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Views On Health Care Tied To Income

According to the latest CBS News/New York Times Poll, views on what should happen to the nation's health care system are strongly tied to household income.

Americans with lower incomes want to see a major overhaul of the health care system in the U.S., greater government involvement, and more are willing than their higher-earning counterparts to pay more in taxes in order for all Americans to have health care coverage.

When asked their view of the current U.S. health care system, half of Americans earning less than $30,000 a year think there is so much wrong with the system that it needs to be completely rebuilt -- a higher percentage than any income group. Majorities of those earning more think fundamental changes to the system are needed but stop short of endorsing a totally rebuilt system.

 VIEWS OF THE U.S. HEALTH CARE SYSTEM BY INCOME
$30K-50k $50K-75K $75K+
Minor changes 11% 17% 13% 13%
Fundamental changes 34% 61% 58% 55%
Completely rebuilt 50% 21% 29% 30%
Don't know 5% 1% 0% 2%

By more than 3 to 1, Americans on the lower end of the income scale think the government would do a better job than private insurance companies on providing medical coverage. Fewer than half of those with higher incomes think the government would do a better job.

 GOVT. VS. PRIVATE INSURERS ON PROVIDING MEDICAL COVERAGE
$30K-50k $50K-75K $75K+
Better job 61% 48% 45% 49%
Worse job 17% 36% 42% 39%
No different 2% 2% 3% 3%
Don't know 20% 14% 10% 9%

Still, majorities of all income groups do say the government should guarantee health insurance for all Americans, with those earning less money even more likely to support that.

When presented with the option of a government-administered health insurance plan something like Medicare to compete with private health insurance companies, all income groups favor it. Eighty-one percent of those earning less than $30,000 back the idea, as do 68 percent of those earning $75,000 and higher.

 GOVT. HEALTH PLAN TO COMPETE WITH PRIVATE INSURERS
$30K-50k $50K-75K $75K+
Favor 81% 78% 63% 68%
Oppose 10% 14% 31% 27%
Don't Know 9% 8% 6% 5%

There are also differences by income when it comes to whether the government should go as far as requiring all Americans to have health insurance (similar to auto insurance), as long as it provides financial help to those who can't afford it on their own. Fifty-seven percent of Americans earning less than $30,000 think the government should require this, while those earning more are divided.

 SHOULD GOVT. REQUIRE EVERYONE TO HAVE INSURANCE?
$30K-50k $50K-75K $75K+
Yes 57% 41% 46% 47%
No 26% 40% 43% 43%
Don't Know 17% 19% 11% 10%

While those at the lower end of the economic scale may be earning less, a majority of them are willing to pay more for everyone in the U.S. to have health insurance. Sixty-seven percent of Americans earning less than $30,000 would be willing to pay higher taxes so that all Americans would have health insurance they can't lose, compared to 55 percent of those earning $75,000 or higher. There is even less willingness among those with household incomes between $50,000 and $75,000 to pay more in taxes for universal coverage.

 WILLING TO PAY HIGHER TAXES FOR INSURANCE FOR ALL?
$30K-50k $50K-75K $75K+
Yes 67% 61% 47% 55%
No 27% 28% 47% 43%
Don't Know 6% 11% 6% 2%

QUALITY OF CARE AND COSTS

The level of satisfaction with the quality of one's own health care increases with household income. While majorities of all income groups report being at least somewhat satisfied with the quality of their own health care, just a third (35 percent) of those with incomes under $30,000 are very satisfied with their health care, compared to 60 percent of those earning $75,000 or more. Fewer than half of those in between report being very satisfied with the quality of care they receive.

 SATISFIED WITH QUALITY OF YOUR OWN HEALTH CARE…
$30K-50k $50K-75K $75K+
Very satisfied 35% 48% 46% 60%
Somewhat satisfied 31% 27% 35% 26%
Somewhat dissatisfied 8% 7% 4% 7%
Very dissatisfied 24% 16% 12% 5%
Don't Know 2% 2% 3% 2%

In addition, those with lower incomes are more likely to be very concerned about the health care costs they and their family might face in the coming years. Sixty percent of those earning less than $30,000 are very concerned, as are 55 percent of those incomes between $30,000-$50,000. Fewer of those with higher incomes report being very concerned.

 CONCERN ABOUT HEALTH CARE COSTS IN NEXT FEW YEARS
$30K-50k $50K-75K $75K+
Very concerned 60% 55% 44% 41%
Somewhat concerned 28% 37% 47% 41%
Not concerned 12% 8% 9% 16%
Don't Know 0% 0% 0% 2%

Cost has impacted care for some people. Four in 10 Americans earning less than $30,000 report having gone without medication they needed because they couldn't pay for it. A third (32 percent) of those earning $30,000-$50,000 also report that. Those earning more money are significantly less likely to have gone without medication because they couldn't afford for it

 NOT TAKEN MEDICATION BECAUSE COULDN'T AFFORD IT?
$30K-50k $50K-75K $75K+
Yes 42% 32% 16% 8%
No 58% 68% 84% 92%

The poll also finds that those with lower household incomes are more likely to be without out health insurance. Uninsured Americans are generally younger and lower income, more likely to have children under 18 and to be unmarried.

Read more from the CBS News/NY Times poll on health care



Jennifer De Pinto is manager of election and survey information for CBS News. Poll Positions is weekly Hotsheet feature on polling trends from the CBS News Survey and Polling Unit. Click here for more posts from the series.
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