% 69% NOT SURE 9% 5% 12% 8% 6% 9% 9% 10% 8% 9% 8% 9% 12% 8% 8% 7% 7% 9% 8% 8% NO ANSWER 23 LH RESEARCH, INC. TABLE 9 - QUESTION 5 OVERALL VIEW OF THE HEALTH CARE SYSTEM IN THIS COUNTRY PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% ON THE WHOLE, THE 10% 10% 9% 11% 10% 10% 9% 11% 13% 9% 10% 5% 7% 6% 7% 14% 14% 15% 9% 7% HEALTH CARE SYSTEM WORKS PRETTY WELL AND ONLY MINOR CHANGES ARE NECESSARY TO MAKE IT WORK BETTER THERE ARE SOME GOOD 53% 51% 51% 56% 52% 53% 50% 53% 61% 55% 43% 45% 51% 50% 52% 55% 59% 56% 52% 51% THINGS IN OUR HEALTH CARE SYSTEM, BUT FUNDAMENTAL CHANGES ARE NEEDED TO MAKE IT WORK BETTER OUR HEALTH CARE 36% 38% 38% 32% 36% 36% 37% 35% 25% 33% 46% 48% 41% 44% 39% 30% 24% 28% 37% 41% SYSTEM HAS so MUCH WRONG WITH IT THAT WE NEED TO COMPLETELY REBUILD IT NOT SURE 2% 2% 3% 1% 2% 2% 4% 3% 1% 3% 2% 2% * 1% 3% 1% 2% 1% 3% 1% NO ANSWER 24 LH RESEARCH, INC. TABLE 9 - QUESTION 5 OVERALL VIEW OF THE HEALTH CARE SYSTEM IN THIS COUNTRY HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% ON THE WHOLE, THE 10% 14% 6% 10% 11% 9% 6% 16% 5% 13% 5% 8% 7% 6% 26% 10% 10% 8% 8% 9% HEALTH CARE SYSTEM WORKS PRETTY WELL AND ONLY MINOR CHANGES ARE NECESSARY TO MAKE IT WORK BETTER THERE ARE SOME GOOD 53% 47% 58% 63% 60% 54% 49% 59% 57% 43% 43% 53% 48% 51% 55% 55% 54% 55% 54% 54% THINGS IN OUR HEALTH CARE SYSTEM, BUT FUNDAMENTAL CHANGES ARE NEEDED TO MAKE IT WORK BETTER OUR HEALTH CARE 36% 38% 34% 24% 28% 36% 42% 25% 38% 42% 50% 38% 43% 41% 17% 33% 35% 35% 36% 36% SYSTEM HAS so MUCH WRONG WITH IT THAT WE NEED TO COMPLETELY REBUILD IT NOT SURE 2% 2% 2% 1% 1% 2% 3% 1% 1% 2% 2% 2% 2% 1% 2% 2% 1% 1% 2% 1% NO ANSWER 25 LH RESEARCH, INC. TABLE 10 - QUESTION 7G PRIORITY CLINTON ADMINISTRATION SHOULD GIVE TO HEALTH CARE REFORM PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% THE HIGHEST PRIORITY 47% 48% 49% 44% 47% 45% 54% 58% 35% 43% 62% 57% 58% 45% 46% 43% 42% 32% 56% 48% SOMWEHAT HIGH PRIORITY 47% 46% 44% 51% 44% 48% 40% 37% 61% 50% 31% 35% 38% 48% 48% 52% 50% 56% 41% 47% NOT A HIGH PRIORITY 5% 3% 4% 5% 7% 5% 5% 3% 4% 5% 6% 3% 1% 5% 6% 4% 8% 9% 1% 5% AT ALL NOT SURE 2% 2% 3% 1% 1% 2% 1% 3% 1% 2% 2% 6% 2% 2% 2% 1% * 2% 2% 1% NO ANSWER 26 LH RESEARCH, INC. TABLE 10 - QUESTION 7G PRIORITY CLINTON ADMINISTRATION SHOULD GIVE TO HEALTH CARE REFORM HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% THE HIGHEST PRIORITY 47% 43% 50% 38% 45% 46% 56% 33% 45% 54% 100% 52% 67% 54% 27% 45% 42% 48% 51% 50% SOMWEHAT HIGH PRIORITY 47% 48% 45% 55% 50% 47% 42% 54% 52% 39% 44% 30% 44% 54% 52% 51% 48% 45% 46% NOT A HIGH PRIORITY 5% 7% 2% 6% 6% 5% 1% 11% 3% 5% 2% 1% 1% 17% 2% 6% 3% 2% 3% AT ALL NOT SURE 2% 1% 3% 1% 1% 1% 2% 1% 2% 2% 2% 1% 2% 1% 1% 1% 1% 1% NO ANSWER 27 LH RESEARCH, INC. TABLE 11 - QUESTION 7H WHETHER HEALTH CARE IS A FUNDAMENTAL RIGHT PARTY AFFILIATION REGION RACE AGE INCOME RE INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15 $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% SHOULD BE A 85% 89% 85% 82% 86% 83% 93% 83% 90% 84% 85% 81% 93% 89% 82% 82% 77% 74% 91% 88% FUNDAMENTAL RIGHT SHOULD NOT BE A 10% 7% 11% 12% 9% 11% 6% 9% 7% 12% 12% 7% 5% 6% 11% 13% 20% 20% 6% 7% FUNDAMENTAL RIGHT NOT SURE 5% 4% 4% 5% 5% 6% 1% 9% 3% 4% 3% 13% 2% 5% 7% 5% 3% 6% 4% 5% NO ANSWER 28 LH RESEARCH, INC. TABLE 11 - QUESTION 7H WHETHER HEALTH CARE IS A FUNDAMENTAL RIGHT HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% SHOULD BE A 85% 81% 89% 81% 82% 84% 91% 72% 86% 90% 94% 100% 92% 91% 67% 87% 83% 85% 90% 88% FUNDAMENTAL RIGHT SHOULD NOT BE A 10% 16% 4% 16% 15% 11% 6% 21% 9% 5% 4% 3% 5% 28% 9% 14% 11% 7% 8% FUNDAMENTAL RIGHT NOT SURE 5% 3% 6% 3% 3% 5% 4% 6% 5% 5% 2% 5% 4% 5% 4% 4% 3% 3% 4% NO ANSWER 29 LH RESEARCH, INC. II The Nature of the Mandate for Change In order to explore the nature of the mandate for change, the survey asked about a number of different potential models. First, it asked all people interviewed, "One alternative is a system of national health insurance, under which the government pays all the bills, with the patient not paying any of the bills directly. However, the government would pay a set amount for each service that people receive from their doctor and hospital, thereby controlling health care costs. Each person could choose his or her own doctor or hospital, much as they do now. Would you favor or oppose this system?" A full 70% say they would support such a national health care system, with 20% opposed and 10% not sure. Strongest support is in the East (76%), among blacks (82%), young people 18-29 (76%), those with incomes below $25,000, Democrats (79%), and Clinton supporters (79%). Lowest support comes from Republicans (54%), Bush voters (50%), and the college educated (51%). However, 65% of those with a postgraduate education support it. Though a very strong result, it is slightly lower than the response to a similar question asked in November of 1991 when 79% said they favored such an approach and 19% said they opposed it. (Table 12 - Q.3b) Second, the survey asked about a "play or pay" approach to health insurance: "Another alternative is a system under which each employer would have to pay for health insurance for the employees of that company or organization, and, if an employer does not pay for such a plan, then the employer is taxed an amount equal to what it would cost to pay for health insurance, and the insurance would be provided 30 LH RESEARCH, INC. by the government. This plan would not cover the costs of long term care, including nursing home or in-home care. Would you favor or oppose this system?" (Q.3c) The "play or pay" approach to health care found 33% in favor, compared to 56% against, with 11% undecided. Those most in favor include Hispanics (45%) and those 18-29 (47%), perhaps in both cases because their relative youth means that long term care is of less importance. Those most opposed are those 50-64 years old (68%), those 65 and over (66%) and those earning over $50,000 a year (64%). (Table 13 - Q.3c) Third, the study examined a "Managed Care" option. The questionnaire put forward the following proposal and asked for the public's reaction: "Another plan is called Managed Competition, under which large health maintenance organizations would be encouraged to provide most of the health care in the country. They would compete with others in the same community for people's business. At the same time, the government would set prices for all health services received. The privately owned HMO's would guarantee everyone signed up in them full doctor and hospital services, although under some HMO's, patients may not have the same doctors to take care of them. The plan would not include costs of long-term care including nursing home or in-home care. Would you favor or oppose such a system?" By 59-30% Americans reject such an approach. Those most strongly in favor (though it should be stressed that among no group is there a majority in support), are people earning $25,000 - $35,000 (38%) and those with a postgraduate education (40%). Those most opposed include blacks (65%), Americans 65 years old and above (65%), those earning under $15,000 (63%), and Clinton voters (64%). In both, the case of "managed care" and "pay and play" those who are most concerned about the 31 LH RESEARCH, INC. importance of long-term care are the strongest in opposition (66%) in the case of the former and (55%) in the case of the latter. (Table 14 - Q.3d) A fourth proposition was put forward - another version of the concept of "managed care" - involving the use of a payroll tax. The question put to respondents was as follows: "Finally, another system of health care would also encourage people to sign up in special organizations approved by the government, representing large numbers of people. These sponsor organizations, as they would be called, would then drive bargains for their members with private health maintenance organizations. All medical costs would be paid for by a payroll tax on each employer and employee, which would go into a fund regulated by the government, individual sponsoring organizations would then offer their members two HMO's to choose from, deciding which would appeal to them more. If a person wanted more services beyond the basics, they could pay more for more extensive coverage. This plan would not cover the costs of long-term care, including nursing home or in-home care. Would you favor or oppose such a system?" The results are very similar to those in the previous two questions - 59% opposed, 30% in favor. Those most in favor include the young (37%), Hispanics (35%), and those earning over $50,000 (35%), and then those with a postgraduate education (35%). In no case, does a majority of any group support the proposal. Those most opposed are blacks (64%) and those earning $35,000 - $50,000 (64%). (Table 15 - Q.3e) Then a fifth, and final, general proposition was put forward - Universal Medicare Coverage: "Another plan would create a health security system similar to Social Security. Like Social Security, Medicare would expand to include people of all ages. 32 LH RESEARCH, INC. Everyone would pay into the health security program during their working years in exchange for comprehensive and long-term care protection when they are unemployed, retired, disabled, or chronically ill. Employers would be required to provide the same comprehensive package of benefits as the public health security program either through private insurance or by buying into the public plan. Comprehensive budgeting to control costs would be an important part of this plan, as would quality control provisions. Would you favor or oppose such a system?" (Q.3f) Nearly two-thirds (66%) favor such a system while 26% are opposed and 8% undecided. Those most favorable are blacks (81%), Hispanics (77%), Clinton supporters (72%), and those who give long-term care a high priority (74%). Most opposed are those earning over $50,000 (37%), Republicans (37%), the college educated (39%), those with