Widespread Pessimism: Large Majority Thinks Health Care System Will Get Worse U.S. Poll Shows Large Majority Also Sees Health Care More as an Entitlement Than as a Private Economic Good ROCHESTER, N.Y., Oct. 27 /PRNewswire/ -- Most Americans are profoundly pessimistic about the future of the American health care system, according to this recent national survey of U.S. adults. One reason for this pessimism may be the rapid increase in health care costs, a substantial part of which is now being passed on to those with health insurance and to patients. Another reason contributing to this pessimism may be the sight of the Congressional Conference Committee on the Future of Medicare struggling to reconcile the different demands of Republicans, Democrats, the House and the Senate, and the various interest groups who are seeking to influence this debate. Even among Republicans, there are sharp differences between members of the House of Representatives and the Senate. It is still not clear whether any bill will actually emerge and be signed into law. If it is not, public pessimism may grow. Even if it is, the public may be less than enthusiastic about any new bill. Yet another reason for pessimism may be that while most people think that health care should be a right, or an entitlement, that is not the way the administration or the Congress see it. A survey by Harris Interactive conducted online with a nationwide cross section of 2,306 adults surveyed between September 16 and 23, 2003 finds a lopsided 62% to 25% of the public are more pessimistic than optimistic about the likelihood that the health care system will improve in the next five years. Majorities of all segments of the population that Harris Interactive analyzed are pessimistic. The highest level of pessimism is found among liberals, independents, moderates, Democrats, those with post-graduate education, and among lesbians, gays or bisexuals. The most optimistic (or, rather, the least pessimistic) groups are the Republicans, conservatives, and people aged 65 and over, who stand to benefit eventually if there is a new Medicare drug benefit. TABLE 1 OPTIMISTIC/PESSIMISTIC THAT HEALTH CARE SYSTEM WILL IMPROVE? "On the whole are you more optimistic or more pessimistic about the likelihood that the health care system will improve and become better in the next five years?" Base: All Adults Total Party I.D. Republican Democrat Independent % % % % Optimistic 25 34 20 20 Pessimistic 62 55 66 69 Not sure 13 10 13 11 TABLE 2 MOST OPTIMISTIC AND MOST PESSIMISTIC GROUPS Most Optimistic (Least Pessimistic) Optimistic Pessimistic Republican % 34 55 Conservative % 34 56 Aged 65 + % 31 55 Incomes $25,000 to $34,999 % 30 59 The West % 29 62 Aged 18 - 24 % 28 52 Most Pessimistic Liberals % 19 72 With postgraduate education % 20 71 Independents % 20 69 Lesbian, gay or bisexual % 18 68 Moderates % 22 67 Democrats % 20 66 Should health care be more a public good (an entitlement) or a private economic good? By a much wider than 2-to-1 majority (65% to 23%), most people think that health care policy should treat health insurance more as an entitlement like education, police and fire protection and highways, rather than as a product or service like cars, houses, food and clothing, or homeowner's insurance, where you get what you can afford and want to pay for. There are substantial differences between Democrats and Republicans on this issue. By a large 79% to 10% majority, most Democrats think that health insurance should be more like an entitlement. Only a 46% plurality of Republicans think this way; almost as many (43%) think health insurance should be thought of more as a kind of product or service where you get what you can afford and want to pay for. In this question, independents look more like Democrats than Republicans. TABLE 3 SHOULD HEALTH CARE BE A PUBLIC GOOD (ENTITLEMENT) OR A PRIVATE ECONOMIC GOOD? "Do you think public policy should treat health care and health insurance more as an entitlement like education, police and fire protection and highways or more as a kind of product or service, like cars, house, food and clothes, or homeowners insurance where you get what you can afford and want to pay for?" Base: All Adults Party I.D. Total Republican Democrat Independent % % % % Entitlement 65 46 79 71 As a kind of product or service 23 43 10 19 Not sure 12 10 11 10 So what? In all western democracies, there are substantial public sector and private sector health care providers and insurers. Of course, all the other western democracies provide some form of universal health insurance. What is less well known in America is that they also allow people (with some exceptions) to buy additional health insurance and medical care with their own money. However, in every other western democracy a reasonable level of health insurance is seen as a right, something to which citizens are entitled. So in every country including the United States, health care is of course both an entitlement (for some people) as well as a private economic good. The question is should it tilt more one way or the other. In other countries, it clearly tilts heavily toward being more of an entitlement. Most Americans clearly agree with most Europeans and Canadians that health care could be thought of more as an entitlement or public good than as a private economic good. Downloadable PDFs of the Harris Interactive Health Care News are available at http://www.harrisinteractive.com/news/newsletters_healthcare.asp Methodology The Harris Poll(R) was conducted online within the United States between September 16 and 23, 2003 among a nationwide cross section of 2,306 adults. Figures for age, sex, race, education and number of adults in the household were weighted where necessary to bring them into line with their actual proportions in the population. Propensity score weighting was also used to adjust for respondents' propensity to be online. In theory, with probability samples of this size, one could say with 95 percent certainty that the results have a statistical precision of plus or minus 3 percentage points of what they would be if the entire adult population had been polled with complete accuracy. Unfortunately, there are several other possible sources of error in all polls or surveys that are probably more serious than theoretical calculations of sampling error. They include refusals to be interviewed (non-response), question wording and question order, and weighting. It is impossible to quantify the errors that may result from these factors. This online sample was not a probability sample. These statements conform to the principles of disclosure of the National Council on Public Polls. About Harris Interactive(R) Harris Interactive (http://www.harrisinteractive.com/) is a worldwide market research and consulting firm best known for The Harris Poll(R), and for pioneering the Internet method to conduct scientifically accurate market research. Headquartered in Rochester, New York, U.S.A., Harris Interactive combines proprietary methodologies and technology with expertise in predictive, custom and strategic research. The Company conducts international research through wholly owned subsidiaries-London-based HI Europe (http://www.hieurope.com/) and Tokyo-based Harris Interactive Japan-as well as through the Harris Interactive Global Network of local market- and opinion-research firms, and various U.S. offices. EOE M/F/D/V To become a member of the Harris Poll Online(SM) and be invited to participate in future online surveys, visit http://www.harrispollonline.com/. DATASOURCE: Harris Interactive CONTACT: Bonnie Hughes of Harris Interactive, +1-585-214-7541, or Web site: http://www.harrisinteractive.com/ http://www.harrispollonline.com/ http://www.hieurope.com/

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