The Health Care Commotion
Michael Moore‘s Sicko was just one of the manifestations of many Americans’ seeming discontent on the current status of its policies affecting health care. All of a sudden, there is this more-than-romantic urgency to get packing for France! Or quite simply, curse the insurance companies.
This so called commotion has started long before the movies came out. And now, it is election time. Along with these varied degrees and reasons for this noise, there is this apparent expression of the desire to see changes. Among a gamut of issues in town, health care is one closest to the heart and probably the first card people want laid out on the table by the candidates.
Is America’s health care going to change? How is America’s health care going to change? Where will the next leadership bring the health care system? Will it finally come closer to what the people of the United States really want for themselves?
While we continue to find out and work it out for ourselves in the coming months, here are some highlights of the results of a study done by Blendon, Altman, Deane, Benson, Brodie, and Buhr of the Department of Health Policy and Management, Harvard School of Public Health as a Special Report on the New England Journal of Medicine—Health Care in the 2008 Presidential Primaries.
The attitudes of Republicans and Democrats differ substantially with regard to four issues that could affect future health policy: President Bush’s handling of health care, the health care system generally, their own care, and possible solutions to health care problems.
“…members of both parties are generally dissatisfied with many aspects of health care in America…”
“…nearly half [Democrats] say there is so much wrong that the system needs to be completely rebuilt. Large majorities are dissatisfied with the cost and quality of health care in the United States, and they say the fact that many Americans do not have health insurance is a “very serious problem.”
As to their own health care, Republicans are more likely than Democrats to report being satisfied with the cost and quality of care that they receive, and they are less likely to be worried about losing their coverage, receiving service of worsening quality, or having to pay more for care.
“…a plurality of Democrats say that government should have primary responsibility for making sure that Americans have health care, and the majority say they are willing to pay higher taxes for increased coverage, the plurality of Republicans say health care coverage should be an individual responsibility. Republicans are also more likely than Democrats to view the private health insurance industry as being more effective than government in providing coverage and controlling costs”
Democrats and Republicans also differed with respect to the specific health care issues they said would be most important in their selection of a candidate. Voters in Democratic primaries were divided between a focus on expanding insurance coverage and controlling costs. In contrast, the top issue for voters in Republican primaries was health care costs; substantially fewer cited improving the quality of medical care and reducing medical errors or expanding health insurance coverage. Only a small share of likely voters in primaries for either party identified reducing spending on Medicare and Medicaid as the most important health care issue.
About two thirds of Democrats also said that they want to see their presidential candidates propose “a major effort to provide health insurance for all or nearly all of the uninsured,” even if it “would involve a substantial increase in spending.” In contrast, only a minority of Republicans said they want to hear about this kind of major effort, with about the same proportion saying they would prefer no action on this front. A plurality of Republican voters said they would prefer a more limited, less costly expansion. This difference was not driven by the distribution of the uninsured between the two parties’ likely voters in primaries. Similar proportions of likely Democratic (9%; 95% confidence interval [CI], 7 to 11%) and Republican (6%; 95% CI, 4 to 8%) voters in primaries reported being uninsured.
Looking forward, the ranking of health care as a top issue in the primaries and plans for serious health care reform proposed by both Democrats and Republicans are major steps toward a larger debate in the 2008 general election and beyond. However, the intensity of the debate, and whether it engages the nation the way the last great health care debate did in the early 1990s, remains to be seen. In addition, the prospects for actual health care reform are tempered by two factors: the wide differences in the two parties’ views of what health care reform should look like and the current level of satisfaction that majorities of both parties have with their own health care situations.
Read the complete report and more details of the study here.
Compare candidates’ positions side by side at Health08. I found this to be a nifty site, especially if you are in a hurry and if you like concise straight to the point table presentations. Here is an example:
Stating the obvious: This is not meant to be a campaign article favoring any candidate or group.