a postgraduate education (42%), and Bush supporters (40%). (Table 16 - Q.3f) Observation: While these options do not include all possible health care alternatives, they do represent the major ones being discussed now in Washington. The results show overwhelming support for national health insurance, with a choice of a doctor or hospital. Medicare expansion is only slightly behind national health care in terms of broad public support. The "play or pay" option lacks support, as do two variations of "managed care". In the three options voted down there would be no long term care component - no doubt a significant factor in their defeat. The study also looked specifically at attitudes toward two models of national health insurance the British and the Canadian - compared to the "system we have here". The survey described the British system as one in which "the government pays most of the cost of health care, for everyone out of taxes, and the doctors and 33 LH RESEARCH, INC. hospitals work for the government" and in which "people can choose their family doctors but not their specialist or hospitals." Some 35% say they would favor the British system while 58% say they would "favor the system we have here." The most positive about the British system are those 18-29 years old (41%), those earning $15,000 - $25,000 (42%), and Perot voters (44%), and Independents (42%). Those most opposed are the elderly (68%), Republicans (71%), Hispanics (64%), and Bush voters (73%). (Table 17 - Q.6A) In the case of the Canadian system the survey described it this way, II the government pays most of the cost of health care for everyone out of taxes, and the government sets all fees charged by doctors and hospitals. Under the Canadian system people can choose their own doctors and hospitals." Here the results are very different with 66% preferring the Canadian system and 30% "the system we have here". Support is greatest for the Canadian system among those 18-29 years old (71%), those earning $25,000 to $35,000 (71%), Democrats (76%), Independents (72%), those who give long term health care a priority (71%), those with postgraduate education (73%), and Clinton supporters (78%). Those most negative include those over 65 (38%), the college educated (40%), Republicans, and Bush voters (both 50%). (Table 18 - Q.6b) Observation: While Americans are clearly in favor of more fundamental change than is being discussed in Washington, they are not indiscriminate about the change they want. Yes, they support a single payer system, but they also want choice. Generally those most concerned about the cost of medical care are the most supportive of sweeping change, but significantly other groups are also strongly for it, for example those 18 to 29 years old and those with a postgraduate education. By any token, there are strong majorities in favor of a system of national health insurance, whether through an extension of Medicare or moving toward the Canadian system. Other commonly mentioned alternatives simply do not command substantial support. 34 LH RESEARCH, INC. TABLE 12 - QUESTION 3B WHETHER FAVOR/OPPOSE NATIONAL HEALTH INSURANCE PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 70% 76% 68% 68% 69% 67% 82% 73% 78% 66% 68% 70% 77% 74% 70% 69% 61% 54% 79% 72% OPPOSE 20% 16% 21% 22% 20% 22% 13% 11% 17% 23% 20% 16% 16% 17% 19% 20% 31% 33% 12% 18% NOT SURE 10% 9% 11% 9% 11% 11% 6% 16% 5% 11% 13% 14% 8% 10% 11% 12% 9% 13% 9% 10% NO ANSWER 35 LH RESEARCH, INC. TABLE 12 - QUESTION 3B WHETHER FAVOR/OPPOSE NATIONAL HEALTH INSURANCE HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 70% 66% 73% 51% 65% 67% 79% 50% 65% 67% 80% 75% 80% 100% 74% 67% 68% 76% 72% OPPOSE 20% 25% 15% 35% 28% 22% 10% 39% 22% 22% 11% 16% 11% 100% 20% 25% 22% 15% 19% NOT SURE 10% 8% 12% 13% 7% 11% 11% 11% 14% 11% 8% 10% 9% 6% 8% 9% 9% 9% NO ANSWER 36 LH RESEARCH, INC. TABLE 13 - QUESTION 3C WHETHER FAVOR/OPPOSE "EMPLOYER PLAY OR PAY" PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 33% 33% 37% 30% 29% 32% 35% 45% 47% 34% 24% 17% 34% 33% 35% 38% 28% 32% 37% 30% OPPOSE 56% 57% 52% 58% 61% 57% 57% 39% 46% 53% 68% 66% 55% 53% 58% 53% 64% 57% 54% 57% NOT SURE 11% 10% 12% 12% 10% 11% 8% 16% 7% 13% 8% 17% 11% 15% 7% 9% 7% 10% 9% 13% NO ANSWER 37 LH RESEARCH, INC. TABLE 13 - QUESTION 3C WHETHER FAVOR/OPPOSE "EMPLOYER PLAY OR PAY" HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 33% 36% 30% 34% 32% 31% 32% 28% 35% 29% 32% 34% 31% 35% 33% 100% 44% 41% 39% 36% OPPOSE 56% 56% 56% 59% 58% 58% 59% 59% 55% 53% 57% 55% 55% 55% 61% 48% 50% 50% 55% NOT SURE 11% 8% 14% 7% 9% 11% 9% 13% 10% 18% 12% 11% 14% 10% 6% 8% 8% 11% 10% NO ANSWER 38 LH RESEARCH, INC. TABLE 14 - QUESTION 3D WHETHER FAVOR/OPPOSE "MANAGED CARE" PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 29% 32% 26% 29% 35% 30% 29% 26% 33% 32% 27% 20% 22% 34% 38% 32% 29% 35% 26% 27% OPPOSE 59% 58% 62% 60% 52% 58% 65% 60% 58% 57% 59% 65% 63% 56% 53% 62% 60% 53% 63% 62% NOT SURE 12% 10% 13% 11% 13% 12% 6% 14% 9% 11% 14% 14% 15% 10% 10% 6% 12% 12% 11% 12% NO ANSWER 39 LH RESEARCH, INC. TABLE 14 - QUESTION 3D WHETHER FAVOR/OPPOSE "MANAGED CARE" " HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 29% 35% 24% 34% 40% 30% 26% 34% 33% 23% 26% 29% 23% 28% 37% 39% 100% 45% 27% 31% OPPOSE 59% 55% 62% 54% 56% 58% 64% 54% 51% 62% 62% 60% 66% 62% 54% 52% 44% 62% 58% NOT SURE 12% 9% 14% 12% 5% 11% 9% 12% 16% 15% 12% 12% 10% 9% 9% 9% 11% 11% 10% NO ANSWER 40 LH RESEARCH, INC. TABLE 15 - QUESTION 3E WHETHER FAVOR/OPPOSE "HMO SPONSOR" PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25 $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 30% 35% 28% 30% 30% 30% 30% 35% 37% 29% 29% 25% 30% 34% 28% 27% 35% 32% 31% 29% OPPOSE 59% 58% 62% 59% 53% 58% 64% 58% 55% 60% 60% 60% 58% 55% 59% 64% 55% 55% 60% 59% NOT SURE 11% 8% 10% 12% 18% 12% 6% 8% 8% 12% 12% 15% 12% 11% 13% 9% 11% 13% 9% 12% NO ANSWER 41 LH RESEARCH, INC. TABLE 15 - QUESTION 3E WHETHER FAVOR/OPPOSE "HMO SPONSOR" HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 0/0 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 30% 33% 27% 31% 35% 31% 30% 32% 33% 27% 31% 30% 26% 30% 34% 38% 46% 100% 34% 31% OPPOSE 59% 58% 59% 59% 53% 58% 60% 56% 55% 62% 58% 58% 62% 60% 57% 53% 41% 56% 58% NOT SURE 11% 9% 13% 11% 11% 11% 10% 12% 13% 11% 11% 11% 12% 10% 10% 9% 13% 10% 11% NO ANSWER 42 LH RESEARCH, INC. TABLE 16 - QUESTION 3F WHETHER FAVOR/OPPOSE "MEDICARE EXPANSION" " PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15 $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 66% 72% 67% 63% 61% 63% 81% 77% 71% 65% 68% 55% 67% 71% 63% 71% 56% 56% 74% 67% OPPOSE 26% 21% 25% 29% 29% 28% 16% 17% 25% 27% 23% 29% 23% 19% 28% 26% 37% 37% 19% 23% NOT SURE 8% 7% 9% 9% 9% 9% 4% 6% 4% 8% 9% 15% 10% 9% 10% 4% 7% 7% 7% 10% NO ANSWER 43 LH RESEARCH, INC. TABLE 16 - QUESTION 3F WHETHER FAVOR/OPPOSE "MEDICARE EXPANSION" HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 65% 64% 67% 51% 55% 64% 72% 52% 63% 71% 71% 70% 74% 72% 49% 77% 61% 74% 100% 70% OPPOSE 25% 30% 22% 39% 42% 28% 22% 40% 26% 21% 21% 23% 17% 21% 45% 19% 30% 21% 23% NOT SURE 8% 6% 11% 10% 4% 8% 7% 9% 11% 8% 7% 7% 9% 8% 6% 4% 9% 5% 7% NO ANSWER 44 LH RESEARCH, INC. TABLE 17 - QUESTION 6A PREFERENCE FOR THE BRITISH NATIONAL HEALTH CARE SYSTEM OR THE HEALTH CARE SYSTEM WE NOW HAVE IN THIS COUNTRY PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% BRITISH SYSTEM 35% 37% 32% 33% 39% 35% 36% 31% 41% 34% 35% 25% 33% 42% 39% 35% 28% 23% 36% 42% SYSTEM WE HAVE HERE 58% 55% 61% 59% 55% 58% 57% 64% 55% 59% 55% 68% 61% 50% 55% 58% 68% 71% 58% 48% NOT SURE 7% 8% 7% 8% 6% 7% 6% 5% 4% 7% 10% 7% 6% 8% 8% 7% 4% 6% 6% 10% NO ANSWER 45 LH RESEARCH, INC. TABLE 17 - QUESTION 6A PREFERENCE FOR THE BRITISH NATIONAL HEALTH CARE SYSTEM OR THE HEALTH CARE SYSTEM WE NOW HAVE IN THIS COUNTRY HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% BRITISH SYSTEM 35% 38% 31% 32% 36% 35% 40% 22% 44% 31% 41% 38% 37% 41% 17% 38% 38% 34% 38% 38% SYSTEM WE HAVE HERE 58% 55% 61% 60% 58% 58% 53% 73% 47% 63% 52% 55% 55% 51% 80% 55% 54% 60% 56% 55% NOT SURE 7% 7% 7% 8% 6% 7% 7% 6% 10% 6% 7% 7% 8% 7% 4% 7% 8% 5% 6% 7% NO ANSWER 46 LH RESEARCH, INC. TABLE 18 - QUESTION 6B PREFERENCE FOR THE CANADIAN SYSTEM OF NATIONAL HEALTH INSURANCE OR THE HEALTH CARE SYSTEM WE NOW HAVE IN THIS COUNTRY PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15 $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% CANADIAN SYSTEM 66% 70% 66% 63% 67% 65% 70% 60% 71% 67% 63% 60% 65% 69% 71% 67% 59% 46% 76% 72% SYSTEM WE HAVE HERE 30% 27% 30% 35% 27% 31% 29% 37% 26% 29% 32% 38% 34% 28% 27% 29% 37% 50% 22% 24% NOT SURE 4% 3% 4% 2% 6% 4% 2% 4% 3% 4% 5% 2% 2% 3% 3% 4% 4% 4% 3% 4% NO ANSWER 47 LH RESEARCH, INC. TABLE 18 - QUESTION 6B PREFERENCE FOR THE CANADIAN SYSTEM OF NATIONAL HEALTH INSURANCE OR THE HEALTH CARE SYSTEM WE NOW HAVE IN THIS COUNTRY HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% CANADIAN SYSTEM 66% 64% 69% 57% 73% 66% 78% 46% 70% 61% 78% 71% 71% 77% 34% 70% 64% 66% 71% 69% SYSTEM WE HAVE HERE 30% 33% 28% 40% 24% 30% 20% 50% 24% 36% 20% 25% 26% 20% 63% 27% 33% 31% 26% 28% NOT SURE 4% 3% 4% 3% 3% 4% 2% 5% 6% 3% 2% 4% 3% 3% 3% 3% 3% 4% 3% 3% NO ANSWER 48 LH RESEARCH, INC. III Health Care Priorities On a scale of one to five, the public was asked to rate the importance of a variety of services in our health care system. On top, with 67% rating it a "one" or "very important" is "hospitals that really care about the patients", followed by preventive care (61%), "fast, convenient outpatient care" (46%), long term home care (33%), long term nursing home care (33%), "unlimited availability of such care as kidney dialysis, organ transplants, and plastic surgery" (33%), "long or extended hospital stays," (30%) and extensive testing of patients (23%). Interestingly, if home care and nursing home care are combined, long term care, with 66%, would rank second to "hospitals that really care about the patients." Rating on a Scale of 1-5 of Health Care Priorities 1 2 3 4 5 Not sure Hospitals that really care about the patients 67 11 9 4 7 2 Preventive care 51 20 16 5 5 2 Fast, convenient outpatient care 46 22 17 7 6 3 Long term home care 33 23 26 8 8 3 Long term nursing home care 33 22 24 10 7 3 Long or extended hospital stays 30 24 25 9 7 5 49 LH RESEARCH, INC. (Table continued) Rating on a Scale of 1-5 of Health Care Priorities 1 2 3 4 5 Not sure Unlimited availability of such care as kidney dialysis, organ transplants, & plastic surgery 33 21 24 9 10 4 Extensive testing of patients 23 20 31 11 10 4 The importance of each of these priorities varies significantly among key groups: Hospitals that Really Care about the Patients (67% total): This is of higher than average concern to a number of groups: blacks (74%), those over 65 (70%), those earning over $50,000 (71%), women (70%), the college educated (72%), Clinton voters (71%), and those who rate their own health in negative terms (73%). Preventive Care (51% total): - This is of greatest importance to those in the West (61%), those fifty and older (56%), those earning more than $35,000 (56%), those with a postgraduate education (67%), and those who rate their own health poorly (46%). Fast, Convenient Outpatient Care (46% total): This is of greatest concern to those in the West (52%), those fifty and older (55%), those earning $35,000 and over (52%), those with a postgraduate education (57%), and those who rate their own health negative (53%). 