Americans Demand Health Reform But Are Unsure About How To Achieve It

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A new national survey published by Consumer Reports reveals a significant disconnect: Americans overwhelmingly support reforms (82%) that would ensure that all uninsured Americans have access to quality, affordable health care, and a large majority agree on six prescriptions for change, but when it comes to how those changes should be adopted, there is less consensus. CR's survey also paints a picture of an adult population -- including the most prosperous people -- that is worry-stricken about the rising cost of health care in America.

Americans Demand Reform But Aren't Sure What Needs Changing

"The survey data really surprised us because there was overwhelming agreement about the need for health-care reform, punctuated by pessimism about rising costs, regardless of age, gender, political orientation, or family income. But when we asked more questions, like what's the best way to achieve reform, we quickly uncovered a problem: Americans are more divided about how a reformed health system should work," said Nancy Metcalf, senior project editor at Consumer Reports.

Six Prescriptions for Change

Among the 1,200 American adults who responded to the CR telephone poll, more than 80 percent said that a reformed system should guarantee the following: coverage for all uninsured children; protection against financial ruin due to a major illness or accident; the ability to obtain coverage regardless of a pre-existing condition; coverage that continues even when people are laid off, changing jobs, or starting their own business; premiums, deductibles, and out-of-pocket expenses that are affordable relative to family income; and, the ability of people to keep their current health insurance if they choose.

Health Care Worries Hit Home

The Consumer Reports survey also found that Americans are worried about escalating health costs, regardless of their financial status. Overall, 81 percent of those polled by CR said they're concerned about being able to afford health care in retirement, 68 percent worry about being bankrupted by medical bills following a serious illness or accident, and 65 percent fear losing their job-related health coverage.

Americans Unsure About How A Reformed System Should Work

When asked for their opinion about how a reformed health-care system should work, Americans were considerably more divided in their responses. "Americans are at once passionate about change and divided about how to get there. That could make it extremely challenging for the presidential candidates when it comes to selling their proposals," noted Metcalf.

CR asked consumers for their opinions on four approaches to reform, including those proposed by the leading candidates. Respondents could choose multiple options, so percentages add up to more than 100:

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-- The most popular proposal -- a mixed public/private system that would require all uninsured Americans to buy health insurance -- drew support from half of the respondents. Massachusetts is in the midst of implementing that type of system and versions of it have been proposed by the leading Democratic presidential candidates.

-- Thirty-six percent of respondents support public insurance, similar to the Canadian health-care system.

-- One-third of respondents favored a mix of employer-sponsored plans, private health-insurance plans, Medicare, Medicaid, and other public programs, which is the arrangement we have today.

-- Only 26 percent supported the idea of giving tax incentives for individuals to purchase insurance and relying on market pressures and competition among insurance companies to hold prices down. Versions of this idea have been proposed by several leading Republican candidates.

Consumers Union Pressing For Reform

Consumers Union, the nonprofit publisher of Consumer Reports, will be pressing for changes that ensure that all Americans can get high-quality health care at a price they can afford, including guaranteed access and improved delivery of care. As state and federal proposals come up for debate, CU will use the following criteria to judge them:

Complete coverage: Private insurance and public programs must be expanded to guarantee that everyone is covered from cradle to grave, regardless of health status and ability to pay.

Fair cost spreading: No family should face financial ruin to pay for health care. Costs should be spread fairly among government, employers, and consumers.

Safer care: Millions of Americans are harmed each year by the care they receive. Improved safety systems would save billions of health-system dollars.

Better care: Comprehensive, easy-to-understand public information about the safety, cost, and quality of care by doctors, hospitals, and nursing homes would help consumers and employers choose the best care.

Prevention: Smoking and obesity related illnesses such as certain cancers, heart disease, and type 2 diabetes threaten to overwhelm health expenditures. The primary-care physicians whose job it is to prevent and control those conditions are the most poorly paid of all doctors. Our system should find ways to fix those problems.

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