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
34429062
label
Polls/Op-Eds/Articles [2]
core
doc
dtoType
document
pageCount
1
Source metadata
Source extras
naId
34429062
levelOfDescription
fileUnit
otherTitles
42-t-7422560-20140536S-041-001-2016
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
ad58caf0250bd45b
ocrText
THE WHITE HOUSE OFFICE OF DOMESTIC POLICY From: Chris Jennings Phone: 6-5560 To: Jen Date: 1/16/95 Remarks: FYI JAN 13 '95 10:01AM P.2 THE LUNTZ RESEARCH COMPANIES Luntz Research & Strategic Services The Public Opinion Company Luntz Corporate Luntz Worldwide Healthcare Leadership Council Benchmark Survey Confidential Final Results The Luntz Research Companies 1000 Wilson Boulevard Suite 950 Arlington, VA 22209 November, 1994 General Public (Adults 18+) GENERAL 1. Generally speaking, are things in this country headed in the right direction, or have they seriously gotten off on the wrong track? 28% RIGHT DIRECTION 62% WRONG TRACK 10% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) 2. And looking ahead to the next two years or so, do you expect national economic conditions to improve, worsen or stay about the same as they are right now? 28% IMPROVE 41% STAY THE SAME 27% WORSEN 4% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) 3. And. what about your own personal financial situation? Over the next two years, do you expect your own financial situation to improve, worsen or stay about the same as it is right now? 42% IMPROVE 46% STAY THE SAME 10% WORSEN 2% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) 00 Wilson Boulevard Suite 950 Arlington. Virginia 22209 Phone (703) 358-0080 Fax (703) 358-0089 P.3 JAN 13 '95 10:01AM 4. Which of the following issues do you think should be the top priority of President Clinton and the Congress in 1995? (READ AND ROTATE) 14% PASSING HEALTH CARE REFORM LEGISLATION 16% REFORMING THE WELFARE SYSTEM 20% FIGHTING CRIME 18% CUTTING GOVERNMENT SPENDING 9% LOWERING TAXES 20% THE ECONOMY AND JOBS 3% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) 5. And, which one should be the second highest priority? 15% PASSING HEALTH CARE REFORM LEGISLATION 21% REFORMING THE WELFARE SYSTEM 18% FIGHTING CRIME 14% CUTTING GOVERNMENT SPENDING 12% LOWERING TAXES 16% THE ECONOMY AND JOBS 4% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) 6. Do you strongly approve, somewhat approve, somewhat disapprove or strongly disapprove of the job Bill Clinton is doing as President? 13% STRONGLY APPROVE 35% SOMEWHAT APPROVE 20% SOMEWHAT DISAPPROVE 28% STRONGLY DISAPPROVE 4% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) 7. Based on what you know, do you strongly favor, somewhat favor, somewhat oppose, or strongly oppose President Clinton's policies on health care reform? 12% STRONGLY FAVOR 24% SOMEWHAT FAVOR 20% SOMEWHAT OPPOSE 35% STRONGLY OPPOSE 9% DON'T KNOW (DO NOT READ) $ REFUSED (DO NOT READ) Luntz Research Companies - Health Care Leadership Forum JAN 13 '95 10:01AM P.4 HEALTH CARE 1995 8. (SPLIT SAMPLE) Generally speaking, are you extremely satisfied, very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied with the health [CARE/INSURANCE] system in the U.S. generally? Total Care Insurance 4% 3% 5% EXTREMELY SATISFIED 9% 10% 8% VERY SATISFIED 32% 34% 30% SOMEWHAT SATISFIED 26% 27% 24% SOMEWHAT DISSATISFIED 25% 24% 27% VERY DISSATISFIED 2% 2% 2% DON'T KNOW (DO NOT READ) 2% 0% 5% REFUSED (DO NOT READ) 9. (SPLIT SAMPLE) Is the current health [CARE/INSURANCE] system meeting the needs of you and your family? Would you say that it is very much meeting the needs of you and your family, somewhat meeting the needs of you and your family, not really meeting the needs of you and your family, or not at all meeting your needs? Total Care Insurance 33% 32% 33% VERY MUCH MEETING NEEDS 43% 44% 43% SOMEWHAT MEETING NEEDS 10% 8% 12% NOT REALLY MEETING NEEDS 11% 11% 10% NOT AT ALL MEETING NEEDS 2% 1% 2% DON'T KNOW (DO NOT READ) 2% 4% 0% REFUSED (DO NOT READ) 10. Do you think that the health care system in this country should be kept basically the same, should it be reformed, or should it be radically changed? 18% KEPT BASICALLY THE SAME 52% REFORMED 28% RADICALLY CHANGED (DO NOT READ) 2% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) 2 JAN 13 '95 10:02AM P.5 11. As you know, federal health care reform legislation did not pass last year. In your opinion, who is most responsible for the failure to pass health care reform (ROTATE) President Clinton, Democrats in Congress, Republicans in Congress, the medical profession, or the health insurance industry? 14% PRESIDENT CLINTON 10% DEMOCRATS IN CONGRESS 25% REPUBLICANS IN CONGRESS 8% MEDICAL PROFESSION 23% HEALTH INSURANCE INDUSTRY 20% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) 12. Generally speaking, do you think that the fact that health reform did not pass last year was a great thing for the country, a good thing, a not so good thing, or a bad thing for the country? 12% GREAT THING 32% GOOD THING 31% NOT so GOOD THING 21% BAD THING 4% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) 13. And, thinking about your own personal situation, is the fact that health reform did not pass last year a great thing for you, a good thing, a not so good thing, or a bad thing for you personally? 12% GREAT THING 32% GOOD THING 27% NOT so GOOD THING 12% BAD THING 17% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) 14. Now that the Republicans control Congress, what do you think the chances are that health reform will pass in the coming year? Do you think that there is an excellent chance, a good chance, a fair chance, or a poor chance that health care reform will pass in the coming year? 3% EXCELLENT CHANCE 12% GOOD CHANCE 27% FAIR CHANCE 52% POOR CHANCE 6% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) JAN 13 '95 10:02AM P.6 15. In trying to pass health care reform this year, do you think that President Clinton should do more to compromise with Congress in agreeing on health reform legislation, or should Republicans in Congress do more to compromise with President Clinton? 46% CLINTON SHOULD COMPROMISE 36% REPUBLICANS SHOULD COMPROMISE 17% DON'T KNOW (DO NOT READ) 2% REFUSED (DO NOT READ) I will now read you some different opinions which people have expressed about health care in this country. After I have read them, please tell me which comes closest to your view. 16. 56% REFORM SHOULD BE LIMITED TO FIXING WHAT IS BROKEN, NOT RESTRUCTURING THE ENTIRE SYSTEM WHICH ALREADY WORKS WELL FOR MOST AMERICANS. OR 44% WE NEED A COMPLETE OVERHAUL OF THE HEALTH CARE SYSTEM IN THIS COUNTRY. 17. 57% THE HEALTH CARE SYSTEM IN THIS COUNTRY IS so BROKEN THAT THE FEDERAL GOVERNMENT HAS TO GET INVOLVED. OR 43% THE GOVERNMENT SHOULD MIND ITS OWN BUSINESS AND STAY OUT OF HEALTH CARE. THE PROBLEMS IN THE SYSTEM WILL WORK THEMSELVES OUT. 18. 30% HEALTH CARE REFORM MUST INCLUDE UNIVERSAL COVERAGE, THAT IS, WHERE THE GOVERNMENT WOULD GUARANTEE THAT EVERY AMERICAN HAS A STANDARD HEALTH INSURANCE BENEFITS PACKAGE -OR-- 70% HEALTH CARE REFORM MUST INCLUDE UNIVERSAL ACCESS, THAT IS, WHERE THE GOVERNMENT MAKES HEALTH INSURANCE MORE AFFORDABLE, HELPS POORER PEOPLE TO GET COVERAGE, BUT DOES NOT REQUIRE THAT EVERYONE SHOULD HAVE HEALTH INSURANCE. Lunt T. JAN 13 '95 10:03AM P.7 19. Suppose for a moment that you could speak to your Member of Congress right now about health care. What would you tell him or her is the single most important change that Congress should make to the health care system? (OPEN-ENDED - PROBE FOR SPECIFIC RESPONSE) 20. And, if all you knew about two health care reform proposals is that one is supported by President Clinton and the other is supported by Congressional Republicans, and you had to choose one of these plans, which one would you prefer? 