50 LH RESEARCH, INC. Long Term Home Care (33% total): - Here the groups showing the greatest concern are blacks (52%) and those over 65 (49%), those earning less than $15,000 (43%), women (39%), and Clinton supporters (38%). Long Term Nursing Home Care (33% total): - This issue raises the greatest concern among blacks (60%), those 50-64 years old (40%), those 65 and older (46%), those earning less than $15,000 (42%), women (39%), and those who rate their own health negative (41%). Interestingly, only 22% of those in the West see this as a priority concern. This is also true of Westerners' attitudes about home care; only 24% give it top priority. Unlimited Availability of such Care as Kidney Dialysis, Organ Transplants, and Plastic Surgery (33% total): - Here the most concerned are blacks (44%), those 65 years old and above (39%), and those who rate their own health negative (41%). Long or Extended Hospital Stays (30% total): - The most concerned about this issue are blacks (48%), and those 50-64 years old (40%). Extensive Testing of Patients (23% total): - The greatest emphasis on this as a priority is among blacks (35%), and those earning under $15,000 (34%). Interestingly the college educated (15%) and those with postgraduate education (17%) are the lowest. (Table 19 - Q.4a) Observation: While this information could be examined in a myriad of ways, for the purpose of this study it should be looked at as a barometer of the American public's concerns about the health care system. Clearly three concerns stand out - hospital quality, preventive care (combining the concern emphasis placed on outpatient care as well as preventive care), and long term care (especially if home care and nursing home care are combined). In the case of home care and nursing home care this especially a concern of blacks and the elderly. 51 LH RESEARCH, INC. People were then asked which one or two of these items they would give the highest priority: Highest Priority for the Health Care System Combined 1st Mention 2nd Mention 1st & 2nd Preventive Care 32 37 69 Hospitals that really care about people 18 25 43 Fast, Convenient Out- patient Care 11 18 29 Long term nursing home care 9 17 26 Long Term Home Care 10 15 25 Unlimited availability of such care as kidney dialysis, organ transplants, and plastic surgery 10 14 24 Long or extended hospital stays 8 12 20 Extensive testing of patients 3 5 8 In this context the order shifts somewhat with preventive care clearly coming out first with 69% mentioning it either as a first or second priority; this is followed by "hospitals that really care about people" (43%), "fast, convenient outpatient care (29%), and long term nursing home care (26%). When home care and nursing home care are combined, long term care would actually come in second, at 51%. 52 LH RESEARCH, INC. When the results are examined by different categories, several fascinating patterns emerge. Taking just first choices into account, preventative health care has the most interest in the West (40%), among those 30-49 years old (42%), and among those earning more than $35,000 (39%). The college educated (49%), and those with some postgraduate education (51%) cite it as their highest priority. Blacks, (28%), those 18-29 years old (25%) and Clinton voters (21%) choose "hospitals that really care about the patients" as a top priority more frequently than other groups. Long term home care is of special interest to those over 65 years old, 21% of whom put it as their number one priority, compared to 10% for the overall population. Long term nursing home care is of special interest to blacks and the elderly; 14% and 17% respectively rate it as their top priority, compared to 9% for the population as a whole. (Table 20 - Q.4b) Observation: These results point to the three basic priorities Americans have for health care - prevention, caring hospitals, and long term care. What Americans are saying is that many of those things which get a lot of attention and have the support of the medical profession are of a far lower order of priority than these three. In effect, the public is saying: emphasize prevention as a way of keeping people out of hospitals, but if they have to go, make sure they receive high quality care and long term care when it is necessary. 53 LH RESEARCH, INC. TABLE 19 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - HOSPITALS THAT REALLY CARE ABOUT THE PATIENTS PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15 $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 67% 70% 65% 67% 69% 66% 74% 68% 68% 65% 69% 70% 67% 63% 65% 69% 71% 60% 68% 71% (2) 11% 12% 13% 12% 10% 12% 7% 10% 13% 13% 6% 10% 11% 15% 15% 9% 11% 16% 11% 10% (3) 9% 7% 8% 11% 11% 9% 9% 8% 7% 8% 13% 8% 9% 8% 9% 11% 7% 10% 9% 8% (4) 4% 3% 4% 3% 4% 4% 4% 5% 5% 4% 2% 4% 3% 3% 4% 4% 5% 5% 3% 2% LOWEST PRIORITY (5) 7% 7% 7% 7% 5% 7% 7% 11% 6% 7% 7% 5% 7% 8% 8% 6% 5% 8% 7% 7% NOT SURE 2% 1% 4% 1% 1% 2% 1 % 2% 2% 3% 3% 3% 1% 1% 1% 1% 2% 1% NO ANSWER 54 LH RESEARCH, INC. TABLE 19 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - HOSPITALS THAT REALLY CARE ABOUT THE PATIENTS HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 67% 63% 70% 72% 71% 68% 71% 62% 70% 73% 71% 69% 69% 68% 60% 65% 70% 69% 69% 69% (2) 11% 14% 9% 15% 11% 12% 9% 17% 12% 9% 10% 12% 10% 10% 15% 13% 13% 14% 11% 11% (3) 9% 11% 7% 8% 8% 10% 9% 10% 11% 8% 9% 8% 8% 9% 11% 9% 8% 7% 9% 9% (4) 4% 4% 4% 3% 4% 3% 3% 3% 5% 1% 3% 4% 3% 4% 3% 6% 3% 4% 4% 4% LOWEST PRIORITY (5) 7% 6% 7% 2% 4% 5% 5% 6% 3% 7% 7% 7% 8% 7% 8% 8% 5% 5% 7% 6% NOT SURE 2% 2% 2% 1% 2% 2% 3% 2% 2% * 1% 1% 2% 3% 1% 1% 1% 1% NO ANSWER 55 LH RESEARCH, INC. TABLE 20 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - PREVENTIVE HEALTH CARE PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID WH- BL- HISP 18 30 50 UNDER $15 $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 51% 51% 44% 52% 61% 52% 45% 55% 39% 54% 54% 58% 42% 50% 56% 56% 59% 45% 52% 54% (2) 20% 24% 24% 16% 16% 20% 21% 28% 25% 22% 19% 8% 19% 19% 20% 19% 23% 22% 21% 19% (3) 16% 14% 16% 20% 14% 16% 16% 13% 24% 13% 15% 15% 19% 19% 14% 15% 13% 19% 16% 16% (4) 5% 6% 5% 4% 5% 6% 4% 2% 8% 4% 3% 7% 6% 3% 6% 5% 2% 6% 5% 4% LOWEST PRIORITY (5) 5% 3% 9% 4% 1% 4% 11% 3% 2% 5% 9% 5% 9% 5% 5% 2% 4% 6% 6% 4% NOT SURE 2% 1% 3% 2% 3% 2% 4% 3% 1% * 8% 5% 3% 1% 3% 2% 1% 3% NO ANSWER 56 LH RESEARCH, INC. TABLE 20 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - PREVENTIVE HEALTH CARE HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 51% 47% 55% 65% 67% 53% 55% 49% 57% 46% 52% 51% olo 51% 51% 49% 47% 56% 53% 49% 52% (2) 20% 23% 18% 19% 20% 21% 21% 24% 15% 15% 20% 20% 20% 21% 20% 23% 20% 23% 23% 20% (3) 16% 17% 16% 13% 7% 15% 14% 15% 19% 22% 14% 17% 16% 17% 15% 19% 15% 14% 17% 17% (4) 5% 5% 5% 2% 2% 4% 3% 6% 4% 7% 6% 5% 5% 4% 8% 6% 4% 5% 5% 5% LOWEST PRIORITY (5) 5% 6% 4% 1% 4% 5% 5% 4% 3% 6% 6% 5% 7% 5% 4% 5% 3% 5% 5% 5% NOT SURE 2% 3% 2% 2% 1% 2% 2% 4% 2% 2% 2% 2% 4% 1% 2% 1% 2% 2% NO ANSWER 57 LH RESEARCH, INC. TABLE 21 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - FAST, CONVENIENT OUTPATIENT CARE PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID WH- BL- HISP 18 30 50 UNDER $15 $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 46% 45% 43% 47% 52% 46% 44% 46% 34% 47% 55% 54% 43% 48% 41% 51% 52% 49% 45% 47% (2) 22% 23% 22% 21% 23% 23% 15% 19% 31% 23% 13% 17% 21% 20% 26% 21% 22% 24% 21% 22% (3) 17% 18% 17% 19% 12% 17% 16% 17% 23% 15% 17% 11% 17% 18% 20% 15% 15% 15% 17% 18% (4) 7% 8% 7% 5% 6% 6% 12% 8% 8% 7% 7% 1% 9% 5% 6% 9% 7% 4% 8% 6% LOWEST PRIORITY (5) 6% 4% 8% 5% 5% 5% 11% 6% 4% 6% 6% 8% 8% 5% 8% 3% 4% 5% 6% 7% NOT SURE 3% 2% 4% 3% 1% 3% 2% 5% * 3% 2% 10% 3% 4% 1% 2% 2% 4% * NO ANSWER 58 LH RESEARCH, INC. TABLE 21 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - FAST, CONVENIENT OUTPATIENT CARE HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 46% 46% 46% 48% 57% 49% 49% 48% 51% 53% 52% 47% 53% 46% 46% 46% 52% 48% 48% 47% (2) 22% 21% 23% 28% 20% 22% 20% 24% 21% 15% 20% 21% 16% 22% 22% 24% 23% 23% 20% 22% (3) 17% 19% 15% 15% 14% 16% 17% 15% 16% 15% 13% 17% 15% 15% 22% 15% 16% 17% 17% 17% (4) 7% 6% 7% 6% 5% 5% 5% 4% 6% 8% 6% 7% 8% 7% 6% 9% 6% 6% 7% 7% LOWEST PRIORITY (5) 6% 6% 5% 3% 4% 6% 7% 5% 6% 5% 7% 5% 6% 7% 2% 5% 3% 5% 6% 6% NOT SURE 3% 2% 4% 1% 3% 3% 4% 1% 5% 1% 2% 3% 2% 4% 2% 1% 1% 2% 2% NO ANSWER 59 LH RESEARCH, INC. TABLE 22 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - LONG-TERM HOME CARE PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 33% 34% 36% 