NYT

March 2, 2007

Most Support U.S. Guarantee of Health Care

By ROBIN TONER and JANET ELDER
A majority of Americans say the federal government should guarantee health insurance to every American, especially children, and are willing to pay higher taxes to do it, according to the latest New York Times/CBS News poll.

While the war in Iraq remains the overarching issue in the early stages of the 2008 campaign, access to affordable health care is at the top of the public’s domestic agenda, ranked far more important than immigration, cutting taxes or promoting traditional values.

Only 24 percent said they were satisfied with President Bush’s handling of the health insurance issue, despite his recent initiatives, and 62 percent said the Democrats were more likely to improve the health care system.

Americans showed a striking willingness in the poll to make tradeoffs to guarantee health insurance for all, including paying as much as $500 more in taxes a year and forgoing future tax cuts.

But the same divisions that doomed the last effort at creating universal health insurance, under the Clinton administration, are still apparent. Americans remain divided, largely along party lines, over whether the government should require everyone to participate in a national health care plan, and over whether the government would do a better job than the private insurance industry in providing coverage.

Looking ahead to the presidential campaign, 36 percent of Americans polled said they had confidence in the ability of Senator Hillary Rodham Clinton, Democrat of New York, to “make the right decisions on health care,” while 49 percent said they were uneasy about her.

But Mrs. Clinton retained the confidence of nearly 6 in 10 Democrats on the issue, despite the politically devastating collapse 13 years ago of the national health initiative she helped develop early in her husband’s presidency.

The poll helps explain why health care already looms large in the presidential campaign, and in statehouses from California — where Gov. Arnold Schwarzenegger, a Republican, has proposed a sweeping coverage plan — to Massachusetts, now instituting a program passed under Mitt Romney, the former governor and current Republican presidential candidate.

John Edwards, the Democratic presidential candidate and former senator from North Carolina, recently unveiled his own attempt at a consensus plan, one that would require everyone to have insurance and require employers to provide it or pay into a fund that would do so. Nearly 4 in 10 said that was a good idea; nearly half said they were unsure.

While Democrats are traditionally strong supporters of expanding health coverage, this survey found many Republicans and independents in agreement.

“I think everybody should have some kind of health care available to them,” said Diane Manning, 66, of Vancouver, Wash., who described herself as an independent.

“I don’t necessarily think that socialized medicine is the answer, but I think everyone should have that right,” said Mrs. Manning, who participated in the poll and agreed to a follow-up interview. “And there are so many people that don’t.”

Nearly 47 million people in the United States, or more than 15 percent of the population, now go without health insurance, up 6.8 million since 2000.

The poll also found overwhelming support behind the Children’s Health Insurance Program, which covers many low- and moderate-income children and is up for renewal in Congress this year. Eighty-four percent of those polled said they supported expanding the current program to cover all uninsured children, now estimated at more than eight million. A similar majority said they thought the lack of health insurance for many children was a “very serious” problem for the country.

The nationwide telephone poll of 1,281 adults was conducted Feb. 23- 27, and has a margin of sampling error of plus or minus three percentage points.

The poll found Americans across party lines willing to make some sacrifice to ensure that every American has access to health insurance. Sixty percent, including 62 percent of independents and 46 percent of Republicans, said they would be willing to pay more in taxes. Half said they would be willing to pay as much as $500 a year more.

Nearly 8 in 10 said they thought it was more important to provide universal access to health insurance than to extend the tax cuts of recent years; 18 percent said the tax cuts were more important.

“I wouldn’t want to pay a lot of taxes, but if it was spread out and everyone paid their fair share, it would be fine,” said Don Galvan, 50, a computer programmer from Ringwood, N.J., who considers himself an independent. “Everybody should have some kind of medical coverage, in case they or their children get sick. Especially children.”

Most participants said they were satisfied with the quality of their health care, but there was widespread concern about costs. Nearly half of those with insurance said an employer had cut back on benefits or required them to pay more for their benefits in recent years.

A quarter of those with insurance said someone in their household had gone without a medical test or treatment because insurance would not cover it. Six in 10 of those without insurance said someone in their household had gone without care because of the cost.

More people now see guaranteeing health insurance as important than did so at the end of the Clinton efforts in 1996. At that time, 56 percent polled said it was the government’s responsibility to do so, and 38 percent said it was not. In the current poll, 64 percent said the government should guarantee health insurance for all; 27 percent said it should not.

Moreover, an overwhelming majority in the current poll said the health care system needed fundamental change or total reorganization, just as they did in the early 1990s, when a deep recession and soaring health care costs galvanized the public and spurred the Clinton drive.

But now, as then, this concern did not translate into a consensus on what should replace it.

One question offered a choice between the current system and a national health insurance program covering everyone, administered by the government and financed by taxpayers. Thirty-eight percent said they preferred the current system, 47 percent the government-run approach.

Robert Blendon, an expert at Harvard on public opinion and health, said politicians had to find some compromise between these philosophical divisions on the role of government, which are deep-seated in American culture, or “we’re going to have the same train wreck we did before.”

The Clinton plan, itself an attempt at a compromise, collapsed under attacks from an array of interests, including the insurance industry, which warned that the plan amounted to a big government takeover.

Mr. Blendon noted that many politicians were seeking a blend between the private market and the government in their health plans.

Megan Thee, Marina Stefan and Marjorie Connelly contributed reporting.