Poll Finding

USA Today/Kaiser Family Foundation/Harvard School of Public Health Survey: The Public on Prescription Drugs and Pharmaceutical Companies: Toplines

Published: Feb 28, 2008

This document provides the detailed toplines from a USA Today/Kaiser/Harvard survey examining Americans’ views on, and experiences with, prescription drugs and the pharmaceutical industry, including drug costs, advertisements, safety issues, government regulation and medical research.

Toplines (.pdf)

Poll Finding

USA Today/Kaiser Family Foundation/Harvard School of Public Health Survey: The Public on Prescription Drugs and Pharmaceutical Companies: Summary and Charts

Published: Feb 28, 2008

This document provides key findings from a USA Today/Kaiser/Harvard survey examining Americans’ views on, and experiences with, prescription drugs and the pharmaceutical industry, including drug costs, advertisements, safety issues, government regulation and medical research.

Summary and Charts (.pdf)

Poll Finding

USA Today/Kaiser Family Foundation/Harvard School of Public Health Survey: The Public on Prescription Drugs and Pharmaceutical Companies

Published: Feb 28, 2008

This poll, the third in a series conducted jointly by USA Today and public opinion researchers at the Kaiser Family Foundation and the Harvard School of Public Health, by USA Today, the Kaiser Family Foundation and the Harvard School of Public Health finds Americans greatly value prescription drugs’ potential benefits for their families, but most believe they cost too much money and many struggle to pay for needed medicines.

The survey also provides a comprehensive look at Americans’ views on, and experiences with, prescription drugs and the pharmaceutical industry, including drug costs, advertisements, safety issues, government regulation and medical research.

The nationally representative telephone survey was conducted between January 3 and January 23 among 1,695 adults ages 18 and older, and has a margin of sampling error of plus or minus 3 percentage points. USA Today ran a series of news stories drawing on the poll’s results.

Summary and Charts

Toplines

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March 4, 2008, USA Today articles

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April 3, 2008, USA Today article

Pulling it Together: Separating the Forest from the Trees in the Health Reform Debate

Published: Feb 19, 2008

The good news for those who care about health care is that the issue is rising again on the national agenda. If we have a big debate about health in the presidential campaign and if it is a factor at the polls in 2008, it will help create a mandate for the new president and Congress to make health care a priority in 2009.

But the real health care debate has been delayed by the focus in the primaries on the differences on health between candidates in each party, especially the differences between the plans put forward by the leading Democratic candidates. While the differences between the candidates’ plans can mean a lot to experts, they mean much less to voters. Senator Edwards described them as “in the weeds,” and our tracking polls  have consistently shown that differences between the candidates’ plans have not had an appreciable impact on voters in the primaries.  In general, the primaries so far have not been driven by differences on issues, but rather by the perceived differences in the leadership qualities of the candidates.  The health care debate that will come next in the general election is much more important because it’s about the truly profound gulf between Democrats and Republicans and the political right and left about the future directions our health care system should take. These are the differences that have paralyzed Washington on health reform for years and will continue to pose a formidable obstacle to compromise when a new President and Congress consider health reform legislation in 2009.

Health08.org contains a unique library of candidates’ statements on health reform, revealing not just the details of their plans, but what they emphasize most consistently about health reform and their vision for the future of the health care system.  A look at the key buzzwords and phrases used by candidates is an entertaining and quick way to reveal the key differences between the two sides.

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 Watch the key buzzwords and phrases used by the candidates.

In listening to candidates at a series of presidential candidate forums in our Barbara Jordan Conference Center and sifting through the hundreds of hours of speeches, debates, and documents by Presidential candidates about health policy we have compiled on the web, here are three critical differences between the parties that set the stage for the next health reform debate.

