Americans want healthcare reform, but divided on how to pay for it

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The public ranks healthcare reform as an important part of efforts to stem the impact of economic recession and views it as a top priority for President Barack Obama and Congress, yet divisions remain on how to fund reform, according to survey results from the Kaiser Family Foundation and the Harvard School of Public Health.

According to the report, those surveyed rank helping newly unemployed afford health insurance coverage second (picked by 33 percent as a top priority), which fell behind helping businesses keep or create jobs (45 percent). Providing states with more federal help to pay for healthcare of lower income residents ranked third (picked by 31 percent), the report said.

The proposed healthcare provisions of the stimulus package ranked ahead of repairing the country’s infrastructure, cutting taxes for the middle class, helping people pay their mortgages (each picked by 27 percent) and helping large businesses hurt by the recession (13 percent), according to the report.

While improving the economy is an overwhelmingly top priority for the new president and Congress—cited by nearly three-quarters of the public—over four in ten Americans view reforming healthcare as a top concern, ranking it third just behind fighting terrorism (48 percent) and above reducing the federal budget deficit (39 percent), improving public schools (37 percent), working to create more clean energy sources (36 percent) and dealing with Iraq (35 percent).

However, a majority of those surveyed (61 percent) believe that given the serious economic problems facing the country, “it is more important than ever to take on health reform now,” according to the Kaiser/Harvard team.

As Congress begins work on the reauthorization of the State Children’s Health Insurance Program (SCHIP), 51 percent of the public favors increasing spending on SCHIP, while 39 percent would maintain current program funding.

However, the survey found that the public is split down the middle in its willingness to sacrifice financially to cover more individuals: 49 percent said that they are not willing to pay higher insurance premiums or taxes, while 47 percent said they are.  

When offered a list of potential taxes that could be used to pay for expanding health insurance for the uninsured, the only options with majority support were those likely to impact the fewest people, in particular, smokers and the wealthy.

Also, those surveyed seemed most concerned that any healthcare plan not raise their costs, or involve government limiting or dictating their choices. According to the survey, nearly two-thirds said they would be less likely to support a plan that would get the government get too involved in personal healthcare decisions, more than six in ten would be less likely to support a plan that increases people’s insurance premiums or out-of-pocket costs, and 56 percent would be less supportive of a plan that limits an individual’s choice in doctors.

“As we have learned from past debates, public support looms for health reform largest at the beginning of the debate, but it's relatively easy to chip away at that support with arguments about tradeoffs,” said Mollyann Brodie, Kaiser vice president and director for public opinion and survey research.

The Kaiser/Harvard research team conducted the survey Dec. 4-14, 2008 among a nationally representative random sample of 1,628 adults, ages 18 and older.