Health Care Gaining as Issue, Poll Says

While education still tops voters’ lists of concerns in California, health care has emerged as the next most pressing issue--soaring above the economy, Social Security, taxes and crime, according to a new poll.

A Field Institute poll, commissioned by the California HealthCare Foundation, found that voters are intent on improving children’s access to care and preventive services, keeping Medicare financially afloat, providing seniors access to prescription drugs and ensuring that health plans are accessible and affordable to everyone.

Other concerns are easing access to specialists, protecting patients from medical errors and ensuring the confidentiality of medical information.

The booming economy appears to have eliminated or tempered other worries--crime and joblessness, for example--but has not improved Californians’ access to health insurance or care.

“In fact, this problem is getting worse,” said Mark Smith, president and chief executive of the California HealthCare Foundation. “The uninsured problem is getting worse during the best economy in 30 years.”

More than four in 10 Californians are “very concerned” that they or someone close to them will be without health insurance in the near future, according to the poll. Almost the same proportion of the state’s electorate has gone without insurance or is financially responsible for someone who has been uninsured in the last two years.

“I don’t worry about it for us,” said Elizabeth Evans, 39, a Whittier Republican, voicing a sentiment common among those surveyed. “But I know someone--my stepdaughter and her live-in boyfriend. . . . Without job skills there is no coverage.”

The poll found broad support for proposals aimed at expanding health coverage for the uninsured: allowing low-income people to participate in existing government insurance programs at reduced cost; expanding government funding for public clinics and hospitals; and providing health vouchers and subsidies to help low-income people buy private insurance.

Some insured respondents live in fear of losing employer-subsidized coverage. Jobs are the source of health benefits for two-thirds of California’s insured adults.

“If somebody loses his job and gets sick in this country, he cannot get any medications, he cannot get health care,” said Yacoub Shakhshir, 53, a real estate agent and registered Democrat. “I’m worried if I will lose my job or not.”

Shakhshir said he is concerned about more than himself. The father of two believes that California children don’t have adequate access to preventive care, such as vaccines, and that elderly Americans must pay far too much for prescription drugs, which are not covered by Medicare.

Nearly two in three voters, like Shakhshir, believe that it is “very important” for Medicare to include some coverage for prescription drugs, according to the poll. More than two in three voters want to tie Medicare benefits to recipients’ ability to pay. And 70% consider it a top priority to ensure children’s access to health care regardless of their families’ ability to pay.

Overall, 45% of the state’s voters identify health care as a top issue in this year’s presidential campaign, compared to 52% who cite education. The economy ranks third. Five years ago, health care ranked fourth in voters’ priorities, lagging behind education, crime and the economy.

There were definite differences between respondents depending on political affiliation. California Democrats ranked health care as the No. 2 issue; Republicans ranked it fourth.

This primary season, as in the past, health care has been a more burning issue for Democratic candidates, but Republicans are expected to enter the debate during the general election.

“Candidates will have to respond at some level,” said Robert Blendon, a health policy expert at the Harvard School of Public Health. “California is a political bellwether. If [health care] plays well there, it will also influence the congressional agenda.”

Still, Blendon and others said that in times of prosperity, issues such as health care and education may be less important to American voters than their perceptions of candidates’ character and moral attributes. The Field poll didn’t measure that.

“To the extent that issues are going to play a role, health will be one,” said Mollyann Brody, director of public opinion and medical research at the Kaiser Family Foundation, a California health care philanthropy. “But issues won’t be the only thing that will play out in this election.”

The Field poll was based on a telephone survey last month of 2,514 California adults, and has a sampling error of plus or minus 2 percentage points.