First, there is a basic difference on whether guaranteeing universal or nearly universal health insurance coverage should be the primary goal of health reform. Democrats consistently say it should be, though the leading candidates’ plans differ somewhat on how to get there and whose plan represents a better approach. Republicans do not have universal coverage as their overarching goal. They believe it requires too big a role for government to guarantee universal coverage and will cost too much to pay for it. Instead, they want to make coverage more available in the private marketplace and give people a tax break to help those who want it afford it. The top priority they emphasize is to create a more efficient, and in their view, more affordable private health insurance marketplace based on individual choice and competition. This, they believe will expand coverage, but guaranteeing coverage for all is not their main goal.  This difference reflects the greater priority their base gives to controlling costs over expanding coverage, as documented repeatedly in the tracking polls that Molly Brodie, who heads our polling group, and her team conduct at the Foundation.

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 Watch the candidates discuss the goals of reform.

A second big difference is in how Democrats and Republicans would organize the health insurance system. The leading Democratic candidates emphasize building on the current employment-based health insurance system and public programs. They call for greater regulation of insurers, for example requiring them to accept all applicants and limiting their administrative costs. The Republicans, by contrast, prefer a system in which more people purchase insurance themselves in the individual marketplace, with fewer requirements on insurers. While Democrats would spend more to get to universal coverage, and their plans are perceived as more expansive as a result, it is actually the Republicans who envision bigger changes because they want to see more people get their insurance in the individual marketplace rather than through the workplace where most Americans get it today.  No leading candidate on either side is proposing scrapping the current health care system, only Congressman Kucinich proposed that, but while the Democrats have the bigger plans, it is the Republicans who envision a more fundamental transformation of the health insurance system, a difference which has been lost in the discussion to date.

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 Watch the candidates discuss their differences on how to organize the health insurance system.

Third, there is also a fundamental difference in what the two sides see as the basic purpose of health insurance. Democrats favor comprehensive insurance with front-end protection, which in their view encourages more preventive care and protects people better from financial costs of an illness. Republicans generally promote plans with high deductibles on the front end and catastrophic protection on the back end, coupled with tax-preferred savings accounts people would use to pay for routine care. They believe this will encourage people to become more prudent consumers of health care and use less health care overall.  Whether high deductible health plans with savings accounts are a forward-looking reform that will introduce market incentives and lower costs as advocates claim, or represent skimpier insurance surrounded by market rhetoric as critics believe, is an important question to debate and study as these new forms of insurance enter the marketplace. My purpose here is to characterize differences, not to referee these debates. There is no question, however, that the difference between the parties on the very nature and purpose of health insurance is a fundamental one that needs to be elucidated for voters.

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 Watch the candidates discuss their view on the nature and purpose of health insurance.

When we get beyond the primaries, the two candidates will lay out their multipart health reform plans, the media will pick apart the details of the plans, and the ads and the charges and counter charges will fly. All of the rhetoric, from “shared responsibility” on the one side to “personal responsibility” on the other side, will sound appealing to many, and the public again will be confused. Of course the candidates should be accountable for the substance of the plans they propose, but details will matter much more when there is a legislative debate in 2009. Moreover, with presidents having learned the hard way about the limits of a “my way or the highway” approach to health reform in 1993, the debate this time may be driven as much by ideas hatched in the Congress as by the President and the Executive Branch.

If we are to have a meaningful debate about health in the campaign, the bigger challenge will be to look beyond the details of plans proposed in a political campaign and debate the basic, very fundamental differences in priorities and direction for our health system being offered by the two sides, which are evident from the video clips from the campaign trail. This is especially a challenge for the news media, which often sees its role as exposing the juiciest details of the candidates’ plans rather than explaining more fundamental choices.  By focusing on the forest as well as the trees, we could have a health care debate that will engage the American people rather than confuse them, and set the stage for the even more difficult task of bridging health care’s ideological divide in the Congress in 2009.

Understanding the New UNAIDS Estimates

Published: Feb 1, 2008

This fact sheet presents an overview of the updated estimates on the global HIV/AIDS epidemic, released by UNAIDS in November 2007. The fact sheet describes how the new estimates compare to prior estimates, what they mean for understanding the future course of the epidemic, and what the major factors were that drove the revisions.