35% 24% 30% 52% 36% 25% 31% 37% 49% 43% 34% 27% 30% 29% 20% 39% 34% (2) 23% 25% 22% 19% 25% 24% 20% 20% 28% 24% 16% 18% 19% 26% 25% 21% 25% 25% 23% 24% (3) 26% 23% 23% 24% 37% 27% 17% 28% 28% 26% 29% 17% 18% 24% 28% 28% 32% 31% 23% 26% (4) 8% 7% 8% 10% 4% 8% 6% 7% 11% 8% 6% 4% 6% 7% 11% 10% 7% 12% 6% 6% LOWEST PRIORITY (5) 8% 8% 8% 6% 8% 8% 5% 9% 8% 7% 9% 6% 10% 5% 10% 9% 6% 9% 7% 6% NOT SURE 3% 2% 2% 5% 2% 2% 1% 1% 1% 3% 2% 7% 5% 5% 1% 1% 1% 3% 1% 3% NO ANSWER 60 LH RESEARCH, INC. TABLE 22 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - LONG-TERM HOME CARE HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 33% 27% 39% 24% 25% 33% 38% 26% 31% 37% 41% 34% 49% 36% 22% 28% 26% 34% 37% 33% (2) 23% 23% 22% 24% 26% 23% 24% 22% 23% 16% 22% 23% 18% 20% 26% 23% 25% 22% 22% 23% (3) 26% 29% 23% 38% 33% 26% 24% 28% 27% 24% 20% 26% 16% 25% 29% 30% 32% 28% 24% 27% (4) 8% 8% 8% 8% 10% 9% 7% 12% 8% 7% 6% 7% 5% 7% 10% 10% 8% 7% 6% 7% LOWEST PRIORITY (5) 8% 9% 7% 4% 5% 7% 5% 8% 7% 10% 8% 7% 9% 8% 9% 8% 8% 6% 8% 7% NOT SURE 3% 4% 2% 2% 3% 1% 4% 5% 7% 3% 2% 3% 3% 4% 1% 2% 2% 3% 3% NO ANSWER 61 LH RESEARCH, INC. TABLE 23 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - LONG-TERM NURSING HOME CARE HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 33% 27% 39% 22% 20% 32% 36% 28% 29% 41% 45% 36% 51% 36% 24% 29% 28% 30% 38% 35% (2) 22% 25% 19% 29% 26% 23% 22% 21% 29% 17% 19% 23% 19% 22% 23% 23% 23% 25% 23% 23% (3) 24% 24% 24% 33% 31% 25% 26% 24% 24% 20% 19% 24% 15% 22% 29% 26% 30% 25% 23% 24% (4) 10% 13% 8% 10% 13% 11% 8% 14% 12% 11% 7% 9% 4% 9% 12% 13% 10% 11% 9% 9% LOWEST PRIORITY (5) 7% 8% 7% 4% 9% 7% 5% 10% 5% 8% 8% 6% 9% 8% 8% 8% 8% 6% 7% 7% NOT SURE 3% 3% 3% 1% 1% 3% 3% 4% 1% 2% 2% 2% 2% 3% 3% 1% 1% 2% 1% 2% NO ANSWER 62 LH RESEARCH, INC. TABLE 23 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - LONG-TERM NURSING HOME CARE PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 33% 35% 36% 36% 22% 30% 60% 29% 29% 28% 40% 46% 42% 37% 25% 29% 29% 25% 37% 32% (2) 22% 23% 20% 22% 25% 24% 8% 24% 27% 26% 13% 16% 19% 18% 27% 25% 24% 22% 21% 23% (3) 24% 23% 22% 20% 36% 25% 15% 29% 22% 27% 28% 12% 17% 28% 29% 25% 24% 28% 23% 26% (4) 10% 9% 10% 12% 9% 10% 13% 11% 15% 10% 6% 7% 8% 7% 11% 12% 14% 13% 10% 8% LOWEST PRIORITY (5) 7% 8% 9% 6% 6% 8% 4% 7% 5% 7% 11% 7% 8% 6% 7% 8% 7% 9% 7% 7% NOT SURE 3% 2% 3% 3% 4% 3% 1% 1% 2% 2% * 12% 4% 5% 2% 1% 1% 3% 2% 3% NO ANSWER 63 LH RESEARCH, INC. TABLE 24 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - LONG OR EXTENDED HOSPITAL STAYS PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 30% 28% 33% 29% 26% 28% 48% 21% 28% 24% 40% 33% 35% 34% 26% 26% 26% 27% 30% 30% (2) 24% 23% 19% 27% 27% 23% 22% 38% 33% 24% 17% 17% 26% 22% 22% 27% 27% 21% 24% 27% (3) 25% 27% 24% 24% 26% 27% 13% 26% 26% 29% 22% 16% 20% 21% 32% 26% 27% 28% 25% 22% (4) 9% 9% 12% 7% 9% 10% 9% 7% 9% 11% 6% 8% 6% 10% 11% 11% 10% 12% 10% 7% LOWEST PRIORITY (5) 7% 10% 7% 7% 5% 7% 7% 7% 2% 9% 10% 7% 6% 6% 7% 8% 8% 9% 7% 7% NOT SURE 5% 4% 6% 6% 6% 5% 1% 1% 2% 3% 5% 18% 7% 8% 4% 2% 2% 3% 4% 7% NO ANSWER 64 LH RESEARCH, INC. TABLE 24 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - LONG OR EXTENDED HOSPITAL STAYS HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 30% 28% 31% 24% 20% 28% 32% 25% 25% 31% 35% 32% 39% 33% 19% 28% 27% 27% 33% 31% (2) 24% 27% 21% 26% 26% 25% 27% 22% 22% 25% 21% 25% 20% 24% 21% 25% 26% 25% 24% 24% (3) 25% 23% 27% 28% 30% 26% 23% 27% 31% 17% 24% 25% 25% 24% 27% 27% 25% 28% 25% 25% (4) 9% 11% 8% 12% 11% 10% 9% 12% 8% 8% 7% 8% 3% 8% 14% 9% 11% 11% 8% 8% LOWEST PRIORITY (5) 7% 7% 8% 6% 11% 6% 4% 9% 8% 9% 8% 6% 9% 6% 12% 9% 8% 6% 7% 7% NOT SURE 5% 5% 5% 4% 2% 5% 5% 5% 6% 10% 5% 5% 4% 4% 7% 3% 2% 3% 3% 4% NO ANSWER 65 LH RESEARCH, INC. TABLE 25 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - UNLIMITED AVAILABILITY OF SUCH CARE AS KIDNEY DIALYSIS, ORGAN TRANSPLANTS, AND PLASTIC SURGERY PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID WH- BL- HISP 18 30 50 UNDER $15- $25 $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 33% 31% 33% 34% 32% 30% 44% 34% 31% 30% 35% 39% 36% 36% 28% 33% 29% 27% 35% 34% (2) 21% 23% 15% 26% 21% 21% 16% 26% 25% 20% 19% 17% 19% 18% 25% 25% 20% 18% 21% 26% (3) 24% 23% 27% 20% 24% 25% 21% 18% 27% 25% 26% 11% 23% 20% 27% 22% 29% 29% 23% 21% (4) 9% 6% 10% 11% 11% 9% 13% 5% 9% 11% 7% 11% 11% 9% 8% 9% 9% 12% 10% 6% LOWEST PRIORITY (5) 10% 14% 11% 6% 8% 10% 6% 11% 5% 11% 10% 12% 6% 13% 11% 9% 10% 12% 8% 10% NOT SURE 4% 4% 4% 3% 4% 4% 1% 7% 3% 3% 3% 10% 6% 4% 2% 2% 2% 1% 3% 3% NO ANSWER 66 LH RESEARCH, INC. TABLE 25 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - UNLIMITED AVAILABILITY OF SUCH CARE AS KIDNEY DIALYSIS, ORGAN TRANSPLANTS, AND PLASTIC SURGERY HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 33% 31% 35% 26% 23% 33% 36% 25% 38% 41% 38% 35% 44% 35% 20% 33% 29% 33% 36% 33% (2) 21% 21% 21% 19% 23% 22% 25% 19% 20% 17% 22% 23% 16% 22% 22% 20% 23% 20% 22% 22% (3) 24% 25% 23% 28% 24% 23% 22% 27% 18% 17% 21% 22% 22% 22% 30% 25% 24% 24% 23% 24% (4) 9% 10% 9% 13% 14% 10% 8% 13% 10% 9% 8% 9% 8% 9% 11% 11% 10% 9% 9% 9% LOWEST PRIORITY (5) 10% 10% 9% 10% 15% 9% 8% 11% 10% 12% 7% 8% 6% 9% 14% 10% 12% 9% 8% 8% NOT SURE 4% 4% 3% 3% 2% 3% 2% 5% 2% 4% 3% 3% 3% 3% 5% 2% 2% 5% 2% 3% NO ANSWER 67 LH RESEARCH, INC. TABLE 26 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - EXTENSIVE TESTING OF PATIENTS PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 23% 25% 24% 22% 18% 21% 35% 28% 22% 19% 28% 28% 34% 25% 20% 19% 18% 16% 26% 22% (2) 20% 22% 21% 19% 21% 20% 20% 32% 23% 22% 21% 11% 21% 18% 27% 17% 22% 21% 19% 26% (3) 31% 27% 29% 32% 37% 31% 24% 25% 35% 32% 27% 27% 23% 31% 33% 34% 35% 33% 29% 32% (4) 11% 10% 12% 11% 11% 12% 11% 3% 15% 11% 12% 7% 11% 10% 11% 14% 12% 13% 12% 9% LOWEST PRIORITY (5) 10% 11% 10% 10% 9% 11% 8% 5% 5% 10% 10% 20% 8% 11% 8% 11% 11% 14% 10% 8% NOT SURE 4% 4% 4% 4% 4% 4% 2% 7% 1% 6% 2% 8% 4% 5% 3% 5% 2% 3% 4% 3% NO ANSWER 68 LH RESEARCH, INC. TABLE 26 - QUESTION 4A PRIORITY OF HEALTH CARE ISSUES - EXTENSIVE TESTING OF PATIENTS HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% HIGHEST PRIORITY (1) 23% 23% 23% 15% 17% 21% 26% 14% 23% 28% 29% 24% 32% 25% 16% 24% 23% 24% 24% 24% (2) 20% 20% 20% 22% 20% 20% 18% 21% 22% 13% 21% 21% 19% 21% 18% 19% 20% 20% 22% 21% (3) 31% 32% 30% 34% 41% 32% 29% 34% 35% 30% 27% 30% 25% 30% 35% 30% 28% 33% 31% 31% (4) 11% 11% 12% 14% 14% 11% 12% 11% 9% 8% 10% 11% 9% 11% 15% 16% 15% 13% 10% 12% LOWEST PRIORITY (5) 10% 10% 10% 11% 7% 11% 12% 13% 8% 15% 10% 10% 12% 10% 11% 9% 10% 9% 10% 10% NOT SURE 4% 4% 4% 3% 3% 4% 4% 6% 3% 6% 4% 3% 3% 3% 6% 2% 3% 2% 3% 3% NO ANSWER 69 LH RESEARCH, INC. TABLE 27 - QUESTION 4B MOST IMPORTANT HEALTH CARE ISSUE PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% PREVENTIVE CARE 32% 32% 27% 33% 40% 33% 22% 32% 23% 42% 26% 30% 22% 28% 37% 40% 40% 28% 30% 40% LONG-TERM HOME CARE 10% 12% 10% 11% 7% 10% 13% 11% 8% 9% 7% 21% 11% 15% 7% 11% 7% 7% 12% 6% LONG-TERM NURSING 9% 7% 10% 12% 4% 8% 15% 4% 7% 6% 11% 17% 11% 11% 4% 8% 4% 10% 8% 11% HOME CARE LONG OR EXTENDED 8% 9% 9% 5% 6% 8% 8% 10% 10% 6% 10% 4% 6% 11% 10% 6% 8% 8% 9% 6% HOSPITAL STAYS FAST, CONVENIENT 11% 11% 11% 7% 15% 11% 5% 10% 12% 11% 11% 7% 8% 11% 13% 10% 11% 17% 9% 9% OUTPATIENT CARE HOSPITALS THAT REALLY 18% 18% 19% 18% 15% 17% 28% 23% 25% 16% 19% 9% 28% 12% 17% 15% 16% 14% 21% 18% CARE ABOUT THE PATIENTS UNLIMITED 10% 8% 10% 10% 8% 9% 8% 10% 10% 8% 12% 9% 10% 10% 10% 7% 12% 10% 10% 8% AVAILABILITY OF SUCH CARE AS KIDNEY DIALYSIS ORGAN TRANSPLANTS AND PLASTIC SURGERY EXTENSIVE TESTING OF 3% 2% 3% 3% 4% 3% 1% 2% 4% 2% 5% 4% 4% 3% 3% 3% 2% 4% 2% 2% PATIENTS NOT SURE NO ANSWER 70 LH RESEARCH, INC. TABLE 27 - QUESTION 4B MOST IMPORTANT HEALTH CARE ISSUE HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% PREVENTIVE CARE 32% 32% 32% 49% 51% 34% 32% 38% 35% 33% 30% 32% 27% 29% 43% 33% 37% 31% 30% 32% LONG-TERM HOME CARE 10% 9% 12% 6% 5% 9% 12% 7% 6% 12% 9% 10% 16% 11% 6% 9% 9% 8% 11% 10% LONG-TERM NURSING 9% 9% 9% 5% 3% 9% 8% 8% 11% 12% 11% 8% 12% 9% 7% 8% 7% 9% 10% 9% HOME CARE LONG OR EXTENDED 8% 9% 6% 6% 6% 7% 7% 7% 6% 9% 9% 8% 7% 8% 8% 9% 8% 8% 8% 8% HOSPITAL STAYS FAST, CONVENIENT 11% 11% 10% 12% 14% 11% 9% 13% 16% 8% 8% 10% 5% 10% 14% 10% 13% 14% 10% 9% OUTPATIENT CARE HOSPITALS THAT REALLY 18% 17% 19% 12% 14% 17% 21% 12% 12% 16% 19% 19% 14% 19% 15% 22% 14% 21% 20% 19% CARE ABOUT THE PATIENTS UNLIMITED 10% 9% 10% 7% 6% 10% 10% 12% 8% 9% 12% 10% 15% 10% 5% 7% 7% 6% 9% 10% AVAILABILITY OF SUCH CARE AS KIDNEY DIALYSIS, ORGAN TRANSPLANTS, AND PLASTIC SURGERY EXTENSIVE TESTING OF 3% 3% 3% 3% 2% 3% 2% 4% 5% 1% 3% 3% 3% 3% 3% 3% 5% 4% 3% 3% PATIENTS NOT SURE NO ANSWER 71 LH RESEARCH, INC. TABLE 28 - QUESTION 4B FIRST/SECOND MOST IMPORTANT HEALTH CARE ISSUE PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% PREVENTIVE CARE 37% 36% 33% 36% 45% 37% 26% 33% 30% 46% 29% 32% 25% 32% 44% 45% 46% 35% 32% 44% LONG-TERM HOME CARE 15% 19% 16% 14% 11% 15% 16% 14% 13% 14% 11% 26% 15% 21% 12% 14% 14% 11% 19% 10% LONG-TERM NURSING 17% 18% 15% 22% 11% 16% 27% 13% 15% 14% 19% 26% 17% 21% 12% 19% 11% 15% 19% 18% HOME CARE LONG OR EXTENDED 12% 16% 12% 10% 11% 12% 11% 15% 15% 9% 15% 10% 11% 17% 16% 9% 12% 12% 12% 11% HOSPITAL STAYS FAST, CONVENIENT 18% 18% 20% 12% 25% 19% 11% 13% 18% 22% 16% 11% 14% 17% 18% 20% 21% 25% 15% 18% OUTPATIENT CARE HOSPITALS THAT REALLY 25% 25% 26% 26% 24% 25% 35% 30% 34% 26% 23% 13% 33% 19% 29% 24% 23% 25% 27% 26% CARE ABOUT THE PATIENTS UNLIMITED 14% 12% 14% 15% 14% 14% 13% 14% 16% 13% 14% 12% 15% 14% 14% 14% 15% 13% 16% 11% AVAILABILITY OF SUCH CARE AS KIDNEY DIALYSIS ORGAN TRANSPLANTS AND PLASTIC SURGERY EXTENSIVE TESTING OF 5% 4% 5% 5% 5% 5% 4% 2% 7% 4% 6% 4% 5% 6% 6% 4% 5% 6% 5% 4% PATIENTS NOT SURE NO ANSWER 72 LH RESEARCH, INC. TABLE 28 - QUESTION 4B FIRST/SECOND MOST IMPORTANT HEALTH CARE ISSUE HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% PREVENTIVE CARE 37% 36% 37% 58% 59% 39% 35% 43% 43% 35% 34% 36% 32% 33% 48% 37% 41% 36% 34% 38% LONG-TERM