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

Costs in the nation's health care system are ensnaring millions more Americans: One in four report problems paying their medical bills, and nearly three in 10 -- rising to nearly half of women with children -- have put off treatment because of the cost, often despite a serious illness or condition. Both are new highs in polls dating back a decade or more.

Such problems contribute to substantial public disapproval of the country's health care system overall, in terms of its cost, the level of uninsured Americans, and to a lesser extent, the quality of care. Yet most people remain satisfied with their own personal costs, coverage and care --experience that makes the risk of change less attractive.

Still, support for change does exist. Most Americans, 56 percent, favor shifting from the current health system to a taxpayer-financed universal health insurance program. But there are provisos: Support has slipped a bit from its 2003 level, as Republicans have moved farther away from the idea. And support for universal coverage drops sharply if it means higher costs, waiting lists for some care or less choice of doctors or treatments.

Support goes much higher for other, somewhat less fundamental, changes. Large majorities favor employer mandates, expanded government health insurance programs and special aid to provide low-income Americans with health coverage. Many of these are not only supported by much of the public, but "strongly" so.

This extensive survey on public attitudes on health care was conducted by ABC News; the Henry J. Kaiser Family Foundation, an independent non-profit research organization that specializes in health care issues; and USA Today. The poll supports a weeklong series, "Prescription for Change: Fixing American Health Care," Oct. 15-20 on ABC.

The poll finds that one reason for discontent with the current system is apprehension about the future. A minority of Americans, 40 percent, are dissatisfied with their own current health care costs. But, given rising rates, six in 10 insured people are worried about being able to afford their premiums over the next few years. And nearly as many worry they could lose their insurance because of the loss of a job. (Many fewer, though, are very worried.)

Cost and insecurity aren't the only concerns: Despite generally positive personal experiences, more than half, 54 percent, are dissatisfied with the quality of health care generally in the country. And 89 percent call the number of uninsured Americans a serious problem or worse, including 52 percent who call it "critical."

Proposals -- Given concerns about losing insurance through the loss of a job, an employer mandate is among the most popular possible changes to the current system. Nearly eight in 10 favor a federal requirement that all employers offer insurance to their full-time workers; 69 percent "strongly" support it.

Nearly two-thirds favor such a requirement for part-time employees as well. And to help pay for it, a vast 86 percent favor tax breaks or other incentives to businesses that do offer health insurance to their workers. Six in 10 strongly back that idea.

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