Poll Finds Confusion on Health Care Reform : Medicine: Most Californians surveyed agree changes are necessary, but they are not sure which plan is best.

Despite overwhelming agreement that the health care system needs to be reformed, Californians are unsure which proposals for change they prefer, a new survey reveals.

The sixth annual Gallup California Health Care Poll showed a high level of discontent about health care, with 82% of those polled saying the system is in a state of crisis in California. Even more respondents--87%--said the system needs to be reformed and 92% agreed that everyone is entitled to health care services.

Three-quarters of those polled said they are worried about whether they and their families will be able to afford the health care they might need. One-third said fears over losing their health insurance prevented them from looking for or taking another job.

But the survey of 1,000 Californians showed deep division and a lack of understanding about which reform proposals should be enacted. More than three-quarters of the respondents said they like the idea of a national health insurance plan, but 80% also like a plan forcing employers to provide insurance. The votes were mixed when people were asked to choose one of various proposals. Almost half of the respondents favored a Canadian-style single payer system, while 23% favored mandatory employee insurance and 25% preferred only minor adjustments to the current system.

“There is a great deal of confusion about what form (restructuring of the system) should take,” said George Gallup, co-chairman of the Gallup Organization. “The public has received mixed signals about what would be best for them.”

The poll revealed that residents are willing to make some sacrifices for health care reform. For example, the majority--65%--said they support increased taxes for health care reform.

“The surprise for me is that in the midst of a severe recession, there is a willingness on the part of the public to pay more taxes to support health care reform,” said Steve Gamble, president of the Hospital Council of Southern California, which joined several state hospital organizations in designing the survey.

But when it came to whether people would support a reform package that would limit their choice of physicians, 57% disapproved while 39% approved.

Limits to the choice of physicians is a major plank in many health care reform proposals.

“(People) are well aware of the problems in the health care system and that the costs of health care are extreme. But they don’t understand all the options (for reform),” Gamble said. “There has not been enough public debate and exposure of the options.”

But he said: “I think we will move through the process of debate and that we will produce a consensus on reform.”

In other findings:

* Residents favor taxes on alcohol, tobacco and firearms to cover health care costs for the indigent. There was far less support for increases in sales or income tax and no consensus on increasing business income taxes to finance health care reform.

* Among the presidential candidates, 44% favored Arkansas Gov. Bill Clinton’s health care plan compared to 23% who favored President Bush’s proposals.

* Californians strongly support hospital mergers and the sharing of expensive services and equipment, by a 71% to 20% margin.

* The number of Californians saying they are “very concerned” about contracting the AIDS virus rose to 22% from 16% last year.

* For the first time in the history of the poll, more Californians said they do not drink alcohol, 51%, than those who said they do, 49%.

Health Care System Reform

Californians overwhelmingly back health care system reform. But a new Gallup Poll shows little consensus about which plan would be best.

Support for reform proposals:

% YES % NO *National insurance 77 21 *Employers required to insure employees 80 17 *Employers required to insure employees’ families 71 25

Percentage of those favoring specific plans:

Mandatory employee insurance: 23 Canadian-style single payer: 46 Minor adjustments to current system: 25