AHA National and Selected Statewide Surveys January, 2004 GREENBERG QUINLAN ROSNER RESEARCH INC Bill...

AHA National and Selected

Statewide Surveys

January, 2004

GREENBERG QUINLAN ROSNER RESEARCH INC

Bill McInturff, PartnerPublic Opinion Strategies

Stan Greenberg, Chairman and CEOGreenberg Quinlan Roser Research

http://www.aha.org/

2GREENBERG QUINLAN ROSNER RESEARCH INC

METHODOLOGY

Public Opinion Strategies, in conjunction with Greenberg Quinlan Rosner Research, conducted a national survey and four statewide surveys on behalf of the American Hospital Association. The national survey was conducted among 800 registered voters from January 5 - 7, 2004. The four statewide surveys were conducted in the early presidential primary states (AZ, IA, NH, and SC) among 1200 registered voters, with 300 interviews completed in each state, from January 6 - 8, 2004.

The margin of error on the 800 national sample is +3.46%. The margin of error on the individual statewide samples of 300 is +5.66%.

33

Health Care is Emerging as a Top Issue


“Affordable health care” has emerged as the country’s leading concern after the economy and jobs.

Combined Choice

The economy and jobs 45%

Affordable health care 27%

Terrorism and national security 27%

Social Security and Medicare 23%

Education 22%

The situation in Iraq 20%

Moral values 10%

The federal deficit 9%

Taxes 8%And, which ONE of the following issues do you believe should be the highest priority for Congress and the

President. And which of the following would be the NEXT issue most personally important to you?


While “affordable health care” continues to be an important concern among core Democratic leaning sub-

groups, it’s also increasingly important to key swing sub-groups as well.

Swing Voter Sub-groups Affordable Health care 27%Women 55-64 44%Hourly Wage Women 41%Working Women 38%Small Business Owners 36%Age 55-64 35%Moms 34%Women 35-54 34%Independent Women 34%Women 33%Rural 33%$20K-$40K HH Income 33%Women less than College 33%

Democrat Leaning Voter Sub-groups Affordable Health care 27%Democrat Women 38%Strong Democrats 35%Salaried Women 34%Women College+ 34%Gore 2000 Voter 33%Total Democrats 32%New England 32%African American 31%Moderate/Liberal Democrats 31%


Driving this, we’ve reached the lowest point in twelve years with voters saying the health care system is

meeting their needs as this figure has dropped to 60%.

61%66% 64%

73%

81%77%

71%68%

60%

35%30% 31%

24%

16%20%

27%30%

38%

Jan'92

Oct'92

Nov 4-5'92

Nov 8-9'94

Oct'98

Jan'99

Feb 11-13'02

Dec 11-13'02

Jan 5-804

Yes No

+26% +36% +33% +49% +65% +57% +44% +38% +22%

Just generally speaking, is the current health care system meeting the needs of you and your family?


And interestingly, Baby Boomers are the least likely to say the health care system is meeting their needs and most likely to report

higher increases in their out-of-pocket health care costs.

60%

38%

56%

42%

Total Yes Total No Total Yes Total No

Health care system meeting the needs of you and your family


All VotersBaby

Boomers*

26%

32%

All PrivatelyInsured Voters

Mean

Baby Boomers*Mean

And thinking about the amount YOU pay out of your own pocket for the cost of your health insurance coverage, including your premium, co-pays and deductibles...If you just had to guess, in the last year, by what percent, if at all, do you think YOUR own out-of-pocket health care costs have ACTUALLY increased this

year as compared to last year?

Percent out-of-pocket health care costs have actually increased

*Baby Boomers are defined as those age 43-60

+22% +14% +6%


There is a substantial difference by a respondent’s health coverage status.

67%

49%

32%31%

51%

68%

ConstantCoverage

For Last Three Years(77%)

In FluxCoverage

Over Last Three Years(12%)

ChronicallyUncovered

For Last Three Years(4%)

Yes No


+36% -2% -36%

Health care system meeting the needs of your family by health care coverage


There is also a sharp difference among respondents by employment status, with respondents in larger companies the most satisfied and

respondents who are self-employed the least satisfied.