32% CLINTON PLAN 44% REPUBLICANS IN CONGRESS PLAN 8% NEITHER (DO NOT READ) 1% BOTH (DO NOT READ) 14% DON'T KNOW (DO NOT READ) 1% REFUSED (DO NOT READ) 21. What specifically concerns you most about the Republicans in Congress handling health care reform? (OPEN-ENDED - PROBE FOR SPECIFIC RESPONSE) 22. SPLIT SAMPLE: What specifically concerns you most about [the Democrats in Congress/President Clinton] handling health care reform? (OPEN-ENDED - PROBE FOR SPECIFIC RESPONSE) JAN 13 '95 10:03AM P.8 ATTITUDES TOWARD HEALTH CARE ORGANIZATIONS AND INDIVIDUALS Now, let me read you a list of organizations and individuals that have been involved in the health care debate, and I want you to tell me how much you trust them when they talk about health care. Do you trust them completely, mostly, somewhat, only a little, or not at all when the following person or organization talks about health care? 23: Doctors, in general 8% COMPLETELY 22% MOSTLY 41% SOMEWHAT 14% ONLY A LITTLE 14% NOT AT ALL 1% DON'T KNOW / REFUSED (DO NOT READ) 24. Dentists, in general 9% COMPLETELY 23% MOSTLY 43% SOMEWHAT 12% ONLY A LITTLE 10% NOT AT ALL 4% DON'T KNOW / REFUSED (DO NOT READ) 25. Pharmacists, in general 14% COMPLETELY 29% MOSTLY 37% SOMEWHAT 9% ONLY A LITTLE 8% NOT AT ALL 4% DON'T KNOW / REFUSED (DO NOT READ) 26. Bill Clinton 9% COMPLETELY 16% MOSTLY 31% SOMEWHAT 15% ONLY A LITTLE 28% NOT AT ALL 2% DON'T KNOW / REFUSED (DO NOT READ) Research Commanies Health Care T endorshin JAN 13 '95 10:03AM P.9 27. Hillary Clinton 10% COMPLETELY 14% MOSTLY 26% SOMEWHAT 10% ONLY A LITTLE 38% NOT AT ALL 3% DON'T KNOW / REFUSED (DO NOT READ) 28. Jocelyn Elders 4% COMPLETELY 7% MOSTLY 26% SOMEWHAT 11% ONLY A LITTLE 27% NOT AT ALL 25% DON'T KNOW / REFUSED (DO NOT READ) 29. Phil Gramm 3% COMPLETELY 6% MOSTLY 31% SOMEWHAT 12% ONLY A LITTLE 22% NOT AT ALL 27% DON'T KNOW / REFUSED (DO NOT READ) 30. Bob Dole 5% COMPLETELY 15% MOSTLY 34% SOMEWHAT 15% ONLY A LITTLE 23% NOT AT ALL 9% DON'T KNOW / REFUSED (DO NOT READ) 31. Newt Gingrich 4% COMPLETELY 9% MOSTLY 25% SOMEWHAT 13% ONLY A LITTLE 27% NOT AT ALL 23% DON'T KNOW / REFUSED (DO NOT READ) P.10 JAN 13 '95 10:04AM 32. The Democrats in Congress 4% COMPLETELY 10% MOSTLY 41% SOMEWHAT 21% ONLY A LITTLE 20% NOT AT ALL 4% DON'T KNOW / REFUSED (DO NOT READ) 33. The Republicans in Congress 5% COMPLETELY 12% MOSTLY 43% SOMEWHAT 18% ONLY A LITTLE 18% NOT AT ALL 5% DON'T KNOW / REFUSED (DO NOT READ) PERSONAL HEALTH CARE BEHAVIOR 34. First, in determining whether a health care provider offers the best total package of cost, quality and choice, which of the following individuals would you, in general, be most likely to believe? (ROTATE) 26% a doctor 32% an independent health care expert 29% a friend or family member 8% a pharmacist 2% none (DO NOT READ) 3% don't know/refused (DO NOT READ) 35. In general, who makes the final decisions in your household regarding health insurance plans? (READ: ACCEPT MORE THAN ONE ANSWER) 53% YOURSELF 12% ANOTHER MEMBER OF YOUR FAMILY 24% JOINT DECISION (DO NOT READ) 16% YOUR EMPLOYER 1% SOMEONE ELSE (DO NOT READ) * DON'T KNOW/REFUSED (DO NOT READ) untz Research Companies - Health Care Londershin P.11 JAN 13 '95 10:04AM 36. Do you currently have health insurance? 89% Yes 11% No * Don't know / Refused (DO NOT READ) (IF NO, ASK, then SKIP TO Q. 48, asking 48-50, skipping 51, and asking 52 through the end:) 37. And why don't you currently have health insurance? (OPEN ENDED -- PRECODED) 16% UNEMPLOYED 44% INSURANCE TOO EXPENSIVE 3% HEALTHY/DONT NEED 32% OTHER 6% DON'T KNOW/REFUSED (DO NOT READ) (IF YES IN Q. 36, ASK:) 38. Do you purchase your own health insurance, is it a government program, do you receive your insurance through your employer, or through a family member's employer? 19% PURCHASE YOUR OWN 13% GOVERNMENT PROGRAM 53% EMPLOYER 14% FAMILY MEMBER'S EMPLOYER 1% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) 39. Do you belong to an HMO, a preferred provider organization, or do you have conventional health insurance? 26% HMO 18% PPO 43% CONVENTIONAL 11% DON'T KNOW (DO NOT READ) * REFUSED (DO NOT READ) (IF "CONVENTIONAL", ASK:) 40. Does you plan require you to make a phone call to get approval to go to the hospital? 33% YES 62% NO 5% DON'T KNOW/REFUSED (DO NOT READ) rch Companies - Health Care Leadership Forum Survey 10 P.12 JAN 13 '95 10:04AM 41. Some health care plans provide a specific list of doctors who are associated with that plan. People in these health care plans pay less to use the doctors on the list than they do to use doctors who are NOT on that list. Is you health care plan organized like this or not? 55% YES 42% NO 4% DON'T KNOW/REFUSED (DO NOT READ) 42. Generally speaking, are you extremely satisfied with your current health care plan, very satisfied with your health care plan, somewhat satisfied, somewhat dissatisfied, or very dissatisfied with your health care plan? 21% EXTREMELY SATISFIED 33% VERY SATISFIED 33% SOMEWHAT SATISFIED 9% SOMEWHAT DISSATISFIED 3% VERY DISSATISFIED 1% DON'T KNOW/REFUSED (DO NOT READ) 43. Why are you (INSERT RESPONSE FROM PREVIOUS QUESTION) (SATISFIED/DISSATISFIED) with your current health care provider? Are there any other reasons? Anything else? (OPEN ENDED - MULTIPLE RESPONSE) 44. And, thinking about COST Are you extremely satisfied with the cost of your current health care plan, very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied with the COST of your current health care plan? 17% EXTREMELY SATISFIED 26% VERY SATISFIED 31% SOMEWHAT SATISFIED 15% SOMEWHAT DISSATISFIED 8% VERY DISSATISFIED 3% DON'T KNOW/REFUSED (DO NOT READ) Earch Companies . Health Care Leadership Forum Survev 11 P.13 JAN 13 '95 10:05AM 45. What about QUALITY? Are you extremely satisfied, very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied with the QUALITY of care you receive under your current health care plan? 22% EXTREMELY SATISFIED 40% VERY SATISFIED 28% SOMEWHAT SATISFIED 4% SOMEWHAT DISSATISFIED 2% VERY DISSATISFIED 3% DON'T KNOW/REFUSED (DO NOT READ) 46. And, finally, thinking about the number of CHOICES you have as a patient under your current health care plan Are you extremely satisfied, very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied with the choices you have under your current health care plan? 20% EXTREMELY SATISFIED 40% VERY SATISFIED 29% SOMEWHAT SATISFIED 7% SOMEWHAT DISSATISFIED 3% VERY DISSATISFIED 2% DON'T KNOW/REFUSED (DO NOT READ) HEALTH CARE COSTS 47. Thinking again about your health insurance, on average, what is your monthly premium? If you don't know the exact amount, just estimate for me. 13% Nothing / Zero / No premiums 33% $100 or less 16% $101 to $200 5% $201 to $250 3% $251 to $300 8% over $300 21% DON'T KNOW / REFUSED ch Companies - Health Care Leadership Forum P.14 JAN 13 '95 10:05AM 48. And how much out of pocket money do you and your family pay for health care services in a typical year? Again, if you don't know the exact amount, just estimate it for me. 7% None 12% Less than $100 12% $101 to $250 14% $251 to $499 16% $500 to $999 11% $1,000 to $1,999 8% $2,000 to $4,999 2% $5,000 to $9,999 2% $10,000 or more 17% Don't know / Refused 49. Still thinking about health care costs, I want you to think about how much money you have spent on health care for you and your family in the past few years. Are you paying a lot more today than you did two years ago, somewhat more, somewhat less or a lot less? 23% A LOT MORE 43% SOMEWHAT MORE 13% SOMEWHAT LESS 7% A LOT LESS 15% DON'T KNOW/REFUSED (DO NOT READ) 50. Thinking ahead two years from now, do you expect to pay a lot more for health care for you and your family, somewhat more, somewhat less, or a lot less than you do right now? 22% A LOT MORE 51% SOMEWHAT MORE 11% SOMEWHAT LESS 4% A LOT LESS 12% DON'T KNOW/REFUSED (DO NOT READ) Has there been any time in the past two years when you, personally, had no health insurance? 