Americans' Views on Health Care: Foolish Inconsistencies?

Abstract

Prologue: The ebb and flow of public policy making, American style, is influenced by a wide variety of factors, certainly not the least of which is public opinion. While a large segment of the public pays little attention to federal and state policy making, most citizens do have opinions on the major issues of the day, including health and medical questions. Time and again, private interests and publie decisionmakers employ the results of public opinion surveys as a way to influence policy. Recently, the American Association of Retired Persons, under attack from some quarters of the elderly lobby for its advocacy of Medicare's new benefit to cover catastrophic medical expenses, unveiled a public opinion survey that 65 percent of those people over age sixty-five who were asked favored the new benefit. For the last decade, the Health Insurance Association of America (HIAA) has surveyed 1,500 American households annually in an effort to chart trends in the public's view of health care. In this paper Jon Gabel and Steven Fink of the HIAA and Howard Cohen, who recently departed that association after eight years for a position on Capitol Hill, report on the conflicting views of most Americans in relation to health care as reported by public opinion surveys. To the degree that their views conflict, they mirror those of most policymakers who are enthusiastic about expanding health care benefits, but a good deal less certain about how to pay their costs. Gabel, who is associate director; research and development, at HIAA, formerly worked as a senior economist at the National Center for Health Services Research and Health Care Technology Assessment. Fink, who oversees the daily conduct of polling at HIAA, holds a master's degree in sociology from the University of Connecticut. Cohen joined the Republican staff of the House Energy and Commerce Subcommittee on Health and the Environment at the beginning of 1989. He holds a doctorate in psychology from the University of Massachusetts and a law degree from George Washington University.