HOME CARE 15% 13% 17% 13% 10% 14% 18% 12% 9% 14% 15% 14% 23% 16% 9% 14% 14% 14% 17% 15% LONG-TERM NURSING 17% 13% 20% 10% 10% 16% 18% 13% 17% 17% 20% 17% 24% 19% 10% 15% 14% 15% 19% 16% HOME CARE LONG OR EXTENDED 12% 12% 12% 10% 6% 11% 12% 10% 9% 12% 13% 12% 11% 13% 11% 14% 11% 12% 13% 12% HOSPITAL STAYS FAST, CONVENIENT 18% 19% 18% 24% 25% 19% 17% 21% 24% 15% 15% 18% 12% 17% 24% 19% 20% 19% 16% 16% OUTPATIENT CARE HOSPITALS THAT REALLY 25% 24% 27% 20% 23% 24% 27% 21% 21% 23% 26% 26% 20% 26% 21% 31% 24% 28% 27% 27% CARE ABOUT THE PATIENTS UNLIMITED 14% 12% 15% 13% 8% 15% 16% 16% 12% 14% 15% 15% 17% 15% 8% 12% 13% 12% 13% 14% AVAILABILITY OF SUCH CARE AS KIDNEY DIALYSIS, ORGAN TRANSPLANTS AND PLASTIC SURGERY EXTENSIVE TESTING OF 5% 6% 4% 3% 5% 5% 5% 5% 6% 3% 4% 5% 6% 5% 5% 5% 8% 5% 4% 5% PATIENTS NOT SURE NO ANSWER 73 LH RESEARCH, INC. IV Long Term Care and the American Health Care System The study examined attitudes about long term care, with a special focus on home care, in some depth. First, it sought to determine just how significant a problem the need for long term care was for the American people. It asked the public whether they, a member of their family, or someone you know "ever needed long term care because they had a chronic disease such as Alzheimer's disease, stroke, or muscular dystrophy, a birth defect, or a permanent disability resulting from an auto accident or something similar?" Some 50% answer in the affirmative while 50% say they have not had such a need. Those most likely to have known someone who needed long term care are Southerners (53%), those 50-64 years old (56%), those earning $25,000 or less (54%), and Bush voters (58%). The groups with the highest percentages saying they or a member of their family have not needed long term care are those who live in the East (56%), those 18-29 years old (58%), blacks (62%), Hispanics (57%), those earning $25,000 - $35,000 (56%), and Clinton voters (56%). (Table 21 - Q.7a) However, experience does not seem to radically alter attitudes on issues involving health care, even long term care, as a result of having had an experience with long term care. LH Research ran a special cross tabulation comparing the answers of those with experience and those without. The results showed almost no significant difference in responses. Then, respondents were asked whether they would prefer nursing home care or home care if they or some member of their family needed long term care. By an overwhelming 79-14% the American public prefer home care over nursing home care, 74 LH RESEARCH, INC. a result that is slightly higher than the 78-17% response to a February 1988 survey that asked a similar question. The most positive about home care are blacks (85%), those earning $35,000 and above (84%), and those with postgraduate education (86%) - an interesting coalition in that it combines one of the poorest groups with the most affluent and educated. Those most positive about nursing home - and it should be kept in mind that in all cases the percentages are small - are the elderly (18%), those earning under $15,000 (22%), and those who rate their own health negative (18%). (Table 22 - Q.7b) Clearly there has been and continues to be an overwhelming mandate for home care over nursing home care. However, in both cases there is very great concern about the cost involved. The survey repeated a question asked in February 1988: "An estimated one million Americans go bankrupt each year trying to pay the costs of long term illness such as Alzheimer's or Parkinson's disease. Today, very few people have long term medical insurance to pay for long term care. It has been estimated that this kind of long term care in your home or in a nursing home can cost as much as between $15,000 and $60,000, or $40 to $160 a day. Would you be able to pay that amount of money for long term care or not?" In 1988, 16% said they could afford it while 82% said they could not. Today, the result is even more striking with only 7% saying they could afford it and 91% saying they could not. Not surprisingly, those earning over $50,000 a year (18%) and those with postgraduate education (16%) are the most likely to say they can afford it, with the highest proportion saying they could not afford it in the West (94%), and among blacks (94%), those earning under $25,000 (97%), and Democrats (94%). (Table 23 - Q.7c) 75 LH RESEARCH, INC. Then the survey repeated a set of questions asked about home care in 1988 - concerning support for a federal program to support home care for the chronically ill or disabled among the elderly, those 20 to 64 years of age, and children 19 years of age or under. In the case of a federal program for those 65 years old and above, 88% say they favor such a program while 9% oppose it. This is approximately the same as the 87-10% margin recorded in 1989. Support is very strong in all groups but highest in the East (92%), and South (91%), among blacks (97%), those earning under $15,000 (92%), those earning $25,000 - 35,000 (92%), and among Clinton voters (95%). (Table 24 - Q.7d) When it comes to a federal program for home care for the chronically ill or disabled 20 to 64 years old, 83% say they favor it, and 10% oppose it. This compares with an 80-16% margin recorded in 1989. The pattern of support is similar to that for the elderly - with blacks the most supportive (94%), those earning under $35,000 (86%), and Clinton voters (91%). Women tend to be more supportive than men (88% compared to 78%). The elderly, perhaps not surprisingly, are the least enthusiastic (75%). (Table 25 - Q.7d) On the issue of a program to provide support for children nineteen and under, the public again is strongly positive. By 86-9%, the American people say there should be a federal program for the chronically ill or disabled. This again is even higher than the results in 1989 which showed an 83-13% margin of support. Once more the pattern of support is relatively similar with the East the most positive region (90%), with blacks among the most positive groups (91%), and Clinton voters (92%) showing high support. In this case those 18-29 years old are the most supportive of any age 76 LH RESEARCH, INC. group (91%), perhaps because of their age but also probably because they know someone who would be affected. (Table 26 - Q.7d) Observation: Back in February 1989 there was very strong support for federally-assisted home care for the chronically ill and disabled, no matter what age. That support is even greater today. Though there are slight variations when it comes to the various age categories, the pattern is generally similar - with the East the most positive region, blacks the most supportive group, and Clinton voters consistently more favorable than those who voted for either Bush or Perot. However, support is one thing; a willingness to pay for it is another. The study asked respondents whether they would support extending the 1.45% Medicare tax on employee wages, which now applies only to the first $130,200, earned to cover all income. This would affect approximately 3% of the population. By 81-15%, the public favors such an approach. This is significantly greater than the 71-24% recorded in a February 1988 study. The level of support is fairly uniform among all groups. Even 82% of those earning over $50,000 endorse the idea. The most positive are those earning $25,000 to $35,000 (90%) while the least positive are those 65 years old and above (74%). (Table 27 - Q.7d). Observation: The results are good news for advocates of home care. The public, by a very sizable margin, prefers it to nursing home care. Support for a federal program to fund home care for the chronically ill or disabled is substantial for all ages, though this is especially true in the case of the elderly. And the public would support a method for funding such care. Then, there is the issue of how high a priority Americans give long term care in the context of a system of national health insurance. Some 31% say it should get a 77 LH RESEARCH, INC. top priority, while 54% say it is a high but not top priority. Only 11% say it should get a lower priority. Those most willing to give it a top priority are blacks (40%), those 50 years old and over (41%), those earning under $15,000 (46%) and those who rate their own health negative (42%). Those least willing to give it a top priority are the affluent (25%), men (26%), the college educated (23%), and those with a postgraduate education (22%). (Table 28 - Q.7f). Observation: While this is generally positive news for home care advocates, it does not guarantee that home care will be at the heart of the debate over national health insurance. Rather than focusing just on the issue of home care, supporters would be better off tying it to a more comprehensive package of reform - one that also stressed preventive care and quality hospital care, the two other top priorities stressed by the American public. Indeed by doing so they could broaden their base of support by picking up the support of those groups, such as the college educated and those with a postgraduate education, who are very supportive of preventive care but less positive about the importance of long term care. Concluding Observation: The Public Mandate for Health Care Reform in America Clearly within the context of long term care, home care has strong support, and the American people would back federal funding to provide it to the chronically ill and disabled of all ages. Indeed, the public is very worried that they will not be able to afford it, especially the poor and blacks. More than just supporting the concept of federal help, the public would back extending the Medicare tax of 1.45% to earnings of over $130,200. In addition, long term home care is seen as one of the three top health care priorities, along with preventive medicine and quality hospital care. All of this represents very good news for home care advocates. However, what the results of this study suggest is that a single issue approach to health care reform may not be the most effective way to marshall public support. What the American people are looking for is less a combination of program initiatives in the health care field than a fundamental change - change that deals with costs, that ensures choice, that, in short, provides truly comprehensive medical care. What is striking about the results is how clear the American people are about what they want. The proposals which are dominating the debate are not what the American people are looking for. They reject two frequently mentioned variations of 78 LH RESEARCH, INC. managed care. They reject "play or pay". They are looking for something much closer to the Canadian system, which has hardly been discussed at all by Congress and certainly not by the new administration. This means that those who want home care might do well to link it to comprehensive health care that emphasizes prevention and quality hospital service as well as long term home care. The public is not just ready for such an approach; they want it very strongly. What this would do is tie home care to America's basic concern and at the same time, as was noted earlier in the report, broaden the base of support. 