The new poll shows the idea of a government-sponsored plan, or "public option," to be fair non-controversial, though Democrats in the Senate have considered nixing the proposal in order to win Republican support for the bill. House leaders on Friday unveiled a health care reform plan that includes a public option.
The poll reveals, however, the obstacles that remain in the way of the public option and broader reform efforts. Many Americans are concerned that their own health care may be compromised if the government is involved, and while they are generally willing to pay more in taxes for universal coverage, that support drops when dollar amounts are mentioned.
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Few support -- and many are unsure about -- some other specific policy options that have been proposed, including creating a government insurance pool for purchasing health coverage. By two to one, Americans disapprove of taxing employer health benefits, and many are uncertain about it.
Views on health care reform are highly partisan, just as they were in 1993, the last time serious reform was debated in Washington. Republicans are largely opposed to most government involvement.
Despite President Barack Obama's overall popularity (63 percent approve of the president), 22 percent don't have an opinion yet about his handling of health care. Still, more approve than disapprove.
Government Involvement In Health Care
While many have criticized Mr. Obama's proposal for a public option, Americans generally see government involvement in health care in a positive light, and most support it. Fifty percent think the government would be better than insurance companies at providing medical coverage (up from 30 percent in 2007), and 59 percent think the government would be at better holding down costs (up from 47 percent in 2007).
More generally, 64 percent of Americans say the government should guarantee health insurance for all Americans. Just 30 percent think this is not its responsibility. Those percentages have been stable for many years.
When presented with the option of a government-administered health insurance plan similar to Medicare to compete with private health insurance companies, 72 percent are in favor and just 20 percent oppose. Even 50 percent of Republicans favor that option.
Still, the debate over government involvement in health care is highly partisan, with 61 percent of Republicans saying it is not the government's job to provide health care. Meanwhile, 85 percent of Democrats think the government does have this responsibility. Similarly, 63 percent of Republicans think government will do a worse job providing medical coverage, and 53 percent think it will do worse holding down costs. Among Democrats, about seven in 10 thinks government will do a better job on both.
Reactions are mixed as to whether the government should go as far as requiring all Americans to have health insurance, as long as it provides financial help to those who can't afford it on their own. Forty-eight percent think the government should require this, while 38 percent think it should not.
The public, however, has acknowledged the need for sweeping changes to U.S. health care, with 51 percent saying it needs fundamental changes and another 34 percent saying there is so much wrong with it that it needs to be completely rebuilt. Just 13 percent think only minor changes are necessary.
In addition, many Americans link problems with the health care system to broader economic problems. While 61 percent think that the rising cost of health care presents a very serious threat to the national economy, 25 percent see that threat as a somewhat serious threat. However, there is no consensus on what effect a government guarantee of health care for all would have on the economy, and more think it would hurt the economy (37 percent) than think it would help (28 percent).
Whom Do You Trust?
President Obama, who receives a 63 percent approval rating overall in this poll, gets a lower approval rating on his handling of health care -- but many don't yet have an opinion. While 44 percent approve, 34 percent disapprove and 22 percent are unsure. Among Democrats, 68 percent approve, but just 13 percent of Republicans do.
Americans are divided when it comes to who they trust more to make the right decisions about health care policy. Just 39 percent trust President Obama, while 35 percent trust Congress. When asked which party is more likely to improve the health care system, by three to one Americans choose the Democratic Party. Even one in four Republicans thinks the Democratic Party is better-suited to reforming health care.
Little Support For Some Specific Care Proposals
One proposal to cover the cost of reform would tax the health insurance benefits workers receive from their employers, with the revenues going toward providing insurance for those without it. There is significant opposition toward this proposal: 20 percent approve, but more than twice as many -- 46 percent -- disapprove. A sizable percentage, 31 percent, is unsure.
The public is uncertain about another proposal that would require all employers to provide health insurance or pay into a pool used to pay for coverage for the uninsured. Twenty-six percent think this is a good idea, and 28 percent think it is a bad idea, but nearly half, 44 percent, are unsure.
Americans have more defined views on whether insurers should cover anyone who applies for coverage, regardless of whether they have a pre-existing medical condition or a prior illness, with 75 percent approving of this proposal and just 17 percent disapproving. Even if the cost of their health insurance rose, 56 percent would still approve of this measure.
The Costs Of Health Care Reform
In addition to supporting a government role in providing universal health coverage, many are willing to pay higher taxes so that everyone can be covered. But when a specific dollar amount or other cost is mentioned, support drops.
Overall, 57 percent of Americans would be willing to pay higher taxes so that all Americans would have health insurance they can't lose. Majorities of Democrats and independents are willing to pay higher taxes, but two thirds of Republicans are not.
However, when a specific dollar amount is included in the question, support drops. Just 43 percent of Americans would be willing to pay $500 a year more in taxes to pay for universal health care.
And although 64 percent of Americans think the government should guarantee health insurance for everyone, they are less supportive when a direct cost is mentioned. If the cost of their own insurance were to rise, support for a government guarantee of insurance for all drops to 47 percent.
There are other costs associated with government involvement in health care, and these also generate substantial concern. Two thirds are concerned their own health care will get worse if the government creates a system to provide health care to all Americans. Concern is highest among Republicans at 78 percent.
Similarly, 68 percent are very or somewhat concerned government involvement would limit access to care, while 53 percent are concerned they may have to change doctors as a result of government involvement.
Most Americans who have health insurance are fairly happy with the cost and quality of their own care, but perceptions of the country's health care in general are much more negative. In terms of quality, 77 percent say they are satisfied with their own care, but only 48 percent are satisfied with the quality of care for the country as a whole. Fifty percent are satisfied with the cost of their own care while just 19 percent are satisfied with costs nationwide.
More than four out of five Americans are concerned about the health care costs they and their family might face in the coming years, including 49 percent who are very concerned. Those with lower incomes are more concerned than those with higher incomes, and nearly six in 10 Americans aged 30 to 64 are very concerned. Among those without health insurance, about six in 10 are very concerned.
One in five report they or someone in their household have had to go without a test, treatment or procedure that their doctor recommended because their health insurance plan wouldn't cover it. Among those with health insurance, 15 percent say they have gone without medical treatment.