Startling Field Poll Results Just Released on California Healthcare--Part Two of Extensive Survey

Cost Related Health Care Issues

Similar to the above results, voters give a plurality of "top priority" results, and an overwhelming support to cost related solutions when these top priority responses are added with the "important/not top priority" responses. Only 13 to 14% felt these were "not important." Here is the rank ordering of the percentages who responded that these particular policy areas were "a top priority." The second percentage figure is for those who considered these areas to be an "important/not a top priority." The last figure is for those who said it was "not important."

• Hold down out-of-pocket costs for doctor visits, medical tests and hospital fees (47%-38%-14%)
• Find ways to hold down people’s out-of-pocket costs for prescription drugs (46%-40-13%)
• Hold down out-of-pocket costs for health insurance premiums (46%-39%-14%)

Greater shared employer, government, and individual responsibility is preferred

When given choices, voters preferred "reforming" the health care system by encouraging shared responsibilities among employers, government, and individuals by a two-to-one margin. In interpreting this data, caution may be advised as the first option is listed as "reforms" while the other two are not. How a question is asked can affect the responses given. But the numbers are rather large and show support for action other than relying on a laissez-faire approach:

Make reforms within the current system by encouraging shared responsibilities among employers, government and individuals 52%

Replace the current system with a new government-run system covering all Californians 24%

Rely on free market competition to improve the health insurance system 18%

Specific Proposals

Three specific reform proposals aimed at providing greater health coverage for Californians are supported strongly or somewhat strongly by at least three quarters of the voters:

• 78% endorse the “pay or play” employer mandate-- to "require all employers with 20+ employees to provide health insurance for their full-time workers or be required to pay into a state fund that would provide insurance for their employees." 44% strongly support this while 34% somewhat support it. Only 9% strongly oppose it and another 11% are somewhat opposed.

• 76% back expanding the eligibility of existing state government health insurance programs for low-income people to provide coverage for more people without insurance (39% strongly and another 37% somewhat). Only 8% strongly oppose this and 14% are somewhat opposed.

• 75% support exists offering part-time workers and other uninsured residents a choice of health plans on a family-by-family basis, with costs shared among employers, government and individuals. The same 8% are strongly opposed and 14% somewhat opposed.

Considering the margin of error of this poll, these are all pretty much the same.

Looking at the crosstabs, there is a majority of all major politics and demographic subgroups of voters on all three of these.

These are followed by two other health reform proposals that both receive large margins of support:

Requiring every Californian to have health insurance, either from their employer or another source, and offering government subsidies to low income residents to help them pay for it--supported 68% to 30%.

Encouraging individuals to open tax-free health savings accounts to pay for their regular
health care bills, accompanied by a catastrophic insurance plan they must also purchase to help pay for major medical bills, supported 61% to 35%.

Narrowly opposed, within the margin of error of the poll is the "single payer" system:

Consolidating the money and resources now spent by employers, individuals, government and insurance companies to operate the current health insurance system and replace it with a new system administered entirely by state government covering all Californians. It is favored by 47% and opposed by 49%. Upon close inspection, the level of opposition appears to have more intensity to it--a full 31% strongly oppose and 18% oppose somewhat. The strongly support is only 19% and 28% somewhat support this concept.

There are wide splits on single payer in the demographic subgroupings, with Democrats supportive 61% and Republicans only 26%. 72% of households with less than $20,000 of earnings are supportive versus only 33% of households with incomes above $80,000.

The Bottom Line

Voters want something done here and support a variety of approaches. They are about evenly split on a single payer approach. There is wide room for the legislature and the Governor to act--and act they should. If a single payer approach is to be enacted, which I personally support, there needs to be more education and persuasion of those who are currently registered to vote--or registration of new voters.

Politics is the art of the possible. Given the campaign contributions made by those who oppose single payer and the resources at their disposal to lobby and influence the political process in Sacramento, as things stand now, single payer has an uphill fight--but one that can be won if the commitment is there. Note should be taken that the highest response in the first part of this poll as to important causes of the high cost of health costs was "high profits made by drug and insurance companies." That is what gives hope that these dots can be connected.

More analysis and comments are undoubtedly called for on the crosstabs of this poll and the numbers elsewhere in the poll of the numbers of voters who do not feel very confident in whether they have enough information to make the right decisions regarding health plans.