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In Mass., Conflicting Emotions About Controlling Health Care Costs

Oct 21, 2011

This story is part of a reporting partnership that includes WBUR, NPR and Kaiser Health News.

Massachusetts, the state that set the direction for the national health care overhaul, now aims to crack the code on rising health care costs. Democratic Gov. Deval Patrick and legislative leaders have made controlling health care costs a top priority and are working on plans to tackle the problem. But what does the public think? A new poll has the first comprehensive look at public opinion on health care costs since the state passed the 2006 health coverage law. 

Pollster Robert Blendon, with Harvard's Kennedy School and the Harvard School of Public Health, spoke to WBUR's Martha Bebinger about the survey.  In this poll, Social Science Research Solutions surveyed 1,002 Massachusetts adults for the Harvard School of Public Health and the Blue Cross Blue Shield of Massachusetts Foundation from Sept. 6-19. The poll has a margin of error of +/- 3.73 percentage points.

Q: Respondents say the high cost of health care is either a crisis (25 percent) or a major problem (53 percent). Why does the public say health care costs are too high?

A: The main reasons were excessive charges by pharmaceutical firms, hospitals and insurers. There was less concern about the things experts always talk about: using too much high cost technology, going to expensive teaching hospitals or not shopping for care. The big takeaway here is that 74 percent of respondents want the state to take action.

 

Q: But 51 percent of respondents have little or no confidence in state government to lower health care costs even though they want the state to take action? What kind of opening does this create for state House leaders?

 

A: There is ambivalence about whether state or federal government can solve problems, but the public wants government leaders to try. So if state House leaders propose major legislation to address the cost problem, they’ll do it with a window of support from people who are frustrated and want the state to move ahead. The poll doesn’t say what should or should not be done, but it gives legitimacy to those in public life to come out with a major initiative and say, "We're doing it because people in the state want some action on this cost problem."

Q: The poll suggests steps the public is not ready to accept, such as limits on where patients can go for care or imposing higher charges for higher-cost hospitals.

A: There will need to be a significant public discussion about how to address costs, because, at the moment, people think they are just being charged too much, and the reasons don't make a lot of sense to them. So the proposals that come forth, if they don't focus on reducing charges, are really going to require a public education campaign. The experts say people need to use fewer services and less expensive services, but the public's diagnosis is, "I'm being charged too much."

The one place where respondents did acknowledge some responsibility was for people who are not living a healthy lifestyle (too much food, smoking and drinking).  It’s one of the first times we’ve seen this factor that highly ranked in polls (63 percent said poor health behaviors are a major reason for high health costs). 

Q:  Do Democrats and Republicans you polled have different views about how to control costs? How will these findings be important in Massachusetts?

A: The key finding is that the majority of Democrats, Republicans and independents all supported state action (to control health care costs).  The reason this is important is that nationally, we’ve reached a political gridlock, where leaders and members of either party just can’t agree on what to do about health care issues. So what’s really important for state action is that the majority people, whichever party they identify with, think something should be done about rising health care costs, and they think it’s legitimate for state government to act.  On the national scene, that’s not the case.

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