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Attitudes about health care reform changing with more information?

Health Care Reform and Policy
by Jacqueline Lee
Recession could lead tens of millions to lose health insurance
Recession could lead tens of millions to lose health insurance

The conversation around the national health insurance and health care markets has become quite heated in recent years. The broad acknowledgement - on all sides of the issue - seems to be that prices are rising quickly, especially for prescription drugs, and something has to be done about it.

Due in large part to the cost of coverage and treatment these days, as well as the fact that the system is constantly brought up in political circles, Americans appear to be learning more about the issue all the time. With that ever-growing knowledge comes a better understanding of the pluses and minuses of each proposed approach. Generally speaking, there is an appetite for change, but what that change could be is still very much up in the air.

Developing opinions
For some time now, the majority of Americans have been of the opinion that proposed changes to overhaul the national health care system - like Medicare for All or the creation of a public option to compete directly with private insurers - seems to be the way to go. For instance, 51% of respondents to a Kaiser Family Foundation survey said they favor Medicare for All, though that number was down five points from April. But at the same time, nearly 2 in 3 Americans polled said they favored the creation of a public option, and more than half would like to expand the Patient Protection and Affordable Care Act to provide more insulation from rising costs.

The poll also found respondents' opinions could be dramatically swayed by hearing arguments for or against a public option. Consequently, it's fair to say there may still be significant ground to cover when it comes to a cogent, cohesive public opinion about the federal government taking another step into the health care business.

Interestingly, though, this comes as 83% of respondents view Medicare favorably, and about 3 in 4 feel the same way about private insurance and Medicaid. Nearly everyone on Medicare (95%) like that coverage, compared with 86% who like their employer-sponsored plans.

Building on opinions
One of the biggest hurdles around the implementation of things like Medicare for All or a public option is that, as the KFF poll shows, many people like their plans as they stand currently, though they perhaps don't like how much those plans cost. A HealthPocket survey recently found only about 56% of people with health insurance would be at least somewhat unhappy to lose their current health insurance plan, versus 44% whose reaction would range from indifferent to extremely happy.

Another issue at present, with millions of Americans still going without health insurance, there is some debate about whether access to health care should be considered a human right. With the general public, there's little ambiguity: 70% say it should be, and another 13% are unsure. Along those lines, 34% of people say they would be willing to help pick up the tab for someone else's coverage if that person couldn't afford it, and 33% said they would not, showing how split opinions on the matter are.

Cost is at the heart of the issue
To that end, it should come as little surprise that Americans generally don't have a lot of confidence in any institution to keep health care costs down on an ongoing basis. Among a choice of six entities - federal health agencies, health care providers, Congressional Democrats, Congressional Republicans, the private insurance industry and the pharmaceutical industry - none had the trust of at least half of Americans to depress price growth in this arena, Morning Consult found.

Highest-polling of that group were federal agencies, with a combined 43% of respondents expressing "a lot" or "some" trust in these entities. Not far behind, at 41%, were care providers. Lowest-polling in these groups, at less than a quarter and less than a fifth, respectively, were private insurers and big pharma. On the other hand, more than two-thirds of respondents had little to no trust in private insurers, and even more - 3 out of 4 - felt the same way about the pharmaceutical industry.

Is the current system tenable?
After years of living under the ACA, the general public seems to have a solid appreciation for what it does to control costs for Americans, according to a separate KFF poll. There was a healthy amount of skepticism about the law from the time it was first implemented in early 2010, and as recently as December 2016, it had a higher unfavorable rating among consumers than those who liked it.

However, favorability for the ACA has surged since that time, with a good-sized and consistently growing gap developing over the past two and a half years. These findings were especially true among the people the law was intended to help most: younger people and people earning less than $40,000 annually.

With all these shifting opinions in mind, it's vital for care providers and insurers alike to do more to develop contingency plans for any additional changes to the health care system that may come over the next few years and beyond. At the same time, they should be in regular communication with patients or policyholders to ensure all involved know what's going on.



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