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What to Do About Health Care
Political Junkie

By Richard Morin
Washington Post Polling Director
Monday, May 22, 2000

Most Americans believe that the rising number of people without health insurance is a serious national problem but the public remains stymied about what to do about it, according to a new national survey of public attitudes toward the medically uninsured.

But the poll also found that many Americans also hold outdated, incomplete or flatly wrong perceptions of the 44 million people, about one in six Americans who lack heath insurance.

A majority of adults — 57percent — incorrectly believes that more of the uninsured are unemployed or from families where people are unemployed, while, in fact, the majority of uninsured individuals come from working families, according to analysts for the Henry J. Kaiser Family Foundation, which sponsored the survey with The NewsHour with Jim Lehrer.

The national survey of 1,985 randomly selected adults, including an oversample of 921 uninsured adults, was conducted Jan. 10 through Feb. 9. Analysts included only uninsured adults younger than 65 in their analysis of the uninsured (Medicare covers older Americans). Margin of sampling error for the overall results was plus or minus 3 percent, and plus or minus 3.5 percent for results based only on uninsured adults.

The poll found that half of all Americans — 53 percent — say they know someone who is without health insurance, and an even larger majority believe the lack of coverage is a serious national problem.

Eight in 10 say health care should be provided equally to everyone. But when presented with four options for improving coverage, no consensus emerged. One in five supported proposals that would expand public programs such as Medicaid and the State Children's Health Insurance Program. But similar proportions favored each of three other alternatives: Requiring business to offer private health insurance to their employees, a government-sponsored health insurance program for all Americans, and providing tax deductions and credits to help people purchase private coverage on their own.

What's more, the survey revealed that Americans are unwilling to pay much to expand health care coverage. Slightly more than half — 53 percent — said they were willing to pay at least $30 per month more to cover the uninsured, and a politically formidable 46 percent were only willing to pay $5 a month or nothing to help the uninsured get coverage.

The unwillingness to pay more on the part of a large number of Americans and the lack of consensus on an approach to the problem suggest that incremental approaches are likely to continue to be favored in the future, says Drew Altman, president of the Kaiser Family Foundation.

The survey also highlighted the problems faced by uninsured Americans. They are less likely [than those with medical insurance] to have gotten such preventive services as mammograms (16 percent versus 40 percent) and Pap smears (49 percent versus 76 percent) among women, or prostate exams (12 percent versus 20 percent) among men, survey analysts wrote.

The uninsured also are less likely to have a regular source of care to turn to when they're sick or need medical advice, or to have routine physical exams. Why don't the uninsured have insurance? Nearly half — 47 percent — said they can't afford it. Another 15 percent said their job doesn't offer coverage, and an equal percentage said they were unemployed or between jobs.

In addition, many people without health coverage are embarrassed about their lack of insurance — 43 percent — said they are uncomfortable telling their families and friends they are uninsured.

Bad News for Bill

Well, so much for Clinton nostalgia. Ever since President Clinton entertained them at last month's White House Correspondents Dinner, a small army of reporters has been pounding out Clinton Nostalgia stories based on little more than inside-the-Beltway buzz.

Andrew Kohut, director of the Pew Research Center for the People & the Press, decided to test the perception that people were starting to feel more warm and fuzzy about their president. Clinton Nostalgia failed the test. Despite talk that the public is longing for an extended Clinton era, the president's favorability ratings have dropped significantly since last year, he found in his survey of 1,303 randomly selected adults.

Kohut said that 48 percent of those interviewed said they had a favorable impression of Clinton, compared with 55 percent in March of last year. These are among the lowest ratings the president has received since he took office in 1992.

The president has lost some ground among most demographic groups. Most notable, perhaps, is Clinton's loss among core Democrats. One year ago, 85 percent of Democrats said their overall opinion of Clinton was very favorable or mostly favorable. Today, that number is 73 percent.

Good News for Bill

Almost six in 10 Americans — 58 percent — say Clinton's actions in the Lewinsky scandal should not cost him his law license, according to a new ABC News survey. Arkansas authorities may act soon on a conservative legal group's petition to have Clinton disbarred.

Richard Morin is director of polling for The Washington Post. "What Americans Think" appears Mondays in The Washington Post National Weekly Edition. Morin can be reached at morinr@clark.net .

© Copyright 2000 The Washington Post Company

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