15% YES 84% NO 1% DON'T KNOW/REFUSED (DO NOT READ) Companies Health Care Leadershin P.15 JAN 13 '95 10:06AM SPECIFIC REFORMS 52. Even though all of the following features are very important, which of these five features is THE most important to YOU, personally, in terms of your own personal health care (ROTATE, THEN ASK:) (ACCEPT ONE RESPONSE FOR EACH QUESTION) 39% the quality of your health care 10% the cost of your health care 30% the freedom to choose doctors and hospitals 10% accessibility of your doctor and health care facility 9% availability of low cost prescription drugs 3% DON'T KNOW / REFUSED (DO NOT READ) 53. And, which of these features would be your second choice? (Re-read list if necessary) 20% the quality of your health care 21% the cost of your health care 20% the freedom to choose doctors and hospitals 17% accessibility of your doctor and health care facility 18% availability of low cost prescription drugs 3% DON'T KNOW / REFUSED (DO NOT READ) Some people want Congress to create medical savings accounts as part of health care reform. These are like IRA's, in that they are voluntary and would enable you to put away a percentage of your income in a special, tax-free account. The money in this account could be used only for medical expenses. If you and your family don't spend all of your insurance money this year, you can save it for as long as your lifetime, to help pay for emergencies and long-term care later on. Thinking about the type of medical savings account I just described for you, would you strongly support, somewhat support, somewhat oppose, or strongly oppose the creation of it as part of health care reform? 38 22% STRONGLY SUPPORT 34% SOMEWHAT SUPPORT 15% SOMEWHAT OPPOSE 21% STRONGLY OPPOSE 8% DON'T KNOW/REFUSED (DO NOT READ) Companies - Health Care Leadershin Forum Survey 14 P.16 JAN 13 '95 10: 06AM 55. And, if such a tax-free medical savings account were available, would you definitely use one, probably use one, probably not use one, or definitely not use one? 14% DEFINITELY USE 43% PROBABLY USE 21% PROBABLY NOT 16% DEFINITELY NOT 7% DON'T KNOW/REFUSED (DO NOT READ) DEMOGRAPHICS 56. Age 10% 18-24 9% 25-29 12% 30-34 11% 35-39 13% 40-44 10% 45-49 7% 50-54 5% 55-59 6% 60-64 6% 65-69 9% 70+ 2% Refused 57. What is the last grade of formal education you have completed less than high school, high school graduate, vocational/some college, college graduate, or post graduate? 9% less than high school 30% high school graduate 27% vocational/some college 25% college graduate 8% post graduate 2% DON'T KNOW / REFUSED (DO NOT READ) 58. What is your current marital status are you married, single and never been married, divorced, widowed, or separated? (CODE ENGAGED AS SINGLE) 19% single and never been married 62% married 7% widowed 10% divorced or separated 2% DON'T KNOW / REFUSED (DO NOT READ) Companies - Health Care Leadership Forum Survey 15 P.17 JAN 13 '95 10:06AM 59. Do you have any children under the age of 21 living at home with you? 41% Yes 56% No 2% DON'T KNOW / REFUSED (DO NOT READ) 60. Generally speaking, how often do you discuss politics with family and friends? 10% TWICE A DAY 17% ONCE A DAY 33% ONCE OR TWICE A WEEK 32% RARELY 6% NEVER 2% DONT KNOW/REFUSED (DO NOT READ) 61. In the recent election for U.S. Congress, did you vote for the (ROTATE) Democratic candidate for Congress or the Republican candidate? If you are registered but did not vote, just say so. If you are not registered to vote, just say so. 32% Democrat 40% Republican 3% Independent (DO NOT READ) 1% Other candidate (DO NOT READ) 11% Registered/Did not vote 7% Not Registered 8% Don't know / Refused (DO NOT READ) Companies - Health Care Leadership Forum Survey 16 P.18 JAN 13 '95 10:07AM 62. And, thinking of all elections that you have voted in, would you say that you have voted for 8% ALL DEMOCRATS 18% MAINLY DEMOCRATS 10% A FEW MORE DEMOCRATS THAN REPUBLICANS 18% EVENLY DEMOCRAT AND REPUBLICAN 10% A FEW MORE REPUBLICANS THAN DEMOCRATS 19% MAINLY REPUBLICANS 6% ALL REPUBLICANS 5% NEVER VOTE (DO NOT READ) 7% DON'T KNOW/REFUSED (DO NOT READ) 63. And, what is your total annual family income? Just stop me when I read the correct category 7% less than $10,000 13% 10,000 to 20,000 16% 21,000 to 30,000 15% 31,000 to 40,000 12% 41,000 to 50,000 8% 51,000 to 60,000 6% 61,000 to 70,000 4% 71,000 to 80,000 8% over 80,000 12% DON'T KNOW / REFUSED (DO NOT READ) 64. Do you, or does someone in your family belong to a labor union of any kind? 21% YES 76% NO 3% DON'T KNOW/REFUSED (DO NOT READ) 65. Do you, or does someone in you household work in the health care industry or medical profession? 18% YES 80% NO 2% DON'T KNOW/REFUSED (DO NOT READ) Companies - Health Care Leadership Forum Survey 17 JAN 13 '95 10:07AM P.19 66. What is your race or main ethnic background? (READ LIST) 83% White 9% Black 3% Hispanic 3% Other 2% Refused 67. Thinking of your general outlook politically, would you describe yourself as conservative, somewhat conservative, moderate, somewhat liberal, or liberal? 29% Conservative 21% Somewhat conservative 28% Moderate 10% Somewhat liberal 8% Liberal 5% Don't know / Refused (DO NOT READ) 68. Finally, I would like to describe for you what some people have referred to as "ideal" health care reform package. It contains the following - first, a guarantee that your ability to carry your health insurance from one job to the next; second, a guarantee your ability to keep your health insurance if you lost your job; and, finally, a guarantee that you or a family member could not be turned down by a health insurance company because of a pre-existing condition or illness. Do you strongly approve, somewhat approve, somewhat disapprove, strongly disapprove of this reform package? 52% STRONGLY APPROVE 35% SOMEWHAT APPROVE 5% SOMEWHAT DISAPPROVE 2% STRONGLY DISAPPROVE 6% DON'T KNOW/REFUSED (DO NOT READ) 69. Why did you say that? Why, specifically, do you (INSERT RESPONSE FROM QUESTION 68) this reform proposal? Companies Health Care Leadership Forum Survey 18 P.20 JAN 13 '95 10:07AM 70. (ASK ALL EXCEPT THOSE WHO "STRONGLY APPROVE" IN QUESTION 68) Do you think this reform proposal goes too far or not far enough? 