79 LH RESEARCH, INC. TABLE 29 - QUESTION 7A EXPERIENCE WITH THE NEED FOR LONG-TERM CARE BECAUSE OF CHRONIC DISEASE, BIRTH DEFECT, OR A PERMANENT DISABILITY PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25 $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% EXPERIENCED NEED 50% 44% 53% 49% 50% 50% 38% 43% 42% 50% 56% 51% 53% 55% 44% 52% 50% 53% 43% 55% PERSONALLY OR FOR SOMEONE ELSE NO ONE HAS HAD NEED 50% 56% 47% 50% 50% 49% 62% 57% 58% 49% 44% 49% 47% 45% 56% 48% 50% 47% 56% 45% AND DON' T KNOW ANYONE WHO HAS NOT SURE * 1% * * 1% 1% 1% NO ANSWER 80 LH RESEARCH, INC. TABLE 29 - QUESTION 7A EXPERIENCE WITH THE NEED FOR LONG-TERM CARE BECAUSE OF CHRONIC DISEASE, BIRTH DEFECT, OR A PERMANENT DISABILITY HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% EXPERIENCED NEED 50% 51% 48% 47% 48% 51% 44% 58% 56% 50% 51% 49% 50% 49% 49% 44% 49% 49% 48% 49% PERSONALLY OR FOR SOMEONE ELSE NO ONE HAS HAD NEED 50% 49% 51% 53% 52% 49% 56% 42% 44% 50% 49% 50% 50% 51% 51% 56% 51% 50% 51% 51% AND DON'T KNOW ANYONE WHO HAS NOT SURE * 1% * 1% * * * * * * * * NO ANSWER 81 LH RESEARCH, INC. TABLE 30 - QUESTION 7B PREFERENCE FOR NURSING HOME OR OWN HOME FOR LONG-TERM CARE HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% IN A NURSING HOME 14% 18% 11% 12% 6% 14% 12% 18% 12% 18% 15% 15% 12% 14% 14% 13% 15% 15% 16% 15% IN OWN HOME 79% 75% 82% 82% 86% 80% 81% 75% 83% 74% 78% 79% 82% 79% 80% 80% 80% 80% 79% 80% NEITHER (VOLUNTEERED) 1% 1% 1% 1% 1% * * * 1% 1% 1% 1% 1% 1% 1% 1% * 1% * NOT SURE 6% 6% 6% 6% 6% 6% 6% 7% 5% 6% 6% 6% 5% 5% 6% 5% 5% 4% 4% 5% NO ANSWER 82 LH RESEARCH, INC. TABLE 30 - QUESTION 7B PREFERENCE FOR NURSING HOME OR OWN HOME FOR LONG-TERM CARE PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% IN A NURSING HOME 14% 14% 13% 16% 14% 14% 11% 21% 14% 13% 17% 18% 22% 17% 14% 10% 11% 16% 15% 13% IN OWN HOME 79% 79% 82% 77% 78% 79% 85% 72% 81% 80% 77% 76% 73% 76% 80% 84% 84% 78% 78% 82% NEITHER (VOLUNTEERED) 1% 2% 1% * * 2% 1% 1% 1% 1% 1% * * 1% 1% NOT SURE 6% 5% 5% 7% 7% 7% 1% 7% 5% 6% 6% 5% 6% 5% 6% 5% 6% 6% 7% 4% NO ANSWER 83 LH RESEARCH, INC. TABLE 31 - QUESTION 7C ABILITY TO AFFORD LONG-TERM CARE ($15,000 TO $60,000 A YEAR/$40 TO $160 A DAY) PARTY AFFILIATION REGION RACE AGE INCOME RE INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- - $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% COULD AFFORD TO PAY 7% 5% 10% 7% 5% 7% 6% 13% 8% 7% 5% 8% 3% 3% 4% 7% 18% 11% 5% 7% COULD NOT AFFORD 91% 92% 89% 91% 94% 91% 94% 88% 89% 92% 92% 91% 96% 97% 94% 91% 80% 86% 94% 91% NOT SURE 2% 3% 1% 3% * 2% 1% 1% 2% 1% 3% 1% 2% 1% 3% 1% 2% 3% 1% 2% NO ANSWER 84 LH RESEARCH, INC. TABLE 31 - QUESTION 7C ABILITY TO AFFORD LONG-TERM CARE ($15,000 TO $60,000 A YEAR/$40 TO $160 A DAY) HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% COULD AFFORD TO PAY 7% 10% 4% 12% 16% 7% 5% 11% 8% 7% 4% 5% 3% 5% 14% 6% 7% 5% 6% 6% COULD NOT AFFORD 91% 88% 94% 85% 83% 91% 93% 87% 91% 92% 94% 93% 96% 93% 84% 93% 92% 94% 93% 92% NOT SURE 2% 2% 2% 3% 1% 2% 1% 2% 2% 1% 2% 2% 1% 2% 3% 1% 2% 1% 1% 2% NO ANSWER 85 LH RESEARCH, INC. TABLE 32 - QUESTION 7D WHETHER FAVOR/OPPOSE A FEDERAL PROGRAM PROVIDING LONG-TERM CARE IN THE HOME FOR CHRONICALLY ILL OR DISABLED - FOR ELDERLY PEOPLE 65 AND OVER HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 88% 84% 91% 010 85% 85% 87% 95% 76% 87% 92% 93% 91% 96% 93% 72% 90% 85% 90% 93% 91% OPPOSE 9% 12% 6% 11% 13% 9% 4% 16% 10% 6% 5% 6% 3% 6% 20% 8% 11% 8% 6% 6% NOT SURE 3% 4% 3% 4% 3% 4% 1% 9% 3% 1% 2% 3% 1% 2% 7% 2% 3% 2% 1% 3% NO ANSWER 86 LH RESEARCH, INC. TABLE 32 - QUESTION 7D WHETHER FAVOR/OPPOSE A FEDERAL PROGRAM PROVIDING LONG-TERM CARE IN THE HOME FOR CHRONICALLY ILL OR DISABLED - FOR ELDERLY PEOPLE 65 AND OVER PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 88% 92% 91% 85% 82% 87% 97% 89% 88% 88% 88% 86% 92% 89% 92% 83% 86% 77% 93% 93% OPPOSE 9% 6% 7% 10% 13% 10% 3% 7% 10% 8% 9% 8% 6% 8% 6% 12% 12% 17% 6% 4% NOT SURE 3% 2% 3% 5% 5% 4% 1% 4% 1% 4% 3% 7% 2% 3% 2% 5% 3% 7% 1% 3% NO ANSWER 87 LH RESEARCH, INC. TABLE 33 - QUESTION 7D WHETHER FAVOR/OPPOSE A FEDERAL PROGRAM PROVIDING LONG-TERM CARE IN THE HOME FOR CHRONICALLY ILL OR DISABLED - FOR PEOPLE 20 TO 64 YEARS OF AGE HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 83% 78% 88% 76% 78% 81% 91% 67% 82% 89% 89% 88% 92% 89% 65% 87% 79% 85% 90% 87% OPPOSE 10% 15% 6% 16% 16% 11% 6% 20% 12% 5% 6% 7% 5% 7% 24% 9% 15% 10% 7% 8% NOT SURE 6% 7% 6% 8% 6% 7% 3% 14% 6% 6% 4% 5% 4% 4% 12% 4% 7% 4% 3% 5% NO ANSWER 88 LH RESEARCH, INC. TABLE 33 - QUESTION 7D WHETHER FAVOR/OPPOSE A FEDERAL PROGRAM PROVIDING LONG-TERM CARE IN THE HOME FOR CHRONICALLY ILL OR DISABLED - FOR PEOPLE 20 TO 64 YEARS OF AGE PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 83% 88% 85% 80% 80% 82% 94% 87% 86% 84% 84% 75% 86% 86% 86% 81% 80% 69% 90% 88% OPPOSE 10% 7% 9% 12% 14% 11% 5% 10% 11% 10% 10% 10% 9% 8% 9% 12% 15% 21% 7% 5% NOT SURE 6% 5% 6% 8% 6% 7% 1% 4% 3% 6% 6% 15% 5% 6% 5% 7% 5% 10% 4% 6% NO ANSWER 89 LH RESEARCH, INC. TABLE 34 - QUESTION 7D WHETHER FAVOR/OPPOSE A FEDERAL PROGRAM PROVIDING LONG-TERM CARE IN THE HOME FOR CHRONICALLY ILL OR DISABLED - FOR CHILDREN 19 YEARS OF AGE OR UNDER PARTY AFFILIATION REGION RACE AGE INCOME RE INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15 $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 86% 90% 86% 84% 83% 85% 91% 90% 91% 85% 85% 77% 86% 86% 89% 85% 84% 77% 89% 88% OPPOSE 9% 6% 9% 10% 11% 10% 7% 4% 7% 10% 10% 10% 11% 8% 7% 10% 13% 16% 7% 6% NOT SURE 5% 3% 5% 6% 7% 6% 1% 5% 2% 5% 5% 13% 3% 6% 5% 5% 3% 7% 4% 6% NO ANSWER 90 LH RESEARCH, INC. TABLE 34 - QUESTION 7D WHETHER FAVOR/OPPOSE A FEDERAL PROGRAM PROVIDING LONG-TERM CARE IN THE HOME FOR CHRONICALLY ILL OR DISABLED - FOR CHILDREN 19 YEARS OF AGE OR UNDER HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 86% 83% 89% 83% 84% 85% 92% 73% 86% 83% 89% 90% 92% 91% 70% 89% 83% 88% 90% 89% OPPOSE 9% 11% 7% 13% 13% 10% 5% 17% 9% 9% 6% 6% 5% 5% 25% 8% 13% 7% 7% 7% NOT SURE 5% 6% 5% 4% 3% 5% 3% 10% 5% 8% 4% 4% 3% 4% 6% 4% 4% 5% 3% 4% NO ANSWER 91 LH RESEARCH, INC. TABLE 35 - QUESTION 7E WHETHER FAVOR/OPPOSE EXTENDING MEDICARE TAX ON ALL INCOME EARNED OVER $130,200 TO FUND A FEDERAL LONG-TERM CARE PROGRAM PARTY AFFILIATION REGION RACE AGE INCOME RE- INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25 $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 81% 84% 80% 82% 78% 82% 77% 78% 79% 82% 87% 74% 82% 76% 90% 86% 82% 75% 85% 84% OPPOSE 15% 13% 16% 13% 18% 14% 23% 15% 19% 14% 11% 15% 15% 19% 9% 11% 15% 22% 11% 12% NOT SURE 4% 4% 4% 5% 4% 5% 1% 7% 2% 4% 3% 11% 3% 5% 2% 2% 3% 3% 4% 5% NO ANSWER 92 LH RESEARCH, INC. TABLE 35 - QUESTION 7E WHETHER FAVOR/OPPOSE EXTENDING MEDICARE TAX ON ALL INCOME EARNED OVER $130,200 TO FUND A FEDERAL LONG-TERM CARE PROGRAM HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% FAVOR 81% 82% 80% 78% 84% 82% 86% 74% 83% 83% 86% 84% 88% 84% 75% 88% 86% 83% 86% 100% OPPOSE 15% 16% 14% 17% 15% 14% 8% 22% 16% 13% 10% 12% 9% 13% 22% 10% 12% 16% 10% NOT SURE 4% 2% 7% 4% 2% 4% 5% 5% 2% 4% 4% 4% 3% 3% 4% 2% 2% 1% 3% NO ANSWER 93 LH RESEARCH, INC. TABLE 35 - QUESTION 7F PRIORITY A LONG-TERM CARE PROGRAM SHOULD HAVE IN A NATIONAL HEALTH INSURANCE SYSTEM PARTY AFFILIATION REGION RACE AGE INCOME RE INDE TO- so- MID- WH- BL- HISP 18 30 50 UNDER $15- $25- $35- OVER PUBL DEMO PEN- TAL EAST UTH WEST WEST ITE ACK ANIC -29 -49 -64 65+ $15K $25K $35K $50K $50K ICAN CRAT DENT WEIGHTED BASE 1249 251 423 347 228 1020 141 104 310 509 262 168 248 238 200 246 214 296 481 329 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% GIVE LONG-TERM CARE A 31% 34% 33% 32% 24% 30% 40% 27% 22% 29% 40% 41% 46% 31% 27% 29% 25% 24% 38% 29% TOP PRIORITY GIVE IT A HIGH BUT 54% 50% 54% 53% 61% 55% 52% 69% 63% 56% 47% 43% 44% 54% 54% 59% 58% 55% 53% 56% NOT TOP PRIORITY GIVE IT A LOWER 11% 10% 9% 12% 12% 11% 6% 4% 13% 11% 11% 7% 7% 8% 15% 10% 15% 16% 7% 11% PRIORITY NOT SURE 1% 6% 4% 3% 4% 4% 2% 1% 3% 4% 2% 8% 3% 7% 4% 2% 1% 5% 1% 5% NO ANSWER 94 LH RESEARCH, INC. TABLE 35 - QUESTION 7F PRIORITY A LONG-TERM CARE PROGRAM SHOULD HAVE IN A NATIONAL HEALTH INSURANCE SYSTEM HEALTH FAVOR GIVE EDUCATION RE- LONG NATIONAL EXTEND VOTED FOR OWN FORM S/B TERM HEALTH EMPL MEDI TAX SEX COL- PRESIDENT 1992 HE- S/B BA- CARE INSURANCE OYER CARE FOR LEGE POST ALTH TOP SIC TOP PAY MAN- HMO EX- LONG TO- WO- EDUC GRAD TO- CLIN PE- NEGA PRIO RI- PRIO FA- OP- OR AGED SPON PAN- TERM TAL MEN MEN ATED UATE TAL -TON BUSH ROT TIVE RITY GHT RITY VOR POSE PLAY CARE -SOR SION CARE WEIGHTED BASE 1249 595 654 144 96 949 473 303 172 212 587 1063 388 873 250 411 368 377 821 1010 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% GIVE LONG-TERM CARE A 31% 26% 36% 23% 22% 29% 35% 24% 23% 42% 44% 34% 100% 36% 17% 29% 24% 27% 35% 34% TOP PRIORITY GIVE IT A HIGH BUT 54% 56% 53% 60% 61% 56% 56% 55% 61% 44% 48% 55% 54% 54% 58% 57% 58% 55% 55% NOT TOP PRIORITY GIVE IT A LOWER 11% 15% 7% 13% 14% 12% 7% 17% 13% 8% 6% 8% 7% 24% 8% 14% 11% 7% 8% PRIORITY NOT SURE 4% 3% 4% 4% 3% 3% 2% 4% 3% 6% 2% 3% 3% 6% 4% 4% 3% 3% 3% NO ANSWER 95 LH RESEARCH, INC. Survey Method The Public Mandate for Health Care Reform in America was conducted by telephone among a nationwide cross-section of 1250 adults aged 18 and over. The interviewing was conducted between December 12, 1992, through January 3, 1993. The sample which was employed is based on methodology that is designed to produce representative samples of persons in telephone households in the 48 continental United States. The sample makes use of random-digit selection procedures which assure sample representation of persons in both households which are "unlisted" in telephone directories as well as persons in households which are "unlisted II in telephone directories. 