Gallup‘s latest poll of Americans’ top health concerns survey are firmly focused on access and cost. This has been true for each of the last seven years that Gallup has conducted this survey.

These data echo the findings of Kaiser Family Foundation‘s last health tracking poll for the 2008 election season from October 2008.
But there are are differences in the role that government should play in the system: while most Americans see that government’s role should expand in health care, 49% would still like to keep the current, private health insurance-based system. 49% of Americans prefer a “government-run system.”

The continuum of more-or-less government involvement in health care seems deeply rooted in party affiliation, with 8 in 10 Republicans supporting the market-based scenario and 6 in 10 Democrats supporting the government-run option.

Still, in the open-ended question of what is the most urgent health problem facing this country at the present time, Americans point to access and cost urgencies ahead of specific disease issues.
This citizen-sentiment is not new. For the last seven years, access and cost have ranked first and second in Americans’ minds, as the chart at left illustrates.

Among health conditions, Americans consider obesity and cancer the most pressing health challenges.

The Gallup poll was conducted between November 13-16, 2008, among 1,009 adults.

Health Populi’s Hot Points:
The KFF election tracking poll in October 2008 found that someone in nearly 1 in 2 American households was postponing health care consumption due to costs in the form of postponing needed care or skipping pills 18% of Americans said they had problems with medical bills of more than $1,000 in the past year. That proportion increased since April 2008.

In this recession, Americans are changing health behaviors to meet the challenges of balancing household finances in tough times. But Gallup’s polls over the past six years show us that access and cost have been top-of-mind health challenges for Americans for a long time.

What the poll misses is the fine print between a “government-run” health system and one based in the private sector. There is a continuum of options across this bipolar axis. What we need is, once and for all, a very public dialogue about whether Americans see health care as a right. Citizens in the rest of the developed world do. Even the American Health Insurance Plans association has come to endorse universal coverage in its own way. Once we agree on that, we can get to “yes” when it comes to providing universal health access.