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Health & Science

A Five-State Poll About Healthcare Reveals Worries About Cost, Coverage, and Choice of Doctors

The Texas Medical Center conducted a large survey comparing opinions about healthcare issues in five populous states: California, Florida, New York, Ohio and Texas. Some of the results may surprise conservative politicians.


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Dr. Tim Garson of the Texas Medical Center's Health Policy Institute presented results from the five-state survey during the plenary session of Medical World Americas in Houston.
Dr. Tim Garson of the Texas Medical Center’s Health Policy Institute presented results from the five-state survey during the plenary session of Medical World Americas in Houston.

The new Health Policy Institute at the Texas Medical Center in Houston conducted the poll, posing questions to 1,000 people in each of five states: Texas, California, Florida, New York and Ohio.

The cost of healthcare was a common complaint. A majority of people in all five states said they were paying more out-of-pocket for healthcare than they were two years ago. Texas had the most people saying that, at 65 percent.

"Clearly, we as a country, we as a state – couldn't we find ways to decrease the overall cost of healthcare?" asked Dr. Tim Garson, the director of the Health Policy Institute.

When it comes to healthcare, voters said “coverage” was the most important thing to them, followed by the choice of doctors. In general, Democrats favored coverage slighty more, while Republicans tended to rate choice of doctors as more important.

The survey did not ask the 5,000 respondents if they liked the idea of a government-funded “single payer” system, similar to the ones in Canada and many European countries. But many respondents did say universal coverage was important, not just coverage for themselves and their family.

“One of my biggest surprises is that 85 percent of everybody asked was looking for ‘coverage for all,'” Garson said. “They are worried about their sisters and brothers. And I think that, at some point, is going to show up in the voting rolls.”

The Affordable Care Act has helped 20 million additional Americans get insurance, but Garson says the law didn't do much to control the actual prices being charged in the healthcare industry. Consumers feel the financial pressure in their deductibles, co-pays and monthly premiums.

"Of the uninsured, 87 percent said when they went to the exchange they couldn't afford it,” Garson said, referring to the online marketplaces where people can buy individual or family insurance plans if their employers don’t provide coverage.

“That, therefore, is the unaffordable Affordable Care Act,” Garson added.

The survey did not ask whether those respondents were talking about the market rates for insurance plans, or the monthly premium they would personally pay, perhaps after receiving a generous government subsidy. Either way, the perception among many uninsured is that insurance plans are still too expensive, Garson said.

The survey compared attitudes about Medicaid, the taxpayer-funded insurance plan for low-income people.

In California, New York and Ohio, politicians took advantage of funding in the Affordable Care Act, and expanded Medicaid to cover more poor adults who previously didn’t qualify. Most residents in those three states said they approved of that decision.

But the Republican leaders of Texas and Florida refused to expand Medicaid. The survey showed two-thirds of people in those two states wanted them to do it anyway.

"Both Texas and Florida, the residents there are hurting and are turning to the idea of Medicaid expansion,” Garson said.

Garson said politicians can’t always assume they know what voters want, and this sort of survey can help shed light on their attitudes.

Garson gave another example of the poll contradicting expectations. A majority of people surveyed said that sugary drinks and junk food should be subject to hefty additional taxes, to combat obesity. That held true even in the two conservative states of Texas and Florida.

Obamacare and health costs will be part of the campaign rhetoric, said Ross Baker, a political scientist at Rutgers University in New Jersey. Baker is not connected to the survey but examined it at the request of Houston Public Media.

Although candidates will talk about healthcare, Baker is not convinced it’s the kind of pivotal issue that will motivate voters to choose one presidential candidate over another.

"Generally, people are mindful of the healthcare issues because they are very practical, day-to-day concerns, but whether or not they would get out of bed on Tuesday morning in November, and go to the polls based on their feelings about whether or not Medicaid should be expanded in their state is, I think, subject to challenge."

Rather, the expected contest between Clinton and Trump will probably be decided on their personality differences, rather than any one specific issue like healthcare, Ross said.