Public Voices Anger Over Health Care

By IRENE WIELAWSKI

May 15, 1991 12 AM PT

TIMES STAFF WRITER

Californians, dismayed by poor political leadership on health care issues, are leaning toward an initiative measure--bypassing the Legislature--to solve the problems of the poor and uninsured in obtaining medical treatment, according to the fifth annual statewide poll on health care by the Gallup Organization, released Tuesday.

Like last year, nearly three-quarters of those surveyed said they considered health coverage for the uninsured to be a state responsibility. Of these, 56% said voters should come up with a remedy through ballot initiative. Only 37% said the responsibility belonged with the Legislature. Overall, 52% said they disapprove of the state Legislature’s performance on health care issues.

“It is a very unfortunate message,” said Stephen Gamble, president of the Hospital Council of Southern California, a co-sponsor of the poll with the state’s two other regional hospital councils and the California Assn. of Hospitals and Health Systems. The poll results, he said, indicate that Californians are giving up on their elected leaders to solve what has become a “major, continuing and worsening problem for them.”

Gamble expressed doubts about a thoughtful solution emerging from the initiative process, particularly if there are several competing proposals on the ballot--as there are likely to be in 1992. He said a solution to the health access problems of about 6 million uninsured Californians and to spiraling health care and insurance costs requires “the deliberative process the Legislature was designed to provide.”

The survey of 1,000 randomly chosen heads of households was conducted by telephone in March. It also studied lifestyle habits related to health and found a continuing downward trend among Californians in cigarette and alcohol consumption, with only 18% admitting to smoking, compared to 25% in 1988. Young women emerged as the healthiest segment of the population, as measured by diet and exercise patterns and by their rates of smoking, drinking and drug abuse.

Asked what they thought was the greatest threat to their health, 1 in 5 of the respondents ranked air pollution as No. 1, ahead of AIDS, cancer and heart disease. In a 1991 national Gallup poll, only 1 in 20 chose air pollution, with the greatest number (26%) citing AIDS. Only 13% of Californians considered AIDS their greatest health threat.

In fact, the 1991 survey recorded a dramatic plunge in public concern about AIDS in California despite a leap in the percentage of people who said they had been tested for infection. In 1989, 18% reported being tested; this year 31% did.

Further evidence of the decline of AIDS as a public priority is the number of Californians who listed AIDS as the most important issue facing the health care system. Two years ago, 10% said it was the most important. This year, only 5% did.

“I think the shock value has worn off,” said pollster George Gallup at a news conference Tuesday to explain the significance of the statistics. He said it does not mean AIDS is less important as a public health concern, only that people are tired of thinking about it.

Gallup said trends and subtle opinion shifts identified by such surveys are useful to guide policy-makers and serve as an “early warning system” on issues likely to emerge with urgency in the future. Californians, he said, will increasingly demand action from their leaders on improving air quality.

The clearest trend revealed by the five Gallup California Health Care Polls since 1986 is growing public concern about health care costs and the plight of the uninsured.

The message comes through with greater urgency in the 1991 poll, according to Robert Nielson, senior vice president of the Gallup Organization. With the concern comes growing willingness to pay higher taxes to improve medical services for the poor. In 1991, 68% said they would accept tax increases for this purpose compared to 59% in the previous two years.

However, the average amount Californians are willing to pay in such taxes each month declined from $43 last year to $30 this year, a development Nielson attributed to the recession. The 1991 poll results are consistent with previous years on the taxes Californians would support. The greatest opposition (61%) is to increased personal income taxes. The greatest support is for higher taxes on tobacco products (80%), alcohol (79%), firearms (77%) and traffic violations (60%). A bare majority (51%) favored increased business taxes, while only 40% said they were willing to pay higher sales taxes.

Those surveyed also were asked to rate Gov. Pete Wilson’s performance on health issues, but the results were equivocal, with 6 out of 10 people saying that they had no opinion. The pollsters attributed the results to Wilson’s short tenure in office. “He is still in a honeymoon period,” Nielson said. In last year’s survey, 36% said they disapproved of Gov. George Deukmejian’s performance, while 29% said they approved.

The poll also included two questions related to the controversial right-to-die issue. Asked if terminally ill adults ought to be allowed to end their lives, three-quarters of those surveyed said yes. An even greater number--85%--said family members ought to be able to refuse life support for seriously and hopelessly ill patients who are unable to decide for themselves.

Health Care Findings

The California Health Care Poll is conducted annually by the Gallup Organization to survey opinion on health issues and monitor health-related lifestyles. The 1991 poll posed questions by telephone to 1,000 randomly selected Californians. Among the questions:

Do you approve or disapprove of the California Legislature’s overall performance on health care issues?

Response 1990* 1991 Disapprove 50% 48% Approve 23% 18% Don’t know 28% 34%

Do you agree . . . that every Californian is entitled to have access to health care services?

Strongly agree: 58%

Agree: 34%

Disagree: 5%

Strongly disagree: 1%

Don’t know: 2%

Do you drink alcoholic beverages?

1986: 62%

1987: NA1988: 61%

1989: 57%