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Jan 19, 2009

New Survey: Experts Say Obama Administration Should Pursue Ambitious Health Care Reform Agenda; SCHIP and Health Information Technology Top Priorities For Early Action

Health Care Opinion Leaders Express Overwhelming Support for Expanding Coverage While Simultaneously Addressing Quality, Efficiency and Costs

New York, NY, January 19, 2009—Leaders in health care and health care policy feel strongly that President-elect Barack Obama should pursue an ambitious health care reform agenda that expands coverage while also improving quality and efficiency, and controlling costs. In fact, two-thirds (66%) of those surveyed in the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey said that the new administration should pursue these goals simultaneously.

When asked which features were important to act on immediately, an overwhelming majority—83 percent—said expanding the State Children's Health Insurance Program (SCHIP) was absolutely essential or very important. Investment in health information technology (HIT) in the economic stimulus package (supported by 78%), and access to public health insurance coverage for the long-term unemployed (supported by 72%) were also seen as crucial.

The survey asked respondents to identify what they think the incoming Obama administration should make its top health care priorities. There was widespread support for many elements of President-elect Obama's health care reform proposal, including allowing uninsured people to buy health insurance through a health insurance exchange (favored by 92%) and expanding eligibility for Medicaid and SCHIP to low-income adults and children (favored by 89%). Survey respondents were, however, sensitive to the realities posed by the current economic crisis. When asked how the administration should prioritize reform measures if they needed to happen in phases, a wide majority felt that Medicaid and SCHIP eligibility expansion (82%) and funding for HIT (76%) should be part of phase one.

Overall, there was wide agreement that the President-elect and his team must move ahead with health care reforms. "The election of the new administration and Congress has opened up a historic opportunity for health care reform—one that could finally give Americans the health security they need and deserve," said Commonwealth Fund President Karen Davis. "Health care opinion leaders agree that focusing on the right policies and priorities can really put the U.S. on the path to a high performance health care system."

Other findings from the survey include:

  • 86 percent support implementing federal insurance market rules such as guaranteed issue and community rating that would help ensure access to affordable coverage for those with health conditions, and 81 percent support an employer "play or pay" requirement for employers to either offer coverage or pay a percent of payroll to help finance expanded coverage.
  • 71 percent said that allowing Medicare to negotiate prescription drug prices, increasing the number of primary care providers, and moving away from fee-for-service toward global fees or episode of care payments would be effective or very effective ways to control costs.
  • 60 percent said that COBRA premium assistance for recently unemployed workers was a very important or absolutely essential feature of an economic stimulus package; slightly more than one of three (35%) felt the same way about increased NIH funding.

The survey is the 17th in a series from The Commonwealth Fund, and the eighth conducted in partnership with the publication Modern Healthcare. Respondents to the health care opinion leaders survey include a diverse group of health care experts representing the fields of academics and research; health care delivery; business, insurance, and other health industries; and government, labor, and advocacy.

Commentaries on the survey results from Montana Senator Max Baucus (D) and Minnesota Governor Tim Pawlenty (R) appear in the January 19th issue of Modern Healthcare. The commentaries are also posted on the Commonwealth Fund's Web site,, along with a data brief on the survey findings from the Fund's Commission on a High Performance Health System.

Methodology: This survey was conducted online by Harris Interactive on behalf of The Commonwealth Fund among 194 opinion leaders in health policy and innovators in health care delivery and finance within the United States between December 1, 2008, and January 2, 2009. Harris Interactive sent out individual e-mail invitations to the entire panel containing a password-protected link and a total of four reminder emails were sent to those that had not responded. No weighting was applied to these results.

Publication Details


Jan 19, 2009