Public Divided on Remedies for Curing an Ailing System

With Congress and the Bush Administration sharply divided over what to do about the nation’s health care system, most observers had given up on significant reforms in this election year.

But there are indications that Congress is willing to try again. And a large new nationwide poll indicates there is ample political justification for doing so.

The survey of 2,000 Americans, conducted last month by Louis Harris & Associates, has found unprecedented public dissatisfaction with the status quo--an unhappiness that has doubled in just five years, to 26% of the population.

At the same time, the poll offered an explanation for the lack of support for any specific government action: The public is utterly confused about the many proposed remedies.

Those include a single-payer, Canadian-style system advocated by Sen. Bob Kerrey (D-Neb.); a requirement that all employers offer insurance or pay a special tax, advocated by many leading congressional Democrats, and a system of tax credits for the individual purchase of insurance, backed by President Bush. But 68% in the Harris poll said they “see no real difference” between Republicans and Democrats.

“The American public is just as divided as Congress as to what we should do,” said Sen. John H. Chafee (R-R.I.).

“It’d be nice if everybody could agree--so the public can get behind one,” said Sen. John D. (Jay) Rockefeller IV (D-W.Va.). “Everybody’s incredibly frustrated about this.”

The poll was commissioned by the Kaiser Family Foundation in Menlo Park, Calif., and the Commonwealth Fund in New York City. It found that:

* 33% favor the employer mandate plan, 30% favor a single-payer approach and 27% favor tax credits. Only 2% are willing to “leave things the way they are.”

* 62% want the federal government to “take the lead” while 30% look to the states. “The public is absolutely ready to settle this one,” said Drew Altman, Kaiser Family Foundation president.

* 25% list health care as the most important issue in the November presidential election--second only after the economy, which was cited by 50%.

* By a margin of 75% to 22%, respondents favor the federal government setting the rates for health insurance premiums. They also favor government rate-setting for doctors and hospital fees and for prescription drugs.

Senate Majority Leader George J. Mitchell (D-Me.) and Rep. Dan Rostenkowski (D-Ill.), chairman of the House Ways and Means Committee, are moving to again test whether some consensus can be forged this session.

Chafee, a leading GOP activist on health care issues, believes progress can be made this year if Democrats and the Bush Administration search for points of agreement rather than wage an all-out battle.

A nudge toward some action soon will come from the influential League of Women Voters, whose president, Susan S. Lederman, said that the group’s chapters throughout the country last weekend reached a consensus to begin a grass-roots lobbying effort. “The league is intensely interested in health care reform,” she said.

Added Thomas W. Moloney, senior vice president of the Commonwealth Fund, “This is no longer a deferable issue.”

Ill Feelings

A survey of 2,000 Americans has found unprecedented public dissatisfaction with the status quo of health care--an unhappiness that has doubled in just five years. 1987*: 13% 1990*: 18% 1992**: 26% * 1987, 1990 Harris Surveys

** 1992 Kaleer / Commonwealth Health Insurance Survey