Californians Willing to Pay to Overhaul Health System : Medical care: Gallup Poll finds 73% would agree to higher taxes to pay for services for the poor and uninsured.

Californians are prepared to accept and pay for a restructuring of the state’s health-care system but fault government leaders for failing to initiate change, said sponsors of the fourth annual Gallup California Health Care Poll released Wednesday.

While Californians remain firm in their opposition to health-care rationing and compromising the quality of care, 73% said they would agree to higher taxes--an average of $43 per person, per month--to pay for health care for the poor and uninsured, the survey found.

Respondents also expressed support for additional taxes on alcohol and taxing firearms to pay for indigent health care. But government leaders received low marks for their handling of problems in health-care access and financing.

“The public is ready to make the hard choices in health care that their elected leaders are not,” said pollster George Gallup. “The public favors concrete ways to meet the health needs of the poor and to improve the health-care delivery system, and apparently is willing to foot the bill.”

The telephone poll, an annual event co-sponsored by the California Assn. of Hospitals and Health Systems and the three Hospital Councils of California, questioned 1,004 Californians regarding health-care issues and personal-health habits. The Hospital Council of Southern California represents 84% of hospitals in the region.

The responses reflected those expressed in a Los Angeles Times Poll conducted in January, which revealed Americans’ willingness to pay higher taxes to expand health-care coverage and their belief that government should take the lead in improving the system.

In the Gallup Poll, two-thirds said that poor people with no Medi-Cal coverage deserve more service. More than half said that government is paying too little to hospitals for poor people on Medi-Cal.

“A significant proportion of Californians believe that health care is a right,” said Robert Nielsen, senior vice president of the Gallup Organization. “They were very clear that some form of government ought to take care of it. Eighty percent of Californians said that government had a responsibility.”

Half said they disapproved of the Legislature’s performance on health-care issues, and 36% said they disapproved of Gov. George Deukmejian’s performance, while 29% said they approved.

“The major crisis in health care is a crisis in leadership,” Nielsen said. “It’s very clear what the general public wants, but it’s not very clear who is going to assume the major burden and carry the political ball and make it happen.”

As in past years, a majority-- 61%--opposed health-care rationing while 25% favored it. Under a rationing plan, services would be prioritized and those perceived of lowest priority would not be paid for. More than three-quarters said they would not be willing to accept a lower quality of health care even if it cost less.

But, along with support for an increase in personal taxes, the poll revealed high interest in selective tax measures to pay for health care--especially on products that are viewed as detrimental to health. The proposed 1990 California ballot initiative designed to cover some indigent health care costs by taxing alcohol drew a 79% approval response while 18% opposed it.

Increased traffic violation fines were also supported, although by a lower margin (57% to 39%). A majority favored a new proposal to tax firearms to pay for indigent health care (70% to 27%) but opposed sales tax increases (40% to 57%).

More than eight of 10 people favored the controversial proposal drafted by state health officials for employer-mandated health insurance, with 50% saying they “strongly agreed” that employers should be required to provide basic health insurance to their employees and another 34% saying they “agreed.”

“Business must be alerted to the finding that 84% of the public are saying that the employers should be the ones responsible for funding health care through employee benefits,” said Stephen Gamble, president of the Hospital Council of Southern California. “Our health-insurance system in America is based upon employer-employee contributions to the pool to finance health care.”

Gamble said legislators traditionally have not viewed health care as an “election issue.” But he predicted that public opinion will influence legislators to propose a major restructuring of the state’s health-care system through a 1992 ballot initiative.

“By then we should have legislation passed to put on the ballot for a better-organized system for the financing and delivery of health care in California,” he said.

The survey also found:

Health maintenance organizations and preferred provider organizations gained popularity, with 29% of respondents enrolled in such programs compared to 19% in 1989.

Pollution was cited most frequently (by 22%) as the state’s greatest health threat, a result that mirrored last year’s findings. AIDS was cited as the major health threat by 19%, and 11% pinpointed the cost of health care.

The majority of women from 35 to 54 indicated that they were on a diet to lose weight in the last year. One-quarter of males said they dieted.

Two-thirds said they exercised at least three times a week.

More Californians said they had been tested for the AIDS virus--24% this year compared to 18% last year. Non-whites were much more likely to express concern about contracting the AIDS virus.

Respondents appeared to favor personal control regarding right-to-die decisions. In response to the question, “Should terminally ill adults be allowed to end their own life or not?” three-quarters of Californians said yes and one-fifth said no. A majority, 86%, believed that a relative should be allowed to make a refusal-of-life-support decision.

Acknowledgment of illegal drug use rose from 20% to 21% in 1990. Whites were more likely to have used illegal drugs than any other racial group (22%) compared to Latinos (21%), Asians (19%) and blacks (16%). Drug use rose with educational level.

(Southland Edition) HEALTH CARE FOR THE INDIGENT

Respondents to the annual Gallup California Health Care Poll were asked if they favored the following proposed increases as ways to help cover the health care costs of the indigent: PROPOSED INCREASE IN:

Tobacco Alcohol Traffic Sales Firearm Tax Tax Fines Tax Tax Favor 78% 79% 57% 40% 70% Oppose 20% 18% 39% 57% 27% Don’t know 2% 2% 4% 3% 3%

NOTE: All categories do not add to 100% because some percentages have been rounded off.