Wednesday, Aug. 27, 2003
12:01 a.m. EDT
Problem Of Uninsured Still Troubles Most Americans
But Raising Taxes Remains A Sticking Point
of Public Health Analysis Shows Less than Half of Americans
Willing To See Taxes Increase To Cover More Uninsured Peoples
BETHESDA, MD — With the issue playing prominently among Democratic presidential candidates, a new analysis in the online edition of Health Affairs shows that the public remains concerned about the millions of Americans who lack health insurance, but they continue to resist the idea of paying higher taxes to expand coverage to more people.
An analysis of ten major public opinion polls by researchers at the Harvard School of Public Health (HSPH) shows that the public now considers the uninsured to be one of the three highest health care priorities for the government to address, following health costs and issues directly affecting the elderly and Medicare. Although most people express strong support for legislation to address the problem of the uninsured, there is still no real consensus on the best approach to pursue, and raising taxes remains “a major sticking point.”
Nearly three-quarters of Americans polled in May-June 2003 said that a law to provide health insurance for most of the uninsured was an extremely or very important priority for the federal government during the next year. But according to the analysis, less than half of Americans say that they are willing to see taxes increase to help more people get health insurance.
In addition, four other new articles on the future of health insurance appear with the Harvard study (all available at www.healthaffairs.org): “A New Medicaid Program,” by Lynn Etheredge and Judith Moore; “Building on the Job-Based Health Care System: What Would it Take?” by Jack Meyer and Sharon Silow-Carroll; “The Politics of Health Reform: Why do Bad Things Happen to Good Plans?” by Jonathan Oberlander; and “Is There Hope for the Uninsured?” by Uwe Reinhardt.
The HSPH analysis, based on a variety of polls conducted in 2002, 2003, and 1993 for comparison purposes, shows that a majority of the public does seem willing to consider trading off future tax cuts to support domestic challenges, including covering more of the uninsured. A May 2003 survey showed that 81 percent of the public believed it was more important to make sure all Americans have access to health insurance than to continue to cut taxes. But researchers say this should be interpreted cautiously.
“Even if tax cuts were rolled back, the public is not committed to earmarking that money for the uninsured problem,” says lead author Robert Blendon, professor of health policy and political analysis at the HSPH and the John F. Kennedy School of Government. “The uninsured will have to compete with other domestic priorities,” he adds.
Other findings from the HSPH analysis:
The authors note that given the government’s focus on international hotspots and terrorist activity, major legislation to help the uninsured “is unlikely” during the next few years. Still, they note that dissatisfaction with health care costs and access is rising. In addition, a slow economy that could lead to more unemployment and the loss of job-based health insurance could prompt more aggressive action on the uninsured problem.
The single biggest challenge is how to raise revenue to pay for an expansion of health insurance coverage, the authors conclude. “With states and the federal government facing significant budget problems, health insurance expansions are unlikely unless the public is willing to support tax increases,” says the HSPH’s Blendon. Without that support, he adds, “policymakers will have to think of new sources of revenue if they want to increase the number of people who have health insurance.”
Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research. Support for publication of all five articles came from The Robert Wood Johnson Foundation.
©2003 Project HOPEThe People-to-People Health Foundation, Inc.