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ISSUE GUIDES: Health Care

PUBLIC VIEW: RED FLAGS

The Red Flags section offers guidance on areas of public opinion research where findings may be misleading, unstable, or easily misinterpreted. Public Agenda uses several indicators to judge when survey results should be reported and used cautiously.

Red Flag Statements

Universal CareLack of Realism on Health Costs?Managed Care: Perception vs. ExperienceMedical Malpractice Lawsuits: How Much is Too Much?

The public clearly favors expanding health care to cover more Americans, but support for a universal health care system varies depending on survey question wording -- an indication that the public is still working through their thinking on this issue. Even though health care is sure to be a focal point in the 2008 presidential elections, the public has yet to come to terms with the various approaches and tradeoffs involved in reform. For example, Americans say they are in favor of a host of proposals to expand coverage, particularly tax credits for employers. But when faced with the possibility of having to pay more in insurance premiums or taxes, responses can change depending on how the question is worded and what tradeoffs are cited. Relatively few say they expect their own health to improve under a universal system, and half say the quality of their care would remain the same. And while most say it is the federal government's responsibility to guarantee health insurance for all Americans, they are divided on whether it should be required by law.

  • About half of Americans say a universal health care system would have little effect on the quality and availability of their...
  • Americans are divided on whether health insurance should be required by law
  • Americans say a number of health care issues are "very" important, but when asked to choose the most important, Americans...
  • Americans say they favor a broad range of proposals for expanding health insurance coverage, especially tax incentives for...
  • Support for a health plan covering all Americans varies depending on question wording
  • Support for paying more in premiums or taxes to expand health care coverage varies depending on question wording
  • Two-thirds of Americans say the federal government should guarantee health insurance for all Americans

The public shows significant concerns about rising health care costs, but there's a perception gap between experts and the public about what might be driving these costs. When asked to name the most urgent health problems in the U.S., Americans say cost and access. Six in 10 say they worry "a great deal" about the availability and affordability of health care today. Most health care experts point out advances in medical treatments, drugs and technology and the fact that people are living longer as reasons for the rise in health care costs. But while the public agrees that the aging population is a major factor, surveys show pluralities blame excess profits by drug and insurance companies, malpractice suits and fraud.

  • Americans say a number of factors contribute to rising health care costs but say profits, malpractice and fraud are the...
  • Cost and access to health care are the most urgent problems in the eyes of the public and six in 10 say they worry "a great...

There is something of a paradox in the public's thinking about managed care. In general, Americans are divided on whether they have a favorable view of managed care and more than half say HMOs do a poor job of serving their consumers. Majorities also say managed care plans have made it harder to see specialists and have decreased the amount of time doctors spend with patients; however, many say they don't know. Six in 10 believe HMOs are mainly interested in making a profit and few say they trust what HMOs say in their advertisements. At the same time, most Americans say they have not personally had any problems with managed care. Also, most people give high marks for their health coverage and three-quarters of those with private health insurance say they belong to some kind of managed care plan.

  • Americans are divided on whether they have a favorable view of HMOs and other managed care plans, but many say they don't know
  • Majorities say HMOs have made it harder for sick people to see specialists and have decreased the amount of time doctors...
  • Most Americans say they have not personally experienced any problems with an HMO or managed care plan
  • Most people rate their health coverage as "excellent" or "good" and seven out of ten of those with private health insurance...

A majority of Americans think patients bring too many lawsuits against doctors and half say they're awarded too much money, but there is ambiguity in the public's thinking. Double-digit don't know responses are a clear indicator that public attitudes are unsettled. Also, half of Americans say patients should be awarded money for pain and suffering and six in 10 believe the number of lawsuits filed against a doctor tells them a lot about his or her quality. Yet, a majority of Americans say patients should not be awarded money as a way to punish doctors for neglect or carelessness. And support for limiting personal injury awards varies depending on how questions are worded - a classic warning sign that people's attitudes on this issue should be reported with caution. When asked specifically about options for regulating malpractice lawsuits, Americans are divided on whether lawsuits should be more difficult to file or if the awards should be capped and if so, what the limit should be.

  • Americans are divided on whether medical malpractice lawsuits should be more difficult to file or if the awards should be...
  • Half of Americans say they approve of juries awarding patients money for pain and suffering, but more than half say they...
  • Six in 10 Americans say a doctor's medical malpractice record tells them "a lot" about his or her quality
  • Six in 10 Americans say patients bring too many lawsuits against doctors and about half say juries award too much money...
  • Support for limiting personal injury awards for medical malpractice can vary depending on question wording

Public Agenda uses several indicators to judge when survey results should be reported and used cautiously:

  • Results change when survey questions are reworded slightly.
  • Results change when implications or trade-offs of a policy are pointed out.
  • Results may be misleading if reported in isolation or out of context.
  • Other research suggests that people have incomplete or inaccurate knowledge in this area.