47%

57%

64% 62%

51%

42%

35% 36%

Self-Employed(11%)

Less then50 Employees

(21%)

50-1000Employees

(17%)

1000+Employees

(21%)

Yes No


-4% +15% +29% +26%

Health care system meeting the needs of your family by company size


It is important to note there is a significant disconnect between how voters perceive whether the current health care system is working for themselves

compared to how they perceive it for most Americans.

60%

38%

21%

74%

Total Yes Total No Total Yes Total No

Health care system meeting the needs of you and your family

Health care system meeting the needs of most Americans


And, just generally speaking, is the current health care system meeting the needs of most Americans?

+22% -53%


For those respondents who believe that the current health system is meeting the needs of their family, but who think it is not meeting the needs of most Americans we asked them to give us some reasons why they felt this way.

In virtually all cases, people said they felt they were fortunate enough to afford it, to have it through an employer, or to be in good health, while others were not so privileged.

“Because we have the means to get health care, and a lot of people cannot pay for it. There needs to be something for the underprivileged.”

“I happen to have good insurance provided by my employer. I am very lucky….I don’t know how anyone would pay for it without assistance.”

“I don’t have a lot of health problems, so I don’t need it. But for those who have problems, the high price of medication. That is definitely the problem for those on limited incomes.”

“There are Americans who don't have health insurance, children, the elderly. We need to be concerned about them. The individuals on Medicare. Prescriptions need to be affordable for all Americans.”

“Because we're fortunately employed by an employer who has a good benefits package. That's it. Because there are many working poor who cannot afford health care. “

1212

Seven Steps to a Healthier America


• The American Hospital Association has outlined seven steps to improve the health care system. We tested voters support as well as the vote impact of AHA’s seven principles. In addition, we tested six other health care priorities identified through our health care research as important to Americans. The following slide shows AHA’s seven principles.

• In order to test the importance and impact of Medicaid versus Medicare, we split one of AHA’s principles in two, one focused on Medicaid and one focused on Medicare. We half sampled these two principles with 400 voters hearing AHA’s principle on Medicaid and 400 hearing the principle on Medicare.


• Guarantee health insurance coverage to every American child under 18

• Help provide special health insurance for catastrophic coverage for all Americans to protect them from any unusually high expenses related to facing a significant health crisis

• Protect every American’s continued access to emergency room medical services whether or not they can afford to pay by increasing the level of federal funding to hospital emergency departments

• Maintain the funding for the federal government health care program that covers the working poor, children in low-income homes and very low-income seniors to make sure they have continued access to quality hospital care

• Maintain the funding for the federal government health care program that covers America’s seniors to make sure they have continued access to quality hospital care

• Make sure all Americans have access to preventative care services, such as immunizations, cancer screening, and tests for diabetes and high cholesterol.

• Provide federal funds to help encourage spending by healthcare providers on information technology that would reduce medical errors and provide meaningful information on the quality of care delivered by different physicians and hospitals.

• Require Medicare and other insurers to cover the costs of coordinating the complicated medical care of people with chronic health conditions such as heart disease and diabetes and to improve health education to help these patients.

American Hospital Association’s Seven Steps to a Healthier America:


Strongly Favor

Total Favorable

Oppose

Make sure all Americans have access to preventative care services, such as immunizations, cancer screening, and tests for diabetes and high cholesterol. 79% 94% 5%

Maintain the funding for the federal government health care program that covers America’s seniors to make sure they have continued access to quality hospital care 78% 94% 4%

Maintain the funding for the federal government health care program that covers the working poor, children in low-income homes and very low-income seniors to make sure they have continued access to quality hospital care

77% 94% 5%

Guarantee health insurance coverage to every American child under 18 74% 90% 8%

Require Medicare and other insurers to cover the costs of coordinating the complicated medical care of people with chronic health conditions such as heart disease and diabetes and to improve health education to help these patients.

65% 89% 8%

Help provide special health insurance for catastrophic coverage for all Americans to protect them from any unusually high expenses related to facing a significant health crisis 62% 89% 9%

Protect every American’s continued access to emergency room medical services whether or not they can afford to pay by increasing the level of federal funding to hospital emergency departments

62% 88% 9%

Provide federal funds to help encourage spending by healthcare providers on information technology that would reduce medical errors and provide meaningful information on the quality of care delivered by different physicians and hospitals.