Fact Sheet (.pdf)

Poll Finding

NPR/Kaiser/Harvard Survey: The Public on Requiring Individuals to Have Health Insurance – Summary and Chartpack

Published: Feb 1, 2008

This summary and chartpack provides an overview of the results from a February 2008 survey conducted jointly by NPR and public opinion researchers at the Kaiser Family Foundation and the Harvard School of Public Health that examines how the public views different approaches for expanding health coverage, including provisions that would require individuals to purchase insurance or parents to obtain coverage for their children.

A nationally representative sample of 1,704 adults participated in telephone interviews from Feb. 14-24, 2008. The margin of error is plus or minus 3 percentage points.

This survey is part of a series of projects about health-related issues by NPR, the Henry J. Kaiser Family Foundation, and the Harvard School of Public Health. Representatives of the three organizations worked together to develop the survey questionnaire and to analyze the results, with NPR maintaining editorial control over its broadcasts on the surveys.

Summary and Chartpack (.pdf)

Medicare and the President’s Fiscal Year 2009 Budget Proposal

Published: Feb 1, 2008

Medicare and the President’s Fiscal Year 2009 Budget Proposal

This fact sheet summarizes key Medicare-related provisions in the Bush Administration’s fiscal year 2009 budget proposal, as well as additional legislation that responds to the Medicare Trustees’ “Medicare Funding Warning.”

Fact Sheet (.pdf)

Report Examines the Potential Impact of New Federal Initiative To Review Payment and Eligibility Errors in Medicaid

Published: Feb 1, 2008

Report Examines the Potential Impact of New Federal Initiative To Review Payment and Eligibility Errors in Medicaid

The federal government has launched a new initiative, Payment Error Rate Measurement (PERM), to estimate the number of errors states make in determining eligibility for Medicaid and the State Children’s Health Insurance Program (SCHIP). This paper reports on interviews of state officials conducted during the summer of 2007. The primary findings include:

  • State officials generally find measuring errors to ensure program integrity a worthwhile goal.
  • Most of the state officials responsible for executing PERM reviews remain unclear about what PERM requires — and about key elements of the PERM process.
  • Most states expect PERM to significantly increase their focus on maintaining documentation, which could undermine longstanding efforts to facilitate the enrollment of eligible people.
  • Implementing the new Medicaid citizenship documentation requirement could lead to high PERM errors in some states.

Report (.pdf)

President’s FY 2009 Budget and Medicaid

Published: Feb 1, 2008

President’s FY 2009 Budget and Medicaid

The President released his Fiscal Year 2009 budget plan in January 2008. The President would reduce federal Medicaid spending by over $17 billion over the next five years by reducing the federal match rate for certain services, making changes to managed care, long-term care, reimbursement for prescription drugs and making other administrative changes. This fact sheet summarizes the proposals and potential implications.

Fact Sheet (.pdf)

Poll Finding

NPR/Kaiser/Harvard Survey: The Public on Requiring Individuals to Have Health Insurance

Published: Feb 1, 2008

This survey conducted jointly by NPR and public opinion researchers at the Kaiser Family Foundation and the Harvard School of Public Health examines how the public views different approaches for expanding health coverage, including provisions that would require individuals to purchase insurance or parents to obtain coverage for their children. The survey looks at whether or not the public supports such provisions, the major reasons behind their views, and how opinions differ among Democrats, Republicans and independents.

A nationally representative sample of 1,704 adults participated in telephone interviews from Feb. 14-24, 2008. The margin of error is plus or minus 3 percentage points for the full sample.

This survey is part of a series of projects about health-related issues by NPR, the Henry J. Kaiser Family Foundation, and the Harvard School of Public Health. Representatives of the three organizations worked together to develop the survey questionnaire and to analyze the results, with NPR maintaining editorial control over its broadcasts on the surveys.

Summary and Chartpack

Toplines

NPR Coverage