One-third to buy cheaper Canadian drugs, 100 million find insurance coverage cut or costlier

Faced with a double-barreled crisis of shrinking health care coverage and fast-rising medical costs, two out of three American adults (67 percent) now think health care coverage should be a “guarantee” as in Canada, Britain and other nations.

Three out of four American adults (78 percent) agree that health care is a necessity like water, gas and electricity and should be “regulated by government.” The same share of Americans – including a surprising 71 percent of conservatives – would support health insurance companies being treated like auto insurance companies that have to get the permission of some states before raising premiums.

These are among the key findings of “Americans & Health Care Reform: How Access and Affordability Are Shaping Views,” a new national opinion survey of 1,020 U.S. adults conducted between September 2-5, 2004 by Opinion Research Corporation on behalf of Results For America (RFA), a project of the nonprofit and nonpartisan Civil Society Institute.

The new RFA survey documents strong levels of support for extensive health care reform in the face of a worsening crisis in both health care access and rising medical costs. According to the survey findings, half of U.S. adults with health insurance – an estimated 100 million people – have seen their coverage cut and/or out-of-pocket costs go up. A third of adults (34 percent) who use prescription medications already buy or are planning to purchase cheaper drugs from Canada or other nations. Additionally, more than 20 million Americans (18 percent of those buying prescription medications) are so worried about drug costs that they are taking chances with their health by skipping or reducing medicine doses in order to “stretch” their medications.

Civil Society Institute President Pam Solo said: “This is a picture of American health care in crisis. For many Americans, the time for debating is over about the need to support tough new steps to ensure that they can get medical treatment when they need it. These ideas may not yet have caught on in Washington, but they are being debated in state capitols around the United States. It could very well turn out that the next wave of major health care reforms comes from the grassroots to Washington. Lawmakers who are closer to the people already understand that Americans are panicking today.

Americans want continued access to ‘medically necessary’ treatment and they understand that real controls may have to be imposed by government in order to rein in hospital and pharmaceutical costs. There is a simple and insidious math at work here: The longer our leaders fail to take steps to ensure access to reasonably priced health care, the more millions of Americans will be squeezed out of the health care system and left out in the cold.”

Opinion Research Corporation Senior Researcher Wayne Russum: “Most Americans are concerned about reduced health insurance coverage and high prescription drug prices. As a result, they appear more willing to look at new ways to ensure access to affordable health care. The depth of concern among the public about health care may be seen in the strong majorities that now support major reforms and the lack of meaningful differences among demographic groups. For example, while there is some variation along political lines, large percentages of conservatives now join moderates and liberals in supporting sweeping health care reforms.”

Key Survey Findings

Access to health care and the cost of medications are an increasingly severe problem for tens of millions of Americans:

• Half of adults have seen their health care coverage cut and/or costs go up. A total of 56 percent of adults with health insurance – representing an estimated 100 million American adults – have had their coverage cut or been forced to pay more on an out-of-pocket basis for coverage. In many cases, Americans have seen their coverage shrink and then had to pay more to get the narrower health insurance protection.
• A third of adults who use prescription medications already buy or are planning to purchase cheaper drugs from Canada or other nations. Among American adults with health care insurance who buy prescription drugs, a net of one-third (34 percent) are already purchasing (6 percent) or planning to purchase (33 percent) lower costs drugs from pharmacies in Canada or other nations.
• More than 20 million Americans worried about drug costs are playing “Russian roulette” with their medications. Nearly two in ten (18 percent) say they either skip medications or reduce dosages to “stretch” their medication due to high costs. Concerns about access to health care and rising medical costs are driving clear majorities of Americans to favor a greater government role in health care:
• Three out of four American adults (78 percent) agree that health care is a necessity like water, gas and electricity and should be “regulated by government to ensure fair prices, accountability, access for everyone and quality services.” A strong 78 percent of all American adults – including 71 percent of conservatives – support requiring state permission before health insurance companies can raise premiums.
• Eight out of ten (83 percent, including three out four conservatives) say that the U.S. should follow the lead of other nations and negotiate buying prescription drugs on a bulk basis in order to help control the costs of these medications. Six in ten Americans (and a surprising 50 percent of conservatives) favor limiting the profits of pharmaceutical companies, while 55 percent (including 47 percent of conservatives) would support restricting pharmaceutical companies’ spending on marketing.
• Two out of three (67 percent) feel that it would be a good idea for the U.S. to adopt the approach of other major nations and “guarantee … citizens health insurance on the job, through government programs, or via a nonprofit source.” Labels that might be given to such a guarantee have only limited impact on the level of support. Support is strong enough to withstand the label of “socialized medicine” or “Canadian-style health care” among 61 percent of those who feel it is a good idea. Call it “National Health Insurance” and 77 percent say they will still support it. The 77 percent support level among those who think a “guarantee” would be a good idea – even when it is called “national health insurance” translates to a majority (52 percent) of all U.S. adults.
• Substantial numbers of conservatives would favor sweeping health care reform. For example: Three out five conservatives (61 percent) agree that health care should be regulated like utilities. Another case in point: Half of conservatives, 62 percent of moderates and 72 percent of liberals would support government controls on hospital costs.
• Restricting the legal rights of patients in order to control health care costs is supported by few Americans. Three quarters of American adults (including 71 percent of conservatives) disagree with the idea that patients who get HMO or other medical coverage on the job in the private sector should “have fewer legal rights than people who get their health care benefits from a government job or through Medicare or Medicaid.” An even higher 83 percent (with 76 percent of conservatives) believe that patients should have the right to sue their HMOs for damages if the health-care maintenance organization denies coverage for “medically necessary” care ordered by a doctor.
• Only one in five (19 percent) of Americans are willing to give “HMOs the power to reject more medical procedures ordered by doctors as ‘medically necessary’” as a cost control method.
• Eight in ten agree that all Americans should have access to the kinds of comprehensive health insurance available to most federal employees. Liberals overwhelmingly (92 percent) agree that all Americans should get such coverage. They are joined in this view by two-thirds of conservatives and 81 percent of moderates.
• Strong support exists for a federal health insurance program covering all children. Four out of five Americans (81 percent) agree that “all children in America should all be covered under a federal health care program that would provide for both their preventive and acute health care needs.” Support for such federal insurance for children extends to 65 percent of conservatives, 86 percent of moderates and 95 percent of liberals.

Survey Methodology

The RFA survey results are based upon telephone surveys conducted by Opinion Research Corporation among a national probability sample of 1,020 adults 18 and older living in private households in the continental United States. The survey was conducted September 2-5, 2004. Completed interviews were weighted by four variables: age, sex, geographic region, and race, to ensure reliable and accurate representation of the total adult population. The margin of error at a 95 percent confidence level is plus or minus three percentage points for the entire sample. Smaller sub-groups will have larger error margins.