Most voters say the U.S. health system works for them, but not others

A majority of voters are unhappy about health care costs and don't think the health system works well for others, but most are satisfied with how the system works for them, according to a comprehensive survey released May 13 by the Stanford Center on Longevity.

The survey, called "Politics, Scholars and the Public: Health Security Project: Building Sensible Health Care Solutions," is an attempt to go beyond typical polls and examine which reforms voters might choose when presented with benefits and drawbacks of each proposal.

The public has anxiety about changes to health care, said Laura L. Carstensen, PhD, professor of psychology and founding director of the center. "As lawmakers are preparing large-scale legislation with the goal of improving health care in our country, it is critical that leaders engage the public in an intelligent discussion about the options for change and what they mean both for individuals and for the system broadly."

The project began in fall 2007 with dialogues among professors and health policy experts to identify top health system challenges and possible solutions. The team developed a framework to discuss the ideas with the public. It consulted with Washington, D.C.-based policy experts in early 2008 on the initiative, then held forums to solicit the opinions of more than 2,000 voters in late 2008 and early 2009.

The survey revealed that 62% of Americans believe the health system works well for them, but 68% say it doesn't work for a majority of Americans. Also, 58% of voters were dissatisfied with the cost and affordability of health care in the U.S., and half were dissatisfied with the quality of care.

The project revealed some predictable fault lines among partisan voters, the researchers said. Only 2% of Democrats worried about keeping the government from controlling the health system, while 26% of Republicans expressed the same concern.

However, the survey revealed that only 38% of all voters -- with little variation based on political party -- support paying physicians and hospitals based on patient outcomes. While about 24% of voters said such a proposal could reduce costs without lowering quality, 37% said they feared physicians and hospitals could manipulate the system and deny care.

The survey can be accessed on the center's Web site (link).