Today is 4th November 2019, exactly one year to the day that Americans can express their political will and cast their vote for President of the United States. Health care will be a key issue driving people to their local polling places, so it’s an opportune moment to take the temperature on U.S. voters’ perspectives on healthcare reform. This post looks at three current polls to gauge how Americans are feeling about health care reform 365 days before the 2020 election, and one day before tomorrow’s 2019 municipal and state elections.

Today’s Financial Times features a poll that found two-thirds of U.S. adults say they’re not better off under President Trump’s presidency. Here’s The Hill‘s coverage on the survey, which was conducted with the Peter G. Peterson Foundation.

“When asked what was the biggest threat to the US economy, 27 per cent of poll respondents pointed to trade disputes with major trading partners such as China and Mexico. Another 26 per cent cited rising healthcare costs, while just 7 per cent pointed to the Fed’s interest rate policies. Last week, the Fed cut interest rates by 25 basis points for the third time this year,” the FT-Peterson Center analysis observed.

Where people are dissatisfied with their financial status, the key factors related to flat wages, lack of savings, and debt. “Persistently slow wage growth appeared to be a main driver of discontent, with 36 per cent of those who said they were worse off blaming their income levels,” where last week’s Bureau of Labor Statistics reported that hourly wages rose 3% in October, lower than levels seen before the Great Recession. Household debt was also a factor of household economic dissatisfaction for 1 in 5 Americans.

There’s a sharp division between Americans based on their party affiliation: 45% of people say they’re doing better in the U.S. economy, and 45% say they’ve been hurt, the FT-Peterson poll discovered. That boils down to 10% of Democrats saying they’ve been helped, versus 84% of Republicans.

The second poll we’ll consider is the survey from The Harvard Chan School of Public Health published in October 2019 (conducted in July-August 2019) teamed with the Commonwealth Fund and the New York Times.

Americans are roughly split — and/or equally confused — about the differences between three major health reform approaches: Medicare -for-All, improving the existing Affordable Care Act, or replacing the ACA with state-run health plans.

The split across U.S. voters was 32%, 28% and 29% respectively.

Notwithstanding that fragmented finding across the three health reform policy prescriptions, see the second chart which illustrates that nearly 8 in 10 Americans believe that “All Americans should have a right to health care regardless of their ability to pay.” Majorities of people agree with this statement — even the lowest percentage of 60% of people who would favor replacing the ACA with state-run health plans.

There is a large chasm between that group and the other two policy preferences when it comes to the “responsibility of the government to make sure all Americans have health insurance coverage,” with only 20% of those favoring replacing the ACA with state plans believing in this. For this group, it’s more local control and influence that’s valued versus a national assurance of health care.

More people in this group (55%) also believe that the U.S. has “the best health care system in the world,” compared with 21% of people who favor Medicare-for-All and 29% who want to improve the ACA. Overall, 36% of Americans say the U.S. has the best health care system in the world.

To that point, 64% of Americans rate the U.S. health care system “fair” or “poor,” again ranging from 75% of people who are for Medicare-for-All, 67% who want to fix the ACA, and 49% of those favoring replacing the ACA with state health plans.

Our third poll to add into this health care politics mix is the CBS News poll conducted in October 2019, Here, 8 in 10 Americans believed the U.S. health care system needs either fundamental changes (46%) or should be “completely rebuilt (30%).

This same poll found that a plurality of U.S. adults believes lowering health care costs is more important than ensuring universal access to health care — another indication that medical bills continue to be a front-of-brain kitchen table issue for mainstream Americans for whom healthcare is a very personal family priority.

And many – more than four in ten – find affording basic medical care a hardship. Lower-income Americans are particularly likely to feel this way:  More than half of those earning less than $50,000 a year describe the affordability of basic medical care for their family as a hardship.

When asked about some specific ways the cost of their medical care may have affected them, 43% of Americans say they or someone in their household has had problems paying medical bills in the last few years, and 38% have gone without medical treatment they thought was needed. Another 31% have not filled a prescription or have cut pills in half because of costs.

Health Populi’s Hot Points:  The Harvard Chan-Commonwealth Fund-NY Times survey asked an important question about trust in health care stakeholders: the most trusted groups in whom Americans held “a great deal” of trust were nurses (58%), followed by doctors (30%), and in third place hospitals, among 18% of people.

Nurses held majority trust across all three political positions for health care reform.

The lowest trust-points were found among State governments, the Federal government, Congress, business leaders, health plans, and pharma companies, all in the single digits across all Americans and all health reform preferences. 

Now look at the last chart, taken from the Financial Times-Peterson poll. This illustrates that fewer women (represented by the orange bars) feel better-off economically under President Trump than do men.

I’ll be participating in a panel this Wednesday at the Microsoft Envision Forum Healthcare meeting where we’ll be discussing what McKinsey found in their annual 2019 Women in the Workplace study. The topline of the study is that, while women have made some strides in advancing in the workplace in terms of pay and management tiers, there remain major obstacles to gender parity in the workplace. Here’s the Wall Street Journal‘s take on the lack of women in health care “at the top” of their organizations.

My own lens on the McKinsey data is that business will continue to provide health benefits for the near-to-medium term, taking on more wellness and health responsibilities with which the public sector had been more involved just a few years ago. Note the Business Roundtable’s latest statement supporting stakeholders’ interests beyond shareholders…this includes community health and sustainability.

In the context of U.S. health politics, women will play a key role as health care voters in both tomorrow polls and in the 2020 Presidential election. Health care access has eroded for many women in the past few years based on several metrics, including but not limited to preventive care, health care costs, and contraceptive care, along with continued challenges with the Pink Tax which I covered in the Huffington Post.

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