Health Care Reform: Tough Choices

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healthcare surveyPolicy makers are expected to spend the next two years cementing their positions on how to fix the out-of-control costs, mediocre quality, and high uninsured rates plaguing the U.S. health care system.

But it doesn't look like the public is going to be much help.

A national survey released Tuesday showed that eight in 10 American adults believe that the health system has problems and needs improvement. But while that may sound like a consensus for big changes, respondents confirmed what researchers noticed long ago: few are willing to sacrifice to get them.

"Americans seem to be hoping for a substantially better deal," says Daniel Gaylin, a researcher who conducted the survey at the University of Chicago

But a better deal, in the form of lower costs and more access, would probably require either a lot more government spending or some rationing of services so that more of the 47 million Americans who lack coverage can get it.

'Self-Sacrifice' Lacking

Nearly 90% of Americans told researchers that employers should be encouraged to offer coverage to more workers. But at the same time, more than 60% said the government should be the one to make sure that all Americans have coverage. Still, most said they want to retain the right to choose their own coverage.

"There is little evidence of self-sacrifice," the report states.

Massachusetts made headlines earlier this year by launching a universal insurance program. It requires individuals to purchase basic coverage and provides government help for low-income people to buy insurance.

But just half of the nearly 1,400 adults surveyed said the government should require all Americans to have some form of coverage. A majority said they were against a policy pushed by President Bush promoting cheaper coverage for high health costs but forcing consumers to pay more money for routine care.

The Role of Politics

Health care is expected to surface as a major issue in the 2008 presidential elections. And major moves to fix the ailing U.S. health care system are not expected until after voters go to the polls.

While most Americans say they want a guarantee of "basic" coverage, there is little agreement of what qualifies as basic vs. a luxury.

"It's an elusive goal full of hard choices," Marjorie Ginsburg, executive director of the California consulting firm Sacramento Healthcare Decisions, said at a forum in Washington, D.C.

The health insurance industry's main lobbying group proposed on Monday to cover all Americans by expanding government programs for low-income people and giving tax breaks to employers for offering more coverage.

"It was good to see it. It's public-private. It's getting a little more momentum," Sen. Max Baucus, a Montana Democrat expected to gain the chair the Finance Committee, tells WebMD.

Congress must renew the State Children's Health Insurance Program (SCHIP) next year. Democrats taking over Congress want to use the renewal to expand medical coverage to more than 8 million children who now lack it.

"That would certainly be the desire. I think you're going to see a swing back to health care," says Sen. Jay Rockefeller, D-W. Va., incoming chairman of the subcommittee controlling children's health insurance.

Meanwhile, Mark Smith, president of the California Healthcare Foundation, warns that Americans may be in for a wake-up call when Washington finally starts making tough choices about health care.

"A man in the desert wants ice water. That don't mean he's going to get it," he says.

source - WebMD