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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