Home > News

MONDAY, March 29 (HealthDayNews) -- A majority of Americans say issues surrounding health care could determine their vote come November.

In fact, a new poll shows a clear majority of both Republican and Democratic voters would support reducing or repealing existing Bush administration tax cuts to help salvage the country's beleaguered health-care system.

"The survey reveals a broad sense of urgency -- things are not only getting worse, they're getting a lot worse, and people really want action on the chronic and growing problem of health insurance coverage," said Karen Davis, president of the nonprofit foundation The Commonwealth Fund, which sponsored the poll. Highlights from the survey were announced at a press conference held Monday in Washington, D.C.

The poll, conducted between September 2003 and January 2004, involved interviews with a representative sample of more than 4,000 adults from across the country.

According to the survey, 57 percent of Americans say the Presidential candidates' policies on reforming the health-care system will be "very important" in helping them decide who to vote for in November.

Many expressed deep anxieties over the soaring numbers of uninsured -- as well as declines in the quality of health care for those lucky enough to have kept their coverage.

Twenty-six percent of those surveyed said they were either without health-care coverage at the present time or had gone without insurance for a period of time over the past year.

Lower- and middle-income Americans seemed most vulnerable: Thirty-five percent of respondents with incomes between $20,000 and $34,999 said they had no health insurance or had recently gone without coverage, the pollsters report.

Even those who are insured worry that the quality of the health care they receive is in decline. About half -- 49 percent -- say their insurance premiums have risen or their benefits have fallen over the past two years.

Many are forgoing needed health care due to rising out-of-pocket expenses. While 29 percent of respondents to a 2001 Commonwealth Fund poll said they had skipped prescriptions or doctor's visits because they couldn't afford it, that number rose to 37 percent in this most recent poll.

"Medical debt" is another emerging problem. According to the Fund survey, 41 percent of U.S. adults under 65 said they've had trouble paying medical bills over the past year, or are still paying bills amassed over the past three years. In many cases, individuals are using money meant for essentials such as food or rent and putting it toward out-of-pocket health-care costs.

Helen Darling, president of the National Business Group on Health, said the health-care "crunch" is "not only going to continue, but there's every reason to assume it will get worse -- much worse. Because of underlying cost pressures that have been driving these changes, there's no end in sight."

Already, Darling said, employer-sponsored health-care costs per worker total an average of $6,831 per year -- while U.S. wages remain stagnant at a median $27,000 per year. As health-care costs rise, workers will pay the price as employers cut back on raises and retirement benefits. "We're going to be putting a lot of money into the health system," Darling said, "and not nearly enough in the pockets of workers."

Gerald Shea, assistant to the president for governmental affairs at the AFL-CIO, offered up organized labor's perspective. He said the recent, contentious labor dispute among California grocery store workers -- which ended up costing workers health-care benefits -- is just the tip of the iceberg in a growing trend, with big business slowly shedding its traditional role in the health-care system.

For example, number one retailer Wal-Mart no longer offers workers comprehensive health-care coverage, opting for a voluntary system where workers can buy coverage for catastrophic illness or injury -- if they choose to do so. "That's a huge paradigm shift for U.S. employers," Shea said.

Still, a large majority of Americans polled by the Commonwealth Fund continue to reject state-run, socialized medicine. Most still support the "shared" model of health-care coverage, where business, government and the individual all contribute to a kind of patchwork system covering most, if not all, Americans.

One thing is clear, however: The system is in crisis. In fact, 62 percent of respondents said they would favor a repeal of the Bush administration tax cuts if such a move could help shore up the health-care system. Not surprisingly, "support for a rollback of the tax cuts was strongest among Democrats and Independents," said survey senior program officer Sara Collins, while Republicans were more likely to support "a limited repeal" of the tax cuts. "When we asked whether they would favor or oppose capping the tax to no more than $1,000 per person, support rose to 69 percent," Collins noted.

Collins said the public's growing sense of alarm over a declining health-care system may be pushing parties involved in the debate toward real compromise. Looking at proposals put forward by the Bush and Kerry campaigns, she noted "they are a departure from the past in the sense that they are a hybrid approach, where they've bridged differences between public and private approaches, or approaches that have been associated with the left or the right."

According to Shea, the public is fed up with talk and is impatient for real action when it comes to ensuring quality health care now and in the future. "People want any solution," he said. "It's really about leadership."

More information

You can access the report from The Commonwealth Fund. Learn about the major Presidential candidates' issues on health care by visiting the camps of George W. Bush or John F. Kerry.

(SOURCES: March 29, 2004, news teleconference with Karen Davis, president, and Sara Collins, senior program officer, The Commonwealth Fund, New York City; Helen Darling, president, National Business Group on Health, Washington, D.C.; Gerald Shea, assistant to the president for governmental affairs, AFL-CIO, Washington, D.C.; The Affordability Crisis in U.S. Health Care: Findings from The Commonwealth Fund Biennial Health Insurance Survey)

Copyright © 2004 ScoutNews, LLC. All rights reserved.