As Health Care Costs Take a Toll, Some Changes Win Broad Backing

Priorities --While self-interest is a factor in views on health care policies, it's not the sole motivator. Indeed 68 percent in this survey say it's more important to provide health care coverage for all Americans, even if that means raising taxes, than to hold down taxes, if that means some Americans lack coverage. (This is, however, down from 79 percent in 2003.)

This view has a partisan cast: Eighty-four percent of Democrats say it's more important to cover all Americans than to keep taxes down, as do 66 percent of independents. Fewer Republicans – but still about half, 49 percent – agree. The divisions among liberals, moderates and conservatives are similar (86, 72 and 52 percent, respectively).

There's more division on another policy matter, whether it's more important to reduce health care costs (50 percent say so) or to increase the number of insured Americans (42 percent). Uninsured people are more likely to say it's more important to cut health care costs than to increase coverage; costs apparently are their most pressing concern. Similarly, lower-income Americans also say it's more important to cut health care costs than increase coverage. Even people who prefer a universal system over the current one are split over what's more important.

Six in 10 Republicans say lowering costs is more important; Democrats and independents are more divided.

Universal --While 56 percent support a shift to universal coverage, far fewer, ranging from 15 to 26 percent, think such coverage would actually improve the quality or cost of their own care, the availability of treatments, or their choice of doctors or hospitals. Indeed by 2-1 people think universal coverage would make the quality of their own care worse, and by better than 2-1 think it would worsen their choice of doctors or hospitals.

Support for universal health care peaks among those who'd benefit the most from it -- the uninsured. Eight in 10 support universal care, compared with just over half of insured people. Support is also much higher among those who call the uninsured population a critical problem, than among those who don't, 69 percent to 43 percent.

Support for universal coverage likewise is higher among people who've had problems paying their medical bills and have put off treatment because of the cost, and among lower-income adults. It's higher among people who are dissatisfied with current costs and quality of care. And universal care does better among people who're worried about future costs, or losing their current coverage.

Naturally, a universal coverage system gets broad support from people who think it would improve the quality, cost and availability of their health care, but it's also favored by most people who think these would stay the same under such a system. Indeed, in a show of altruism, universal coverage is supported by a quarter of those who think the quality of their care and the availability of treatments would worsen, and by just over three in 10 of those who think their costs would rise and their choice of doctors would suffer under such a system.

Partisanship also comes into play. More than seven in 10 Democrats and nearly two-thirds of independents favor universal coverage, compared with just three in 10 Republicans. Similarly, three in four liberals and six in 10 moderates prefer it to the current system; four in 10 conservatives agree.

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