33% TOO FAR 34% NOT FAR ENOUGH 26% DON'T KNOW (DO NOT READ) 8% REFUSED (DO NOT READ) 71. Gender 48% MALE 52% FEMALE 72. Region ompanies - Health Care Leadership Forum Survey 19 Date: 12/14/94 Time: 14:49 Poll: Most Want But Don't Expect Health Reform WASHINGTON (AP) The American public still favors health insurance reforms but doubts the new Congress will deliver them, a poll commissioned by health industry groups indicates. The survey released Wednesday found Republicans drew the most blame for Congress's failure to pass health reform in 1994, followed by the health insurance industry, President Clinton and Democrats. But asked to choose sight unseen between a Republican-backed plan and one endorsed by the president, the adults surveyed picked the GOP plan, by a 44-32 margin. And, by 46-36, they said the burden of compromise should fall more on Clinton than the Republicans. GOP pollster Frank Luntz conducted the survey for the Healthcare Leadership Council, an organization including major hospitals, managed-care companies and pharmaceutical firms that actively opposed the Clinton reform plan. Seven out of eight persons surveyed said they supported reforms to allow workers to stay insured when they lose their jobs and to prohibit insurers from turning them down because of a pre-existing condition or illness. Giving Americans the assurance that they can keep their coverage is major health care reform that can and should be passed in the early days of the next session, said Pamela G. Bailey, president of the council. But health reform isn't in the House Republican's Contract With America'' and Clinton has not yet decided what types of reforms he will seek in 1995. The voters surveyed by the Luntz Research Cos. rated health reform as a higher priority for Clinton and the new Congress than cutting taxes, 14 percent to 9 percent. The top priorities were the economy and jobs (20 percent), fighting crime (20), cutting government spending (18) and reforming welfare (16). Forty-five percent were satisfied with the current U.S. health system and 51 percent dissatisfied. A majority believed the failure to enact health reforms this year was bad for the country. But only 15 percent think the chances of passage in 1995 are good or excellent; 85 percent felt they were fair or poor. Luntz found that only 12 percent are dissatisfied with their current health plan, but 23 percent are unhappy with its cost. Dissatisfaction with the entire U.S. health system was much higher. Ironically, Americans tend to be somewhat more content with their coverage now than they were a year ago, when they were being told that such coverage was inadequate and in need of government intervention, a summary of the survey said. Luntz's firm surveyed 1,000 adults by telephone Nov. 28-Dec.1. The margin of error was 3.1 points in either direction. APNP-12-14-94 1447EST THE LUNTZ RESEARCH COMPANIES Luntz Research & Strategic Services The Public Opinion Company Luniz Corporate Lunt/ Worldwide EXECUTIVE SUMMARY A New Congress, An Old Issue: Health Care .95 The failure to pass health care reform in the 103rd Congress has not weakened the desire of most Americans for modifications to the national health care delivery system. By mid-summer 1994. more than 60% of Americans believed that Congress should wait until the next session to consider a "better" bill. That, coupled with Republican attacks on the Crime Bill and its subsequent delay in passage, effectively ended health care reform for 1994. However, Americans did not say table health care reform forever -- they said wait until the next session. That next session is here. Whereas the 1992 election was a call for "change," the 1994 election is a demand for dramatic "reform." But make no mistake. November 8. 1994 was about changing the players on Capitol Hill. and changing the "solutions." Our post-election polling makes clear that the failure of the Administration to understand public sentiment about health care -- and not the placement of health care on the legislative agenda -- was a significant factor in the Democratic defeat in November. Today, less than one in five Americans believe "the health care system in this country should be kept basically the same." A majority (52%) believe it should be "reformed," and 28% maintain that the health care system must be "radically changed." The debate must now progress from generic concepts to specific reforms. The substantiation must lie in empirical evidence. The public will accept no less. They have been left too long to wonder what the entire debate is about. when it will begin. and who will now be in charge of it. The new Congress has been given a strategic opportunity to deliver the type of modest and sensible reform the American people desire. As this national benchmark survey conducted for the Healthcare Leadership Council shows. such reform must be accomplished without the type of government intrusion which was proposed by Washington -- and soundly rejected by the American people -- in 1994. To go bevond what the public will accept is to invite failure on the issue. But to ignore the call for reform altogether is perhaps much worse. for it signals to the public that Washington, despite 100 fresh faces and a newlv-assembled majority in both the House and Senate. is conducting "business-as-usual." 1000 Wilson Bour and Suite 950 Arlington, Virginia 22209 Phone (703) 358-0080 Fax (703) It is within this context that the American people offer their retrospective on "Health Care '94" and issue advice (if not admonition) for "Health Care '95." Lessons from 1994 Americans are disappointed that health care legislation did not pass in 1994. A majority believe that this was a negative occurrence for the country. |________________________ When offered a list of priorities for 1995. health care reform actually finishes above cutting taxes. Satisfaction with the health care system in the U.S. is evenly split: 45% express at least some satisfaction (though the intensity of approval is extremely low), while 51% are dissatisfied. More people disapprove of President Clinton's handling of health care than his overall job performance. The President has lost nearly all credibility on the health care issue. Only one-fourth (25%) of all Americans trust him when he speaks on the issue. With 80% of Americans still calling for health care reform, a majority of Americans believe that the health care system is so broken that the federal government must get involved. The credibility of the health care industry and the medical profession have been imaged by the health care debate: only 30% of Americans trust doctors "completely" or "mostly" when they speak on health care. Further, Americans are most likely to believe an independent health care expert (32%) or a friend or family member (29%) rather than a doctor (26%) in determining which health care package offers the best combination of cost. choice and quality. Healthcare Leadership Council~Executive Summary 2 The most important lesson from 1994 must serve as the first piece of advice for 1995: no proposal can put government in the position of restricting quality and choice. It may have taken a long time to discover this fact and then explain it to the nation in the last session, but once done. the Clinton health care package was doomed. By the end of the health care debate, a majority of Americans felt that the Clinton plan would increase the cost of their coverage. reduce