1 The sample design is also explicitly designed to assure proper representation of households in central city, suburban, and rural areas within each of the 48 continental states. The sample is selected by a three-state, stratified sampling process. The ultimate result of this process is a set of sample selections (phone numbers). In order to assure that the maximum degree of sample control is maintained, the basic sample design has been set up to produce cross-sectional national samples in increments of 500, 1,000, or 1,250 sampling points (i.e. households). The sampling margin of error is +/- 3 percent in 95 out of 100 cases. 1 Some households are "unlisted" as the result of request for an unlisted number by the telephone subscriber. Other households are "unlisted" in the published directory because the telephone number was assigned after the publication date of the directory." Samples that are restricted to directory-listed numbers only may contain serious sample biases because of the exclusion of the various types of unlisted households. 96 LH RESEARCH, INC. Sampling Error The results achieved from national public cross sections are subject to sampling error. Sampling error is defined as the difference between the results obtained from the sample and those that would have been obtained had the entire population been surveyed. The size of sampling error varies both with the size of the sample and with the percentage giving a particular answer. The following table (Table B) sets forth the range of error in samples at different sizes at different percentages of responses: Table B Recommended Allowance For Sampling Error Of Proportions (Plus or Minus) Sampling Tolerance (at 95% Confidence Level) To Use in Evaluating Any Individual Percentage Result Approximate Magnitude of Results Approximate Sample Size Survey Survey Survey Survey Survey of Any Group Asked Percentage Percentage Percentage Percentage Percentage Question on Which Result At Result at Result at Result at Result at Survey Result is Based 10% or 90% 20% or 80% 30% or 70% 40% or 60% 50% 1,250 2 2 3 3 3 1,000 2 3 3 3 3 500 3 4 4 4 4 300 3 5 5 6 6 200 4 6 6 7 7 100 6 8 9 10 10 50 8 11 13 14 14 For example, if the response for a sample size of 1,000 is 30%, in 95 cases out of 100 the response in the total population would be between 27% and 33%. Note that survey results based on subgroups of small size can be subject to large sampling error. The recommended allowances for sampling error were calculated based on a simple random sample. 97 LH RESEARCH, INC. Weighting The study was weighted to the Census Bureau's latest population parameters on sex, age, race, and education. This adjusts these key variables, where necessary, to their actual proportions in the population. In addition, the study was weighted by the number of adults in the household and the number of phone lines in the household. All surveys tend to under-represent to some extent the most disadvantaged stratum of society due to the inherent difficulty of reaching them. Weighting of data by race and education serves to correct any such under-representation and to assure that final results are fully projectable. 98 LH RESEARCH, INC. QUESTIONNAIRE 12:40pm March 2, 1993 LH RESEARCH 1270 Avenue of the Americas New York, NY 10020 Questionnaire No: (1-4) Health -- Study 920016 December 22, 1992 Interviewer I.D.: Date: Time Started: Area Code: Telephone No.: Hello. I'm , from LH Research, the national survey research firm in New York headed by Louis Harris. We're conducting a survey on important issues the public today. Your answers and those of everyone we interview are completely confidential and will only be used for statistical analysis. In order to get a representative sample of the public, I would like to speak to the youngest male who is at least 18 years old and a permanent member of this household. FROM OBSERVATION: Male ( )__-1 Female -2 1 March 2, 1993 12:40pm 1. Overall, how do you feel about the health care services that you and your family have used in the last year. As far as (READ EACH ITEM) goes, would you say you are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied? Some Some Very what what Very Not ROTATE--START AT "X" Satisfied Satisfied Dissatisfied Dissatisfied Sure ( ) 1. The quality of the service you received ( ) -1 -2 -3 -4 -5 ( ) 2. The availability of the kind of health care you want ( ) -1 -2 -3 -4 -5 ( ) 3. The cost of the health care available to you ( ) -1 -2 -3 -4 -5 ( ) 4. The health insurance plan available to you ( ) -1 -2 -3 -4 -5 2a. Now let me ask you about health care, such as hospital or physician services, drugs, nursing home care or assistance to remain at home. In the past 12 months, was there any time when you or a member of your family needed or thought you needed health care but did not get it, or was there no such time? Was such a time -1 (AKD Q.2B) No such time -2 (SKIP TO Q.3) Not sure -3 (SKIP TO Q.3) 2b. What is the main reason that you did not get the health care needed in this situation? (DO NOT READ LIST) (MULTIPLE RECORD) Lack of money, couldn't afford it ( ) -1 No insurance coverage for the condition -2 Couldn't get doctor's appointment -3 Couldn't get into a hospital -4 Told by doctor/hospital condition didn't require medical help -5 Didn't have transportation to Dr/hospital -6 Didn't know where or from whom to get medical help -7 Had insurance but it paid only part of the bill -8 Other -9 Not sure -0 ASK EVERYONE 3a. There have been a number of alternative plans for health care for people in this country. I'd like to get your views on each of them. First, under our present health care system, the government pays most of the cost of health care for the elderly, the poor, and the disabled. Most other people either have health insurance paid for by their employers or have to buy it from an insurance company. Some people have no insurance. Even those with insurance are not covered for the costs of medications, nursing home care and other long-term illnesses. Do you favor or oppose keeping this system as it is? Favor ( ) -1 Oppose -2 Not sure -3 2 March 2, 1993 12:40pm 3b. One alternative is a system of national health insurance, under which the government pays all the bills, with the patient not paying any bills directly. However, the government would pay a set amount for each service that people receive from their doctor and hospital, thereby controlling health care costs. Each person could choose his or her own doctor and hospital, much as they do now. Would you favor or oppose this system? Favor ( ) -1 Oppose -2 Not sure -3 3c. Another alternative is a system under which each employer would have to pay for health insurance for the employees of that company or organization, and, if an employer does not pay for such a plan, then the employer is taxed an amount equal to what it would cost to pay for the health insurance, and the insurance would be provided by the government. This plan would not cover the costs of long-term care, including nursing home or in-home care. Would you favor or oppose this system? Favor ( )__-1 Oppose -2 Not sure -3 3d. Another plan is called managed competition, under which large health maintenance organizations (HMOs) would be encouraged to provide most of the health care in the country. They would compete with each other in the same community for people's business. At the same time, the government would set prices for all health services received. The privately-owned HMOs would guarantee everyone signed up in them full doctor and hospital services, although under some HMOs, patients may not have the same doctors to take care of them. This plan would not cover costs of long-term care including nursing home or in-home care. Would you favor or oppose that system? Favor ( )___1 Oppose -2 Not sure -3 3e. Finally, another system of health care would also encourage people to sign up in special organizations approved by the government, representing large numbers of people. These sponsor organizations, as they would be called, would then drive bargains for their members with private health maintenance organizations. All medical costs would be paid for by a payroll tax on each employer and employee, which would go into a fund regulated by the government. Individual sponsoring organizations would then offer their members two HMOs to choose from, deciding which would appeal to them more. If a person wanted more services beyond the basics, they could pay more for more extensive coverage. This plan would not cover the costs of long-term care, including nursing home or in-home care. Would you favor or oppose such a system? Favor ( ) -1 Oppose -2 Not sure -3 3f. Another plan would create a health security program similar to Social Security. Like Social Security, Medicare would expand to include people of all ages. Everyone would pay into the health security program during their working years in exchange for