47% 80% 16%

AHA’s principles are well received by American voters.


Many of AHA’s principles are competitive with other health care proposals which could be considered by

Congress.Strongly

Favor

Make sure seniors receive prescription drug coverage 81%

Make sure patients can choose their own doctors 81%

Make sure all Americans have access to preventative care services, such as immunizations, cancer screening, and tests for diabetes and high cholesterol. 79%

Maintain the funding for the federal government health care program that covers the working poor, children in low-income homes and very low-income seniors to make sure they have continued access to quality hospital care 77%

Maintain the funding for the federal government health care program covering America’s seniors to make sure they have continued access to quality hospital care 77%

Guarantee health insurance coverage to every American child under 18 74%

Guarantee every American citizen receives health care 70%

Limit lawyers’ fees from medical malpractice lawsuits to help reduce health care costs 66%

Require Medicare and other insurers to cover the costs of coordinating the complicated medical care of people with chronic health conditions such as heart disease and diabetes and to improve health education to help these patients. 65%

Regulate the prices health insurance companies can charge for medical malpractice insurance to help reduce healthcare costs 65%

Help control the out-of-pocket costs that patients pay for premiums, deductibles and co-pays. 64%

Protect every American’s continued access to emergency room medical services whether or not they can afford to pay by increasing the level of federal funding to hospital emergency departments 62%

Help provide special health insurance for catastrophic coverage for all Americans to protect them from any unusually high expenses related to facing a significant health crisis 62%

Provide federal funds to help encourage spending by healthcare providers on information technology that would reduce medical errors and provide meaningful information on the quality of care delivered by different physicians and hospitals. 47%


9-10%

Maintaining the funding for the federal government health care program covering America’s seniors to make sure they have continued access to quality hospital care 59%


Maintaining the funding for the federal government health care program that covers the working poor, children in low-income homes and very low-income seniors to make sure they have continued access to quality hospital care

55%


Protecting every American’s continued access to emergency room medical services whether or not they can afford to pay by increasing the level of federal funding to hospital emergency departments

51%

Helping provide special health insurance for catastrophic coverage for all Americans to protect them from any unusually high expenses related to facing a significant health crisis 43%

Require Medicare and other insurers to cover the costs of coordinating the complicated medical care of people with chronic health conditions such as heart disease and diabetes and to improve health education to help these patients.

41%

Providing federal funds to help encourage spending by healthcare providers on information technology that would reduce medical errors and provide meaningful information on the quality of care delivered by different physicians and hospitals.

28%

A majority of voters rank four of AHA’s seven principles as a “9” or “10” on a scale where ten means “very important…when deciding how to vote for a candidate for U.S.

Congress.”


9-10%

Guaranteeing every American citizen receives health care 59%

Maintaining the funding for the federal government health care program covering America’s seniors to make sure they have continued access to quality hospital care 59%

Making sure seniors receive prescription drug coverage 59%

Making sure patients can choose their own doctors 58%


Maintaining the funding for the federal government health care program that covers the working poor, children in low-income homes and very low-income seniors to make sure they have continued access to quality hospital care 55%


Protecting every American’s continued access to emergency room medical services whether or not they can afford to pay by increasing the level of federal funding to hospital emergency departments 51%

Limiting lawyers’ fees from medical malpractice lawsuits to help reduce health care costs 49%

Helping control the out-of-pocket costs that patients pay for premiums, deductibles and co-pays. 46%

Helping provide special health insurance for catastrophic coverage for all Americans to protect them from any unusually high expenses related to facing a significant health crisis 43%

Require Medicare and other insurers to cover the costs of coordinating the complicated medical care of people with chronic health conditions such as heart disease and diabetes and to improve health education to help these patients. 41%

Regulating the prices health insurance companies can charge for medical malpractice insurance to help reduce healthcare costs 40%

Providing federal funds to help encourage spending by healthcare providers on information technology that would reduce medical errors and provide meaningful information on the quality of care delivered by different physicians and hospitals. 28%

AHA’s most strongly supported principles score well compared to other very popular health care proposals.


9-10%

Improving the economy and create more jobs 73%

Protecting Social Security 70%

Improving the quality of public education 58%

Combating terrorism at home in the United States and overseas 53%


We tested a variety of other issues which voters tell us are among their top priorities to provide a perspective for how high these 13

different health care proposals fare, including AHA’s seven principles.