the number of choices and quality of care they would receive, and relinquish control of health care to a federal government which is out- of-touch and unable to affect positive national change. Repetition of this mistake may lead to repetition of its consequences: a perception that the party in legislative power is unresponsive to the needs of the people and therefore unworthy of their trust (and votes). Advice for 1995 In order to avoid a repeat of last month's tsunami. lawmakers would be wise to listen to the American people and heed their advice for re-approaching health care in 1995. Very few people think that health care reform will pass in 1995. Now that Republicans control Congress. just 15% think there is an "excellent" or "good" chance that reform legislation will be enacted in the next Congress, while an overwhelming 85% think chances for passage are only "fair" or "poor." The public is most likely to blame Republicans in Congress for the failure of health reform passage in 1994: it therefore follows that Republicans would likely be given credit for its passage in 1995-96. Americans would favor a GOP-backed plan over one endorsed by the President. 44%- 32%. From a communications standpoint. Americans react equally favorably to the terms "health care" and "health insurance." Americans categorically reject universal coverage as advocated last session: 70% 1 favor universal access to services. with just 30% favoring that the government guarantee coverage to every American. Healthcare Leadership Council~Executive Summary 3 Americans call for specific components as part of a health care improvement package, namely. portability, guaranteed renewability (when informed of the concept) and medical savings accounts. Specific Reforms What. then. must Congress do? What type of "reform" do Americans want? Simply put. reform that does not change the basic nature of their current health care arrangement but which makes noticeable changes to the perceived deficiencies in the national delivery system. The real challenge for Congress, the medical profession and the health care industry lies in delivering on the simplicity of what Americans want: let me keep my own, and don't let anyone take it away from me. The fact is. those with health care coverage are very pleased with what they have right now: only 12% express dissatisfaction with their health care plan. Even when asked about specific features of their coverage. the level of dissatisfaction still remains quite low: -- 23% are dissatisfied with the COST of their plan; -- 10% are dissatisfied with the range of CHOICES they have; -- 6% are dissatisfied with the QUALITY of care they receive. Ironically, Americans tend to be somewhat more content with their coverage now than they were a year ago. when they were being told that such coverage was inadequate and in need of government intervention. The effort to have Big Brother reach in and touch each of us personally having failed. Americans have a heightened appreciation for the type of coverage they currently enjoy. Healthcare Leadership Council-Executive Summary 4 Leave Managed Care Alone Popular agreement with personal coverage is further supported by the following chart. which illustrates the overwnelming satisfaction by all Americans with the quality and choice of their current health care plan. regardless of their type of insurance. As shown below. this singularity of opinion breaks down somewhat when the issue of cost is examined: TOTAL HMO PPO CONVENTIONAL QUALITY 90% 91% 94% 90% CHOICE 89°, 87% 91% 89% COST 74% 77% 81% 71% This chart destroys "conventional wisdom" put forth by some that "conventional coverage" (fee-for-service) is preferred superior to managed care. particularly with respect to the number of choices and the enhanced quality of care it offers its members. As the survey results demonstrate. in addition to being far more satisfied than their fee-for-service counterparts with the cost of their plan, people in managed care are more satisfied with the quality and choice they receive as well. ? 11 I This data indicates two clear conclusions: (1) That attempts to dismantle the managed care industry over the past two years failed miserably, as its premise chokes the type of marketplace choices which all Americans cherish: and, (2) That efforts by Members of Congress in 1995 to tinker with managed care will be challenged vigorously by members of managed care themselves. Healthcare Leadership Council-Executive Summary 5 The Ideal Health Care Plan In testing various health coverage plan components, Americans themselves have come up with an "ideal health care plan." This reform package is simple in that it consists of just two fundamental features: portability and guaranteed access to coverage despite a pre-existing condition or illness. With a remarkable 87% approving of the following specific health care reform package. including 52% "strongly" so. Congress has an unmistakable opportunity to literally give the people what they want: "An ability to carry your health insurance from one job to the i___________________/ next. A guarantee of your ability to keep your health insurance if you lost your job. A guarantee that you or a family member could not be turned down by a health insurance company because of a pre-existing condition or illness." An examination of specific verbatim responses about the plan further elucidate the reasons why the public embraces this new "Totally Transferable Non-Cancellable Health Care Alternative:" I like it because family members cannot be turned down because of an existing " condition I am about to retire and would like to take my insurance with me. I like the part about not being turned down. One of mv friends who had cancer had a hard time keeping insurance: the insurance knew his cost would be high because of the cancer. I don't think that it you iose your job you should lose your insurance. When I lost mv job. that was it. It shouldn I happen that way. You should have a choice. Healthcare Leadership Council~Executive Summary 6 Medical Savings Accounts Last session. 22 bills sponsored and supported by Members on both sides of the aisle. and endorsed by different groups within the health care and insurance industries. would have provided for "Medical Savings Accounts" (MSA's). Similar to IRA's. MSA's allow employees to recoup any medical insurance dollars which they and their families had not used at the end of the year by placing them in a special tax-free account. For healthy families who do not "spend" all of their insurance money in a given year. MSA's provide a medical nest egg to help pay for emergencies and long-term care later on. As tested by some employers nationwide, MSA's have met with resounding success by employees who feel the double benefit of quality coverage and a financial "bonus." As tested in this national survey. a majority (56%) of Americans support inclusion or MSA's in a national health care reform package, and 57% say they would use such a tax-free medical savings account if it were made available to them. Beyond its support in a telephone poll (where MSA's are defined for respondents who undoubtedly are hearing about them for the first time), MSA's are one of the most popular health care concepts featured in today's discussions. When mentioned in