More common ground in health care reform law disagreement than meets the eye

Less than a quarter of Americans want no changes to the health care legislation signed into law by the president last month but there may be more common ground with other Americans than many think, according to the latest national survey by researchers from Indiana University's Center for Health Policy and Professionalism Research (CHPPR).

When survey respondents were asked how they viewed the new law:

• 21 percent said they were completely satisfied
  
• 28 percent said they wanted changes made in the law
  
• 39 percent said they wanted the law repealed and to start the health care reform process from scratch
  
• 13 percent said they did not want any government health care reform

Of the nearly four in 10 Americans who want the law repealed and new legislation enacted, many still favor the same reforms that are already contained in the new law.

"When we looked at the responses of those who said they wanted to repeal the law and start from scratch, with the exception of the requirement that all Americans purchase health insurance, most of the things that they wanted are already written into the law. It appears that the mandate requiring Americans to buy health insurance may be the one thing they stringently oppose, and that may be the main motive for the push to repeal the legislation," said Aaron Carroll, M.D., M.S., director of CHPPR.

Even more surprising may be what people had to say about creation of a public option - a government-run insurance plan that had been proposed, but dropped from the final version of the law. The survey found the public option to be very popular with 59 percent of those asked supporting this reform.

Another unexpected finding was how much the phrasing of the public option question clearly mattered. When the public option was framed as a government administered option that would "compete" with private health insurance, only 48 percent of Americans supported it. When framed instead as a "choice" between government-provided health insurance or private health insurance, the percentage of Americas who supported it increased to almost 75 percent.

"Obviously how you pitch the public option matters, but its support overall makes it ironic that this aspect of health care reform - one that is apparently popular - was left out in the end," said Dr. Carroll.

Of those who desired further reforms to the health-care system, 83 percent were supportive of adding provisions on medical malpractice reform, 85 percent endorsed the sale of insurance across state lines, and 73 percent wanted to see increased pharmaceutical regulation. However additional health-care reforms actually fell low on the list of priorities for the upcoming legislative session with reduction of the federal deficit and reforming financial system regulation being seen as the most important issues to be addressed.