A survey of Congressional candidates by the National Coalition on Health Care shows bipartisan consensus and strong support for major improvements in the health system including the following:
- Achieving health insurance coverage for all Americans (94%)
- Slowing the rate of growth in private sector health care costs (88%)
- Improving the quality of health care through enhanced efficiency, simplified administration and paperwork reduction (97%)
- Improving the accountability of health insurers and managed care plans (97%)
- Assuring that consumers have sound information on which to base their choice of health plans and health providers (98%).
Candidates from both parties agreed on several measures and mechanisms to achieve universal coverage and health system improvement.
Ninety-two percent of Republicans and 89% of Democrats favored expanding tax benefits for individuals and small businesses to make health insurance more affordable. Such benefits could include allowing an income tax deduction for the purchase of health insurance by any individual or family who buys it on their own; and allowing low-income Americans to take a direct tax credit to offset the costs of individually purchased health insurance.
Candidates from both parties also broadly supported measures that would (1) increase federal funding for health care outcomes research and (2) require health plans to make standardized data on health care quality and patient satisfaction available to consumers. Eighty-five percent of Democrats and 59% of Republicans supported increased outcomes research funding. Ninety-one percent of Democrats and 80% of Republicans supported making data available to consumers.
“Itís clear that these candidates have heard what Americans have been saying for quite some time ñ that they are very concerned about the erosion of health insurance coverage and the problems of cost and quality in our health care system,” said Dr. Henry E. Simmons, President of the Coalition. “The survey indicates there is wide recognition of the need to tackle the deepest health system problems, an openness to substantial change, and real possibilities to move forward.”
Moreover, Simmons noted, the results indicate that even where Democrats and Republicans disagreed on ways to achieve major system improvements, there was clearly room for constructive bipartisan dialogue.
For example, 47% of Democrats favored requiring all Americans to obtain health insurance, with lower-income people getting government help to pay for it. Twenty-three percent of Republican candidates supported such a measure. But fully 25% of Republicans were “neutral” about the idea as were 20% of Democrats. In addition, only 14% of Republicans “strongly” opposed an “individual mandate” and 13% of Democrats were “undecided.”
Likewise, 45% of Democrats favored legislation allowing individuals of any age to purchase health insurance through the Medicare program. Only 18% of Republicans favored such a Medicare buy-in. But 21% of Republicans were “neutral” on the issue as were 16% of Democrats. And only 20% of Republicans were “strongly” opposed.
The same opportunity for possible consensus appears to exist for a plan to allow individuals and employers to buy into the Federal Employee Health Benefit Plan (FEHBP), the health insurance plan covering some 10 million federal government workers and family members. Sixty percent of Democrats supported an FEHBP buy-in as did 31% of Republicans. But 23% of Republicans were neutral on the idea as were 13% of Democrats. And only 15% of Republicans were strongly opposed.
On the question of an “employer mandate,” the Democrat-GOP split was larger. Sixty-one percent of Democratic candidates favored requiring all employers to offer ñ and help pay the cost of ñ health insurance for their workers. Only 18% of Republican candidates supported such a requirement; 19% were neutral. Notably, support for an employer mandate rose to 28% among Republicans (with 17% neutral) if only companies with 100 or more workers were required to offer and help pay for health insurance.
The survey found only modest support among Democrats and little support among Republicans for two methods of reducing health care spending. Forty-seven percent of Democrats and 19% of Republicans favored putting government limits on health insurance premiums. Forty-two percent of Democrats and 20% of Republicans supported putting limits on the fees doctors and hospitals charge in the private sector.
The survey was conducted between June and September 1998. A written questionnaire was sent to approximately 1,000 incumbents and challengers; 306 were returned, a 30% response rate. Of those, 246 were usable. Fifty-two percent of respondents were Democrats; 43% were Republicans. Sixty-one percent were challengers; 39% were incumbents.
The National Coalition on Health Care is the nationís most broadly representative non-partisan alliance working to improve Americaís health and health care system. Former presidents Jimmy Carter, Gerald R. Ford, and George Bush serve as Honorary Co-Chairs. The Coalitionís nearly 90 organizational members include large and small businesses, labor unions, the nationís largest consumer groups, religious organizations, provider groups, and academic health centers.