focus groups. where unlike telephone surveys. discussions expand and definitions turn into explanations. confused or skeptical respondents become informed and supportive. The ``too-good-to-be-true`` mentality that many have of MSA's. dissipates with the introduction of hard-evidence about its implementation and personal success stories from real people. The more intense acceptance of MSA's in the focus group setting suggests popular acceptance of MSA's. However. both the qualitative and the quantitative research -- as well as the real-life stories proves that the educational effort is absolutely necessary. To know MSA's is to love them. To use MSA's is to restore a little bit of faith in a health care system which Americans believe accommodates their own personal needs. but fails to meet the needs of the nation as a whole. Thus. any attempt at sensible id modest reform which attempts to protect the patient's right to access. portability and guaranteed renewability should go one step further by actively creating a reward (MSA's) of long-term health security for responsible insureds who do not abuse the system and who seek long-term coverage security. Healthcare Leadership Council-Executive Summary 7 A Final Note The one certain result of the health care debate of the past two years is the creation of fear among all Americans. Fear that health insurance will be denied because of a pre-existing condition or illness. Fear that career choices may come at the expense of maintaining health coverage. Fear that "Big Brother" will reach in and attempt to legislate the most fundamental component of life -- health care. The only way to eradicate such fear is to respond to it directly. Americans want specifics: details. definitions. imbers. Accordingly, the final piece of advice for health care .95 comes in the form of a checklist of questions to help guide the debate: - What does this particular feature entail? - il "hat does this mean to me? - How much it will cost? - Will I benefit either now or in the future? To all involved in the health care debate: before proposing a generic concept or a specific reform this year. ask yourselves these questions. The American people surely will. Methodology This survey was conducted over the telephone from November 28th until December 1st. one thousand aduits from across the nation were interviewed during this process. This survey has a margin of error of -3.1% with a 95% confidence level. This means that in 95 out of 100 cases. results will fall within the margin of error. Healthcare Leadership Council-Executive Summary 8 News Release THE HENRY 1. KAISER EMBARGOED FOR RELEASE: FAMILY 12:00 p.m. EST FOUNDATION Tuesday, November 15, 1994 For further information contact: 2400 SAND HILL ROAD Matt James or Tina Hoff MENLO PARK CALIFORNIA 94025 TEL 415 854-9400 FAX 415 854-4800 Among Issues, Voters See Health Reform As Top Priority For New Congress; But Reject Major Overhaul of System For More Modest Approach National Election Night Survey Also Finds: Voters Support Spending Cuts to Reduce Deficit in Theory, But Not In Practice When Specific Budget Areas Are Proposed Menlo Park, CA -- A Kaiser/Harvard election night survey of Americans nationwide who voted in the 1994 election has found that health care continues to be a key concern, but the voters are rejecting a major overhaul of the system. Instead, they strongly favor approaches to solving this national problem that are incremental and do not significantly expand government control of the health system. When voters cast their ballots, candidates' stands on issues are just one of many factors that determine their votes. Economic insecurity, values and ideology, attitudes about government and incumbents, and the perceived personal qualities of the candidates themselves all also play a major role. Among issues, however, health care (33%) was number one for voters in deciding who to vote for in the Congressional election, ahead of crime (29%) and taxes (238). In addition, it was named as the top priority issue for the next Congress to deal with. [Tables 1 and 2] In the survey, the voters also made it clear that they want Congress to take the lead in health reform next year, rather than the White House. [Table 3] The survey shows that the voters' vision of health care reform has shifted toward that held by many moderate Republicans and Democrats. Thirty-one percent of those surveyed said they were less supportive of major health reform than six months ago, with half of those citing as their reason that they did not think the government would do it right. More voters now want Congress to make modest changes in the health care system (41%), rather than to enact a major reform bill (25%). In addition, one in four voters favor leaving the system as is. [Tables 4 and 5] more WASHINGTON OFFICE: 1450 G STREET NW, SUITE 250 WASHINGTON, DC 20005 202 347-5270 FAX 202 347-5274 "These results say that voters want the new Congress to place health care high on their legislative agenda," said Dr. Robert Blendon, Professor and Chairman of the Department of Health Policy and Management at Harvard University. "But what the public means by health reform now comes closest to a more moderate vision: one which is more limited in scope, incremental, and that involves a much more limited role for government." A majority of voters (55%) believe that it is better to have the health insurance system run by private health insurance companies than by the government. This is especially the case among those who voted for Republican House candidates (66%). [Table 6] When asked what worries them most about health care reform, a plurality said they worry that there will be too much government bureaucracy (36%) or quality will decline (22%). When asked who they would like to take the lead in health care reform, more than one half indicated a preference for state leadership (54%), a change from previous surveys. [Tables 7 and 8] Voters are split over whether the priority should be guaranteeing universal coverage or making an incremental start. Republican voters favor starting with coverage for some groups who do not have health insurance, but not attempting to cover everyone right away (45%). Democrats more strongly favor guaranteeing health insurance coverage for all Americans as part of whatever legislation is passed (52%). [Table 9] If health insurance cannot be provided to all Americans, voters favor covering children first (40%) and working people who are uninsured (24%). When asked how the Congress might improve the private insurance system, 29 percent favor requiring employers who offer insurance to provide a choice of at least three health plans, and 27 percent favor requiring all employers to contribute part of the cost of health insurance for their employees. [Table 10 and 11] In order to see these changes made in the health care system, a slight majority (518) of voters are willing to pay more in health insurance premiums or taxes. [Table 12] -- 2 -- The Deficit, Taxes, and Entitlements The survey shows that the outcome of the election was also affected by the federal deficit and voters' desire not to have their taxes increased. These were named as the third and fourth highest priorities for the next Congress. When asked what Congress should do about the federal