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Survey: Dem '08 Candidates Savvy on Elements of Health Care Overhaul

By Sara Lubbes, CQ Staff

January 15, 2008 -- Democratic presidential candidates are more in step than their Republican counterparts on what Americans want in a health care system overhaul, said authors of a new voter survey.

The survey, put together by the Commonwealth Fund—a nonprofit group that promotes better public access to health care—shows that more than 80 percent of those surveyed, regardless of their political party, supported the idea that all employers should be required to provide health care to their workers or pay into a government-run fund to provide the care.

The survey, taken of a sample of adults 19 or older from June 2007 to October 2007, also showed the majority of those polled, including 52 percent of Republican voters, say government should require every American to have health insurance, just as all drivers are required to have car insurance.

Study author Sara R. Collins, assistant vice president of the Commonwealth Fund, said the results show that voters agree most with the proposals being pushed by the three leading Democratic candidates for president: former North Carolina Sen. John Edwards, Illinois Sen. Barack Obama, and New York Sen. Hillary Rodham Clinton.

All three candidates would require employers to make some kind of health care contribution or provide health insurance to their workers—the so-called pay or play mandate. Clinton and Edwards also would require all Americans to carry health insurance, while Obama would require families to carry the insurance for their children.

The Republican front-runners, Arkansas Gov. Mike Huckabee, former New York City Mayor Rudy Giuliani, former Massachusetts Gov. Mitt Romney, and Arizona Sen. John McCain, have not called for such reforms yet.

Most have backed the idea that people should be more free to buy their own insurance on the private market and carry that insurance with them from job to job.

"The survey findings are far more in line" with the proposals the Democratic candidates support, Collins said in a press briefing Monday.

Meanwhile, policy experts at conservative think tanks criticized the findings as unrealistic. They said the survey questions were biased because they did not ask voters whether they would support a health care overhaul if those changes led to a tax increase or some people to lose their jobs, two possible consequences critics of the health overhaul predict.

"When you ask people 'do you want everything for nothing,' they're going to say 'yes,' " Grace-Marie Turner, president of the Galen Institute, which promotes free-market-based economic policies, said.

"If you asked people 'do you think you want to be able to have insurance you can take from job to job' " as Republican candidates such as Giuliani are arguing, "people will say 'yes' to that, too," Turner said. "It's totally how you frame the question."

The survey also found that support for the individual mandate that would require everyone to carry insurance "was far strong than I might have expected," Collins said.

About two-thirds of those polled, regardless of their political party, said the government, individuals, and employers should share the health insurance cost burden in America.

About 85 percent of those polled, across party, said the candidates' positions on health care would be "somewhat" or "very" important in their voting decision.

Joe Antos, a health policy expert with the conservative American Enterprise Institute, pointed to a survey finding that 66 to 70 percent of those polled said employers, government, and individuals should share insurance costs—a finding which shows that the majority of Americans think the health care system should not change much, he said.

"This is really a statement that says 'we'd like things to stay about the same,'" Antos said.

He also argued that it's too early in the campaign to know what kinds of health care reforms the eventual Republican nominee will end up supporting. Health care has not been a big issue in the Republican primaries so far because it's not an issue core Republican voters worry about as much as issues such as immigration, Antos said.

"Come the general election, they'll be changing their tune," he said.

Dan Mendelson, president of the public policy strategy Avalere Health and a former head of the Office of Management and Budget's health division under President Bill Clinton, agreed, saying "It's too early to judge the Republican health policy," he said. "They've been silent on it, leaving them a lot of room."

New America Foundation's Len Nichols said the survey's findings confirm what he already believes: that most Americans want employers or the government to provide mandatory insurance. Nichols is director of the Health Policy Program at the foundation, a self-described "post-partisan" public policy think tank.

"These ideas always tend to poll well," and the Democratic plans are tailored to those ideas, Nichols said.

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