Daniel Weintraub: Californians support major change in health care

Although nearly nine out of 10 Californians who have health insurance say they are satisfied with their coverage, a large majority of voters would make major changes in the way health care is delivered in the state, according to a new independent poll to be released today.

Nearly three in four adults say they would support a proposal to require everyone to have health insurance, while sharing the cost among employers, health care providers and individuals.

Two out of three, meanwhile, would favor a system of national health insurance, even if it would require higher taxes, the poll found.

The survey by the Public Policy Institute of California questioned 2,003 state residents from June 12 through June 19. The results for the full sample have a margin of error of plus or minus two percentage points.

About 81 percent of Californians have insurance, and of them, 49 percent report that they are "very satisfied" with their coverage. Another 38 percent say they are "somewhat satisfied" with their insurance. And only 36 percent say they are worried about losing their coverage. Yet many remain concerned about the stability of the system, and about their ability to pay their health care bills in the future.

With most people facing higher and higher health insurance premiums, and with the daily news full of stories about insurance companies rejecting people seeking coverage who have pre-existing health conditions, the issue has become a question of security. Even people who are fairly comfortable with their own situation fear they will not have health insurance or be able to afford health care when they need it.

"For the average Californian, the issue of concern is the uncertainty about the cost and the future of health care," said Mark Baldassare, president of the Public Policy Institute and director of the poll. "That is what is leading them to say they want reform."

Seventy-five percent of adults think the number of people without insurance is a "big problem." And that concern crosses party lines. Eighty five percent of Democrats, 78 percent of independents and 63 percent of Republicans see the lack of universal health insurance as a big problem.

Seventy-one percent of California adults, moreover, are somewhat or very concerned about being able to afford health care when a family member gets sick.

Given those numbers, it's not surprising that 72 percent also think the system needs "major changes." Eighty-one percent of Democrats, 70 percent of independents and 59 percent of Republicans feel that way.

About two-thirds, 66 percent, say they would favor a national health insurance system, even if it meant paying higher taxes. Thirty percent said they would oppose such a system. Democrats (78 percent) and independents (64 percent) were strongly supportive. But only 35 percent of Republicans say they want the federal government to take responsibility for their health care.

Support was more widespread for the outlines of a plan proposed by Gov. Arnold Schwarzenegger, even without voters being told that the popular governor was behind it. Schwarzenegger's plan would require all Californians to have insurance, and it would require employers to provide coverage for their workers or else pay a tax to the state. Doctors and hospitals would also be taxed to help expand coverage for the poor.

Seventy-two percent of adults, including 81 percent of Democrats, 69 percent of independents and 52 percent of Republicans, said they would support such a plan.

"In concept, they support it because they don't see it as taking away from what they have as much as adding some security and certainty for the future," Baldassare said. "The concept of covering everyone is popular with Californians. The idea of spreading the costs is also popular."

But so far, Schwarzenegger has not been able to translate that overwhelming public support into any movement in the Legislature.

Democratic lawmakers have criticized his plan as too friendly to the insurance industry, and they don't like the idea of requiring individuals to take responsibility for obtaining coverage, even with hefty subsidies for the poor and the working poor. They have proposed an alternative that would put more of the financial responsibility on employers.

Republican legislators don't like the idea of taxing employers, doctors or hospitals, or requiring anyone to buy health insurance or provide it for someone else. Instead, they have offered a collection of ideas designed to give consumers more control over their health care. And while Democrats say the governor's proposal does not go far enough in regulating insurance company practices, Republicans say they think it goes too far.

Although detailed negotiations are only now getting under way, the three-way stalemate among Democratic and Republican lawmakers and the governor threatens to block any action this year.

But today's poll results suggest that the issue is not going to go away. If legislators and the governor cannot agree on a plan this year, it seems certain that one or more interest groups will try to put something on the ballot in 2008. And with voters inclined to support universal coverage, a proposal to overhaul the health care industry would start with a significant amount of political good will.

About the writer:

• The Bee's Daniel Weintraub can be reached at (916) 321-1914 or at dweintraub@sacbee.com. Readers can see his blog about health care at www.sacbee.com/healthcare.