deficit in the next session, two thirds of voters (67%) preferred cuts in major spending programs to raising taxes (10%) or "not dealing with the deficit problem now" (10%). [Tables 13 and 14] Survey results reveal a dilemma for the new Congress. Voters support general cuts in government spending in principle, but not in practice when they relate to specific current government spending programs. When presented with a list of 25 selected policies to reduce the deficit, a majority of voters supported only four: Having people over age 65 who earn more than $50,000 a year pay more for Medicare than other seniors (71% favor); Decreasing spending on food stamps (55%) ; Decreasing agricultural price supports (53%) ; and Decreasing defense spending (53%). Voters expressed very low levels of support for spending cuts in Social Security (17%), Medicaid (17%), Medicare (8%), and veterans' benefits (7%). Even when told that one in three dollars spent by the federal government go to Social Security, Medicare, and Medicaid, two thirds of voters (65%) still prefer to see the biggest spending cuts come from other areas, while only 10 percent believe the biggest cuts should take place in these three major spending areas. [Table 15 and 16] These results point to a major obstacle facing the new Congress in its effort to reduce the federal deficit. Voters want Congress to address the deficit, but they do not want their taxes raised. They want spending cuts in principle, but are not willing to support major cuts in the programs that made up the largest part of the non-defense budget. The poll results show sharp contrasts between Democrat and Republican voters. Democrat voters are willing to cut defense spending further in years ahead, while Republicans are less willing. Republicans are more willing to cut AFDC 3 -- (welfare payments) ; Democrats are less so. Voters in both parties are willing to cut spending on food stamps and agricultural price supports, and support asking those seniors who earn more than $50,000 per year to pay more for Medicare. [Table 15] This situation is not aided by voters' general lack of knowledge of what makes up the federal budget. They know what entitlement programs are, but they do not have a very good idea of what are major areas of spending in the federal budget. Asked which of five areas consumed the largest share of federal spending, only 15 percent correctly named Social Security and 30 percent named defense. One in four voters (27%) thought the most federal money was spent on foreign aid, which accounted for only 2% of the 1993 Federal Budget. And, 19% said welfare accounted for the largest share. It was actually 3% of the 1993 budget. [Tables 17 and 18] "The public's misconceptions about the Federal Budget is the Achilles heel in deficit reduction," said Matt James, Vice President, Kaiser Family Foundation. "What the public is willing to embrace will not result in meaningful spending reductions. Policymakers need to do a better job in explaining which areas need to be addressed to achieve real savings or there will be a political price to pay when small-time reductions fail to result in big-time savings." Methodology The Kaiser/Harvard Election Night Survey was a random sample, telephone survey of adults nationwide who said they voted in the November 8, 1994 election. The national sample consisted of 1,200 voters. The survey was designed by the Harvard University School of Public Health's Department of Health Policy and Management and the Kaiser Family Foundation, and was conducted by KRC Communications Research, a national opinion research firm located in Newton, Massachusetts. The margin of error in the national sample is plus or minus 3 percent. The Kaiser Family Foundation, based in Menlo Park, California, is an independent national health care philanthropy and not associated with Kaiser Permanente or Kaiser Industries. The Foundation's work is focused on four main areas: health reform, reproductive health, HIV, and health and development in South Africa. The Foundation also maintains a special interest in health care in its home state of California. The Foundation does not support any particular proposal or approach to health reform. 30 THE HENRY J. KAISER FAMILY FOUNDATION Kaiser/Harvard/KRC NATIONAL ELECTION NIGHT SURVEY * The Voters' Health Care Agenda for the 104th Congress Public Understanding of the Major Entitlement Programs and the Federal Budget November 1994 EMBARGOED FOR RELEASE UNTIL: 12:00 P.M. EST, TUESDAY, NOVEMBER 15, 1994 Contact: Matt James, Vice President Robert J. Blendon, Sc.D. Communications and Media Programs Professor and Chairman Henry J. Kaiser Family Foundation Department of Health Policy and Management 2400 Sand Hill Road Harvard University School of Public Health Menlo Park, California 94025 (617) 432-4502 (415) 854-9400 Fax: (415) 854-4800 TABLE 1 MOST IMPORTANT ISSUE IN DECIDING 1994 U.S. HOUSE VOTE Voters Nationwide VNS Kaiser/Harvard Total Total Voters Voters 1. Health care 1. Health care 2. Crime 2. Crime 3. Econ./jobs 3. Taxes 4. Taxes 4(t). Education 5. Deficit 4(t). Abortion 6. Clinton job 6. Econ./johs Source: Voter News Service and Kaiser/Harvard Surveys 1994 TABLE 2 WHAT VOTERS SEE AS TOP PRIORITIES FOR THE NEXT PRESIDENT AND CONGRESS (1992) AND FOR THE NEXT CONGRESS (1994) 1992 - for the 1994 - for the next President next Congress and Congress 1. Economy/jobs 1. Health care 2. Deficit 2. Crime 3. Health care 3. Taxes 4. Taxes 4. Deficit 5. Education 5. Education 6. Foreign policy 6. Economy Source: Kaiser/Harvard Surveys 1992 and 1994 TABLE 1(a) MOST IMPORTANT ISSUES IN DECIDING 1994 U.S. HOUSE VOTE Total Voters HEALTH CARE 33% CRIME 29% TAXES 23% 0% 5% 10% 15% 20% 25% 30% 35% Source: Kaiser/Harvard Survey 1994. TABLE 2(a) VOTERS' TOP PRIORITIES FOR NEXT CONGRESS (1994) AND FOR NEXT PRESIDENT/CONGRESS (1992) HEALTH CARE 40% 20% CRIME 31% 2% TAXES 17% 7% 1994: NEXT CONGRESS DEFICIT 14% 1992: NEXT PRESIDENT/ 23% CONGRESS EDUCATION 11% 6% ECONOMY 9% 77% FOREIGN POLICY 4% 5% Source: Kaiser/Harvard Surveys, 1992 and 1994. TABLE 3 VOTERS' VIEWS ON WHO SHOULD TAKE THE LEAD IN DEVELOPING A HEALTH CARE REFORM PLAN NEXT YEAR Total Voted for Voted for Voters Republican Democrats in House in House Members of Congress 56% 70% 45% President Clinton 18% 9% 20% Neither/Other (vol.) 13% 11% 10% Both together (vol.) 8% 2% 13% Don't know 6% 7% 3% Source: Kaiser/Harvard Survey 1994 TABLE 4 CHANGE IN VOTER SUPPORT FOR CONGRESS ENACTING A MAJOR REFORM OF THE HEALTH CARE SYSTEM Compared to six months ago... Position hasn't changed ... 43% Less supportive of major reform 31% Reasons for being less supportive: The government wouldn't do it right 49% The reform alternatives were worse than the way the system is now 19% Health care reform is too expensive 10% Less worried about your family's own health care now 9% There's less of a health care crisis now 3% Other (vol.)/Don't know 10% More supportive of major reform 18% Reasons for being more supportive: More worried about my family's own health care now 55% There's more of a health care crisis now 31% Other (vol.)