comprehensive and long-term care protection when they are unemployed, retired, disabled, or chronically ill. Employers would be required to provide the same comprehensive package of benefits as the public health security program for their employees either through private insurance or by buying into the public plan. Comprehensive budgeting to control costs would be an important part of this plan, as would quality control provisions. Would you favor or oppose such a system? Favor ( )___-1 Oppose -2 Not sure -3 3 March 2, 1993 12:40pm 4a. A major problem with health care is the constantly rising costs. Keeping that in mind, on a scale of 1 to 5, with 1 being the highest and 5 the lowest, what priority would you give to each of these in our health care system? (READ EACH ITEM) 4b. Now, if you had to choose, which one or two from that list would you give the highest priorities to? (READ LIST AGAIN ONLY IF NECESSARY) ROTATE--START AT "X" 4a. Rankings 4b. Most Important 1 2 3 4 5 Not sure 1st Mention 2nd Mention ( ) 1. Preventive care ( ) 1 2 3 4 5 6 ( ) 1 ( ) 1 ( ) 2. Long term home care ( ) 1 2 3 4 5 6 2 2 ( ) 3. Long term nursing home care ( ) 1 2 3 4 5 6 3 3 ( ) 4. Long or extended hospital days ( ) 1 2 3 4 5 6 4 4 ( ) 5. Fast, convenient outpatient care ( ) 1 2 3 4 5 6 5 5 ( ) 6. Hospitals that really care about the patients ( ) 1 2 3 4 5 6 6 6 ( ) 7. Unlimited availability of such care as kidney dialysis, organ transplants, and plastic surgery ( ) 1 2 3 4 5 6 7 7 ( ) 8. Extensive testing of patients( ) 1 2 3 4 5 6 8 8 Not sure 9 9 5. Which one of the following statements comes closest to expressing your overall view of the health care system in this country? a. On the whole, the health care system works pretty well and only minor changes are necessary to make it work better ) -1 - or - b. There are some good things in our health care system, but fundamental changes are needed to make it work better -2 .. or - C. Our health care system has so much wrong with it that we need to completely rebuild it -3 Not sure -4 4 March 2, 1993 12:40pm 6a. In the British National Health Service, the government pays most of the cost of health care for everyone out of taxes, and the doctors and hospitals work for the government. Under the British system, people can choose their family doctors, but not their specialists or hospitals. On balance, would you prefer the British system or the system we have here? British system ( ) -1 System we have here -2 Not sure -3 6b. In the Canadian system of National Health Insurance, the government pays most of the cost of health care for everyone out of taxes, and the government sets all fees charged by doctors and hospitals. Under the Canadian system, people can choose their own doctors and hospitals. On balance, would you prefer the Canadian system or the system we now have here? Canadian system ( ) -1 System we have here -2 Not sure -3 7a. Have you, or has any member of your family, or has someone you know ever needed long-term care because they had a chronic disease such as Alzheimer's disease, stroke, or muscular dystrophy, a birth defect, or a permanent disability resulting from an auto accident or something similar, or haven't you known anyone like that? Someone in family or have known someone ( ) -1 No one has had need and don't know anyone who has -2 Not sure -3 7b. Now, suppose you or some member of your family had to have long-term care. Would you prefer to receive that care in a nursing home or in your or their own home? In a nursing home ( )__-1 In own home -2 Neither (vol.) -3 Not sure -4 7c. An estimated one million Americans go bankrupt each year trying to pay the costs of long-term illness such as Alzheimer's or Parkinson's Disease. Today, very few people have long term medical insurance to pay for long-term care. It has been estimated that this kind of long-term care in your home or in a nursing home can cost as much as between $15,000 and $60,000 a year, or $40 to $160 a day. Would you be able to pay that amount of money for long-term care or not? Could afford to pay ( ) -1 Could not afford -2 Not sure -3 7d. Would you favor a federal program that would help provide for long-term care in the home for (REACH EACH ITEM) who are chronically ill or disabled, or would you oppose it? (RECORD BELOW) ROTATE-START AT "X" Favor Oppose Not Sure ( ) 1. Elderly people 65 and over ( ) -1 -2 -3 ( ) 2. People 20 to 64 years of age ( ) -1 -2 -3 ( ) 3. Children 19 years of age or under ( ) -1 -2 -3 5 March 2, 1993 12:40pm 7e. A real question is how a federal long-term care program for the chronically ill and disabled should be paid for. Today, medicare is financed by a tax of 1.45% on employee wages, up to $130,200 of their annual income. This means that 3% of the population who earn more than $130,200 pay this tax on the first $130,200 only, but not on income beyond that. One way to pay for the federal long-term care program would be to make those earning over $130,200 pay this tax on all of their income. Would you favor or oppose extending the Medicare tax to include all income to fund a long-term care program? Favor ( )___-1 Oppose -2 Not sure -3 7f. An estimated one million people go bankrupt each year paying the costs of long-term illness. If a system of national health insurance were adopted in the country, would you give a top priority to a program of long-term care as part of such a plan, a high priority but not a top priority, or would you give long-term care a lower priority than that? Give long-term care a top priority ( )___1 Give it a high but not top priority -2 Give it a lower priority -3 Not sure -4 7g. Do you feel that the new national administration under President Clinton should give the highest priority to health care reform, a somewhat high priority, or not a priority at all? The highest priority ( ) -1 Somewhat high priority -2 Not a high priority at all -3 Not sure -4 7h. Do you believe that health care should be a fundamental right, or not? Should be fundamental right ( ) -1 Should not -2 Not sure -3 8. And how would you rate your own personal health -- excellent, pretty good, only fair, or poor? Excellent ( ) -1 Pretty good -2 Only fair -3 Poor -4 Not sure -5 6 March 2, 1993 12:40pm FACTUAL F1. How old are you? 18 to 24 ( ) -1 45 to 49 -6 25 to 29 -2 50 to 64 -7 30 to 34 -3 65 to 74 -8 35 to 39 -4 75 and over -9 40 to 44 -5 Not sure -0 F2. What is the last grade of school you completed? Less than high school (1-11 years) ( ) -1 High school graduate (12 years) -2 Some college (13-15 years) -3 College graduate (16 years) -4 Post-college graduate -5 Not sure -6 F3. Which of the following income categories best describes your total 1991 household income. Was it (READ LIST)? $7,500 or less ( ) -1 $50,001-$75,000 -6 $7,501-$15,000 -2 $75,001-$100,000 -7 $15,001-$25,000 -3 $100,001 and over -8 $25,001-$35,000 -4 Not sure/refused -9 $35,001-$50,000 -5 F4. Regardless of how you vote, what do you consider yourself a Republican, a Democrat, an independent, or what? Republican ( )(____1 Democrat -2 Independent -3 Not sure -4 F5. In the recent election for president, did you vote for Bill Clinton the Democrat, George Bush the Republican, or Ross Perot the independent, or did you not get around to voting in that election? Clinton ( ) -1 Bush -2 Perot -3 Didn't get around to voteing -4 Not sure -5 F6. Are you of Hispanic descent, or not? Yes, of Hispanic descent ( ) -1 No, not of Hispanic descent -2 Not sure -3 F7. Do you consider yourself white, black, Asian, or what? White ( ) -1 Black, African-American -2 Oriental/Asian or Pacific Islander -3 American Indian, Native America, or Alaskan native -4 Not sure -5 Thank you for your cooperation! CONFIDENTIAL CONE BASE: 1250 ADULTS CROSS SECTION CONFIDENTIAL OF ENTIRE U.S.A. INTERY YEWING DATES: JAN.1993 8 P1. Now I want to read you some statements about Mrs. Hillary Clinton, the wife of President-elect Bill Clinton. For each statement, tell me if you tend to agree or disagree. (READ EACH STATEMENT) ROTATE-START AT "X" Agree Disagree Not Sure ( ) 1. Hillary Clinton will be one of the brightest and most able First Ladies this country has ever had, and should be of great help to her husband, the President Total ( )591 22-2 19-3 ( ) 2. She will get too involved in the running of the government and should be a more traditional First Lady Total ( )341 51-2 15-3 ( ) 3. One of her real strengths is that she cares about children who are in need of help, improving education for the young, and for people who need government to do things for them Total ( Cq-1 12-2 19-3 ( ) 4. Hillary Clinton is too liberal and too much of an activist Total ( )26-1 53.2 21-3 ( ) 5. She has led an active career as a lawyer and as an advocate for children. Now she should use her skills in government to advance the causes she cares about Total, ,221 14.2 9.3 ( ) 6. The less we see or hear Hillary Clinton, the better off the country will Total be( )23-1 65.2 12-3 P2. All in all, if you had to say, do you feel more positive or more negative about Hillary Clinton? More positive ( 0621 More negative 21-2 Not sure 17-3 POSITIVE- NEGATIVE ON HILLARY CLINTON Pos:- New Not Not twe tive Sux Positive Nagative sure Fotal Nation 62 21 17 17 new 55 26 19 East women 70 17 13 70 16 17 midwest 59 26 15 High school n less 60 22 18 South ea 18 17 Some college 63 18 19 West 58 19 23 College graduate 59 26 15 white 60 13 17 Black Postgraduate F 15 8 88 $ - Hispanic 57 11 32 vokdin'az 63 22 IS 18-29 65 20 IS Vold 91 2 J 30-49 60 zz 18 50-64 Voted forBush 28 51 21 62 21 17 65+ + 15 Vetel for Revot 60 17 23 months under 50 15 70 16 14 E woman 70 15 $15-251C 61 22 17 Women over 50 69 19 12 #25-35k cz 22 16 835-50k Democratic women 88 5 7 63 23 15 15 over $50k 13 Republicion women F 42 17 Independent women 7 12 14 Republicin 46 19 Quesent 8569 Independent 65 16 19 DETERMINED TO BE AN CONDUCTED BY LHRESEARCH ADMINISTRATIVE MARKING A POLL BY LOUIS HARRIS INITIALS: SAB DATE: 12-2-13