9-10%

Guaranteeing every American citizen receives health care 59%

Maintaining the funding for the federal government health care program covering America’s seniors to make sure they have continued access to quality hospital care

59%

Making sure seniors receive prescription drug coverage 59%


Maintaining the funding for the federal government health care program that covers the working poor, children in low-income homes and very low-income seniors to make sure they have continued access to quality hospital care

55%

Making sure all Americans have access to preventative care services, such as immunizations, cancer screening, and tests for diabetes and high cholesterol.

54%

Combating terrorism at home in the United States and overseas 53%


But it’s worth noting that some of AHA’s as well as other health care goals exceeded Iraq and combating terrorism and were competitive with the issue

of education in what people told us would decide how they vote.

2121

Attitudes Towards Raising Taxes to Cover the Uninsured


People say they would be willing to pay more per year in federal taxes “to assure every American citizen receives

health care coverage.”Yes69%

No28%

Don't Know3%

Would you be willing to pay MORE in federal taxes to help provide the funding to assure every American citizen receives health care coverage?


While there’s a substantial difference by party identification, it’s worth noting even a majority of Republicans say they would be willing to pay more in taxes to “assure every American citizen

receives health care coverage.”

54%

74%79%

41%

24%18%

Total GOP(36%)

Independent(18%)

Total DEM(44%)

Yes No

Would you be willing to pay MORE in federal taxes to help provide the funding to assure every American citizen receives health care coverage?

+13% +50% +61%


But when asked specifically, 4 out of 10 refused to give a dollar figure for how much

they would be willing to pay.

Less the $100 16%

$100-$299 17%

$300-$999 11%

$1000 or more 14%

Don’t Know 40%

How much MORE per year in federal taxes would you be willing to pay to help provide the funding to assure every American citizen receives health care coverage?

Mean $632

Median $200

Although among those who do provide a figure the amount is very high.

2525

Statements About the Uninsured


Americans clearly understand being uninsured means you lack access to preventative care or early intervention and this has real

consequences on people’s health.

StronglyAgree57%

SomewhatAgree29%

SomewhatDisagree

7%

StronglyDisagree

3%

Don't Know4%

Uninsured patients often have medical conditions that have persisted or worsened because of a lack of early intervention or preventive care.

Total Agree 86%Total Disagree 10%

Now, I would like to read some statements you might hear about the issue of the uninsured. For each statement, please tell me whether you agree or disagree with each statement.


However, this data reinforces our observation from focus groups that one barrier for action is people believe the

uninsured already have access to the medical care they need.

StronglyAgree30%

SomewhatAgree31%

SomewhatDisagree

16%

StronglyDisagree

18%

Don't Know5%

The uninsured DO have access to medical care as in every community there are clinics and hospital emergency departments they can go to receive the care they need.

Total Agree 61%Total Disagree 34%

Now, I would like to read some statements you might hear about the issue of the uninsured. For each statement, please tell me whether you agree or disagree with each statement.

2828

Key Highlights from the Four Selected States


LOOKING AT HOW THE FOUR EARLY PRIMARY STATES COMPARE TO THE NATIONAL ENVIRONMENT

• New Hampshire voters are more focused on the issue of affordable health care and the uninsured compared to the three other early primary states and voters nationally.

“Affordable health care” follows very closely behind “the economy and jobs” and “terrorism and national security” in New Hampshire, with 33% choosing it as their first or second choice as the highest priority for Congress and the President compared to 27% nationally.

• Iowa and South Carolina voters however are more positive about the health care system and more likely to say it is currently meeting their needs.

AZ IA NH SC NAT62% 71% 64% 69% 60% YES/IS35% 26% 36% 30% 38% NO/IS NOT

[email protected] (703) 836-7655

[email protected] (703) 836-7655

BILL McINTURFFBILL McINTURFF

30

GREENBERG QUINLAN ROSNER RESEARCH INC

STAN GREENBERGSTAN [email protected]

(202) [email protected]

(202) 478-8330

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AHA National and Selected Statewide Surveys January, 2004 GREENBERG QUINLAN ROSNER RESEARCH INC Bill...

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