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Americans Want Government to Lead Health Care Overhaul, Surveys Find

By Danielle Parnass, CQ Staff

August 7, 2008 -- Regardless of economic, political, or regional background, health care costs continue to be a top concern for Americans, who increasingly favor a fundamental overhaul of health care and are calling on the government to lead that charge, according to several recent surveys and reports.

In a Commonwealth Fund survey released Thursday, an overwhelming number of respondents, around 90 percent across all demographics, want the next president to propose changes addressing quality, access, and affordability. In addition, cost of care topped respondents' lists of important issues facing the next president. Those who identified as Democrats or who had a lower income were most supportive of a health overhaul, according to the survey of about 1,000 adults conducted in May by Harris Interactive.

Eighty-two percent of those surveyed said the current health care system needs to be either fundamentally changed or completely rebuilt. Results differed about eight percentage points between the insured and uninsured, but more than 80 percent in each group favored change.

Another study released in August by the Washington Post, Kaiser Family Foundation, and Harvard University surveyed low-wage workers in America and found that 72 percent said a top priority for the government should be helping those with lower incomes receive more affordable health insurance. Cost concerns were followed by 71 percent of those surveyed who felt the government's top priority should be lowering gas prices.

Furthermore, 62 percent of respondents in the survey of workers who make low-wages—defined as earning $27,000 or less in 2007—said it was somewhat or very difficult for them to afford health care and health insurance. Fifty-one percent reported postponing medical or dental care in certain circumstances to make ends meet.

"It is clear that our health care system isn't giving Americans the health care they need and deserve," Commonwealth Fund President Karen Davis said in a news release. "The disorganization and inefficiency are affecting Americans in their everyday lives, and it's obvious that people are looking for reform."

Davis also said the upcoming election provides ample opportunity for leaders to listen to what Americans want from the health care system "and respond with meaningful proposals."

In Thursday's Commonwealth Fund survey, 73 percent of respondents reported problems accessing their health care, including difficulty getting timely appointments, phone advice, or after-hours care. Respondents also said the health care system needs to be more cohesive, with 47 percent saying they experienced poorly coordinate care in the past two years. Nine out of 10 people surveyed also said they wanted access to their medical records and gave substantial support for wider adoption of health information technology.

A recent report by the Government Accountability Office highlighted access problems that Medicare Part D beneficiaries have experienced. It found that the Centers for Medicare and Medicaid Services (CMS) and other providers were slow in resolving complaints of patients in the Medicare prescription drug benefit program who were at risk of running out of medications, among other issues.

The Commonwealth Fund released a second report Thursday that called for a reorganization of a system it says is fragmented at the national, state, community, and practice levels. It offered strategies for a higher-performing system after analyzing successful programs around the country, including: a payment overhaul that moves away from the fee-for-service system, patient incentives to seek providers offering the highest quality care, regulatory changes that promote information sharing and coordinated care, and health IT.

"There's no one policy, or practice that will make our health care system run like an efficient, well-oiled machine," James J. Mongan, chairman of the Fund's Commission on High Performance Health System and CEO of Partners HealthCare, said in the release. "This is going to take strong national leadership and a commitment from all of the players in our health care system."

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