Politics affect views on healthcare quality—but not on personal experience with care

What do you think about the quality of healthcare in the United States? Your opinion may depend on your politics, with Democrats perceiving more problems in the healthcare system compared to Republicans, reports a study in the Journal for Healthcare Quality (JHQ).

But among people with a recent illness, there are no differences in personal experience with the healthcare system between political partisans, according to the new research by Kirstin W. Scott, MPhil, PhD, and colleagues of Harvard University. They write, "This may have implications for efforts to improve quality of care in the current polarized healthcare environment."

Political Differences Reflect Views on 'Government Regulation'

The researchers analyzed data from a 2012 survey of attitudes and personal experience with healthcare, based on responses from about 1,500 Americans. The survey assessed perceived experiences with healthcare costs and quality, emphasizing the viewpoints of those with recent hospitalization or other healthcare contacts due to illness or disability.

Participants were also asked about their political affiliation, if any. Perceptions of the healthcare system were compared for participants who identified with (or "leaned to") one of the two major political parties. The study also compared responses for those with ('sick') versus without ('healthy') a recent illness.

Democrats were more likely than Republicans to perceive that healthcare quality was a "somewhat or very serious problem." In the 'healthy' group, that included 57 percent of Democrats and 46 percent of Republicans. For the 'sick' group, the figures were 70 versus 57 percent, respectively. After adjustment for other factors, the partisan difference was significant only among 'healthy' respondents.

When participants were asked about the major reasons for problems in the healthcare system, the answers were nearly identical between political groups. The most common issues were being able to afford needed tests or drugs and the influence of health insurance on treatment decisions.

However, one issue differed by politics: attitudes toward government regulation. "Excessive government regulation" was cited as an important reason for problems with healthcare quality by two-thirds of 'healthy' Republicans versus one-fourth of 'healthy' Democrats. But in the 'sick' group, there was no significant difference—40 percent of both Republicans and Democrats cited regulation as an important factor.

Among 'sick' respondents, there was also no political difference in personal satisfaction with healthcare quality. For those with a recent hospital stay, more than 80 percent of both Democrats and Republicans were satisfied with their care.

Experts agree on the need to improve the quality of healthcare in the United States, but politics can get in the way of efforts to meet this goal—especially since the passage of the Affordable Care Act. The new study provides insights into the "nuanced" differences in opinions about healthcare between political partisans.

"Although their individual experiences with quality of care do not differ, Republicans and Democrats differ in their views on national quality-of-care issues," Dr. Scott and coauthors write. They note some limitations of their study—particularly the use of a one-time survey as well as need to rely on self-reported healthcare experiences as opposed to more objective quality outcomes.

Views on government regulation seem to be a major contributor to political differences of opinion about the healthcare system. "Perceptions of government regulation may help to explain the partisan differences researchers found between healthy Democrats and healthy Republicans, but not among those who were sick," the researchers add. "This may be due to the fact that questions using the term 'government' can elicit hyperpolarized responses relative to other measures, especially in light of strong partisan views on the recent health reform law."