/Don't know 14% Don't know 8% Source: Kaiser/Harvard Survey 1994 TABLE 5 VOTERS' VIEWS OF WHAT THE NEXT CONGRESS SHOULD DO ABOUT HEALTH CARE REFORM Voted for Voted for Total Republican Democrat Voters in House in House Enact a major reform bill 25% 17% 45% Make modest changes in the health care system 41% 46% 28% Leave the health care system alone 25% 31% 14% Other (vol.) 3% 1% 7% Don't know 5% 5% 6% Source: Kaiser/Harvard Survey 1994 TABLE 6 VIEWS ON WHETHER IT'S BETTER TO HAVE THE HEALTH INSURANCE SYSTEM RUN BY THE GOVERNMENT OR PRIVATE INSURANCE COMPANIES November 1994 Voted for Voted for March 1993 Total Republican Democrat Adults Voters in house in house Private insurance companies 39% 55% " 33% Government 41% 24% 11% 42% Neither/No difference (vol.) 9% 15% 13% 19% Don't know 11% 7% 10% 6% Source: Marttilla & Kiley/Harvard/Robert Wood Johnson Survey 1993 Kaiser/Harvard Survey 1994 TABLE 7 WHAT WORRIES THE VOTERS MOST ABOUT HEALTH CARE REFORM IF CONGRESS TAKES ACTION Voted for Voted for Total Republican Democrat Voters in House in House There will be too much government bureaucracy 36% 40% 25% The quality of health care for you and your family will not be as good 22% 24% 24% You will not be able to choose the doctor or hospital you want 20% 17% 21% You will have to pay higher taxes 9% 9% 10% None/Other (vol.) 7% 3% 15% Don't know 6% 8% 5% Source: Kaiser/Harvard Survey 1994 TABLE 8 VOTERS' VIEWS ON WHETHER THE FEDERAL GOVERNMENT OR STATE GOVERNMENTS SHOULD TAKE THE LEAD IN CHANGING THE HEALTH CARE SYSTEM Voted for Voted for Total Republican Democrat Voters in House in House State governments 54% 62% 46% Federal government 32% 24% 44% Neither/Other (vel.) 9% 9% 5% Both together (vol.) 3% 2% 1% Don't know 3% 3% 4% Source: Kaiser/Harvard Survey 1994 TABLE 9 VOTERS' VIEWS ON WHAT CONGRESS SHOULD DO ABOUT HEALTH INSURANCE COVERAGE Voted for Voted for Total Republican Democrat Voters in House in House Guarantee health insurance coverage for all Americans 38% 26% 52% Make a start by covering some groups who do not have health insurance 36% 45% 33% Don't try to see that more people have health insurance 20% 21% 12% Other (vol.)/Don't know 6% 9% 3% Source: Kaiser/Harvard Survey 1994 TABLE 10 VOTERS' VIEWS ABOUT WHICH GROUP SHOULD BE COVERED FIRST IF WE CANNOT PROVIDE HEALTH INSURANCE TO ALL Voted for Voted for Total Republican Democrat Voters in House in House Children 40% 37% 38% Working people who are currently uninsured 24% 27% 18% People who need long-term care 12% 17% 10% All low-income people 9% 5% 17% Other (vol.) 3% 2% 5% None (vol.) 3% 3% 1% Don't know 10% 9% 12% Source: Kaiser/Harvard Survey 1994 TABLE 11 VOTERS' VIEWS ON WHICH WAY OF IMPROVING THE PRIVATE HEALTH INSURANCE SYSTEM IS MOST IMPORTANT FOR CONGRESS TO ENACT Voted for Voted for Total Republican Democrat Voters in House in House Require every employer who offers health insurance to provide a choice of at least three health insurance plans 29% 31% 21% Require every employer to contribute part of the cost of health insurance for all of their employees 27% 26% 31% Outlaw pre-existing condition clauses 18% 18% 18% Require every employer to make health insurance available to all of their employees, without requiring that the employer contribute part of the cost 15% 10% 19% Other/Nome (vol.) 3% 4% 3% Don't know 9% 12% 8% Source: Kaiser/Harvard Survey 1994 TABLE 12 VOTERS' WILLINGNESS TO PAY MORE IN PREMIUMS OR TAXES TO GUARANTEE HEALTH INSURANCE COVERAGE FOR ALL AMERICANS Voted for Voted for Total Republican Democrat Voters in House in House Would personally be willing to pay more, either in higher health insurance premiums or higher taxes 51% 43% 69% Would not be willing 39% 48% 22% Don't know 9% 9% 8% Source: Kaiser/Harvard Survey 1994 TABLE 13 WHAT VOTERS SEE AS TOP PRIORITIES FOR THE NEXT CONGRESS Total Voters 1. Health care 2. Crime 3. Taxes 4. Deficit 5. Education 6. Economy Source: Kaiser/Harvard Survey 1994 TABLE 14 WHAT VOTERS SAY CONGRESS SHOULD DO TO REDUCE THE DEFICIT CUT SPENDING ON MAJOR PROGRAMS - 67% OTHER (VOL.)/ DON'T KNOW - 13% DON'T DEAL WITH THE RAISE TAXES - 10% DEFICIT NOW - 10% Source: Kaiser/Harvard Survey, 1994. TABLE 15 a VOTER SUPPORT FOR 25 SELECTED POLICIES TO REDUCE THE FEDERAL DEFICIT % of voters who favor the proposal Voted for Voted for Total Republican Democrat Voters in House in House STRONG TO MODERATE SUPPORT Having people over age 65 who earn more than $50,000 a year pay more for Medicare than other seniors 71% 69% 73% Decrease spending on food stamps 55% 60% 54% Decrease agricultural price supports 53% 50% 56% Decrease defense spending 53% 40% 64% MODERATE OPPOSITION Paying doctors and hospitals less for the care they provide to seniors under Medicare 48% 44% 55% Decrease spending on public housing 45% 50% 43% Decrease spending on unemployment compensation 43% 44% 42% Increase the proportion of Social Security benefits subject to federal income taxes 42% 40% 47% Decrease federal aid to cities 39% 47% 33% Decrease spending on AFDC 39% 49% 27% Increase the retirement age for Social Security from 65 to 67 39% 44% 28% Increase Social Security or employer taxes 35% 27% 44% Limiting the tax deduction for employers' contributions to their employees' health insurance 32% 38% 27% Requiring people to pay a larger share of nursing home costs before federal assistance begins 32% 38% 24% (continued) Source: Kaiser/Harvard Survey 1994 TABLE 15 b VOTER SUPPORT FOR 25 SELECTED POLICIES TO REDUCE THE FEDERAL DEFICIT (continued) % of voters who favor the proposal Voted for Voted for Total Republican Democrat Voters in House in House STRONG OPPOSITION Decrease or eliminate tax deduction for charitable giving 29% 29% 29% Decrease or eliminate tax deduction for home mortgages 27% 32% 24% Reduce the annual cost of living increase in Social Security 26% 34% 18% Decrease federal aid for college student loans 24% 26% 22% Increase the federal income tax 23% 20% 31% Increase taxes on gasoline and heating oil 20% 15% 25% Decrease federal aid to education 19% 18% 21% Decrease spending on Social Security 17% 21% 13% Decrease spending on Medicaid for the poor 17% 17% 15% Decrease spending on Medicare for the elderly 8% 5% 10% Decrease veterans' benefits 7% 8% 8% Source: Kaiser/Harvard Survey 1994 TABLE 16 VOTERS' PREFERENCES ON SPENDING CUTS AFTER BEING TOLD THAT ONE IN THREE DOLLARS SPENT BY FEDERAL GOVERNMENT GO TO SOCIAL SECURITY, MEDICARE, AND MEDICAID In order to reduce the federal deficit, the biggest spending cuts should come in areas other than Social Security, Medicare, and Medicaid 65% In order to reduce the federal deficit, the biggest spending cuts should come in Social Security, Medicare, and Medicaid 10% We should leave the federal deficit alone and not make major spending cuts in either area 12% Don't know 13% Source: Kaiser/Harvard Survey 1994 TABLE 17 VOTERS KNOWLEDGE OF WHICH PROGRAMS ARE ENTITLEMENTS SOCIAL SECURITY 82% MEDICARE 82% VETERANS BENEFITS 76% MEDICAID 69% UNEMPLOY. COMPEN. 67% AFDC 57% FOOD STAMPS 53% AGRICULTURAL PRICE SUPPORTS 39% 0% 20% 40% 60% 80% 100% Source: Kaiser/Harvard Survey, 1994 TABLE 18-1 WHAT VOTERS SAY IS THE LARGEST FEDERAL EXPENSE TODAY DEFENSE 30% FOREIGN AID 27% WELFARE 19% SOCIAL SECURITY 15% HEALTH 5% DON'T KNOW 4% 0% 5% 10% 15% 20% 25% 30% 35% Source: Kaiser/Harvard Survey, 1994. TABLE 18-2 1993 FEDERAL BUDGET SOCIAL SECURITY 21% DEFENSE 21% FOREIGN AID 2% WELFARE 3% INTEREST RECEIPTS 7% HEALTH 16% OTHER MANDATORY 14% DOMESTIC DISCRETIONARY 16% TOTAL = $1,408 BILLION Source: Congressional Budget Office, 1994