STONY BROOK UNIVERSITY - HEALTH PULSE OF AMERICA - MARCH 2004

February 18 – March 8, 2004

HEALTH CARE AND THE 2004 PRESIDENTIAL ELECTION

Americans Increasingly Concerned About Health Care

Health care is emerging as a key issue in the 2004 presidential election. Sixty-two percent of Americans regard the candidates’ position on health care as important in deciding who they will vote for in November. And when asked about the single MOST important issue in deciding their vote later in the year, health care came in second and was of equal importance to terrorism and the war in Iraq. The economy and jobs was the top issue, mentioned by 32% of Americans. This was followed by 19% who said health care and Medicare, and the same percentage (19%) who mentioned terrorism and the war in Iraq (19%). The issue is most important to low income and older voters, Democrats and Independents.

Americans generally view affordable health care as a major health problem. A quarter of all poll respondents cited affordable and accessible health coverage (including the cost of prescription drugs) as the most important health problem facing Americans today. This exceeded the number who mentioned specific, major causes of death such as cancer (19%), obesity (15%) or heart disease (9%), and represents a shift from August, 2003, when cancer was seen as the top health problem.

Bush v Kerry on Health Care Issue

President Bush has steadily lost support for his handling of health care policy over the last eight months. President Bush’s approval ratings on health care have dropped from 40% in May, 2003 (the inaugural Health Pulse of American poll) to a current low of 28%. A majority of Americans (50%) now disapprove of the way he is handling the issue. Four in ten Americans trust John Kerry to do a better job of handling health care issues compared to a third who trust George W. Bush.

Americans understand that action on health care will cost money and are willing to alter policy and spending priorities to effect these changes. Almost 6 out of ten (57%) Americans want to repeal at least some of the Bush tax cuts to expand health insurance coverage. Indeed, over a quarter (28%) want to repeal the tax cuts for everyone not just the most wealthy as Kerry has proposed. Republicans would prefer to keep the tax cuts, but even they feel torn with 48% in favor of keeping the cuts and 39% supporting some repeal to fund health care. Americans are also willing to make important trade offs in spending priorities. A majority (52%) want more spent on health care and less spent on national defense, and 80% want more spent on health care and less on space exploration.

Cost of Prescription Drugs a Popular Issue for Kerry

John Kerry may have found a winning issue in the complex territory of health care policy –the importation of cheaper prescription drugs from overseas. Kerry has a huge advantage over Bush on this issue. Americans overwhelmingly agree with Kerry’s position on legalizing the re-importation of prescription drugs from Canada. Roughly three in four Americans support action by the United States Congress that would make it legal for individuals to purchase prescription drugs from Canada and roughly 7 out of 10 support changing the law to allow states to import cheaper prescription drugs. Moreover, support for legalizing drug imports has increased over the last few months, rising roughly 5% since November, 2003. And Republicans are just as supportive of drug imports as Democrats.

Should be Legal or Illegal to Purchase Canadian Prescription Drugs?

When asked their view on the safety of prescription drugs purchased from Canada, 66% of Americans thought they were very or somewhat safe, an increase of 8% since November, 2003. Only 12% thought the drugs were somewhat or very unsafe.

Americans also generally support government limits on what pharmaceutical companies can charge for prescription drugs, as happens in Canada. Seven in ten Americans support such price controls and this support was found across individuals of differing educational background, income, and age. Republicans also supported price limits (68%), although somewhat less strongly than did Democrats (77%).

Support for Changes to the Recent Medicare Law

John Kerry and George W. Bush hold differing positions on the recent Medicare drug law and Americans tend to side with Kerry’s proposed changes to the law. Just over a half favor the Medicare law, but an even larger percentage – seven out of ten -- want to change the law to allow the government to import cheaper drugs from Canada. Just over seven in ten would also like the government to be able bargain with pharmaceutical companies to obtain a volume discount for seniors. In addition, Kerry has urged for the repeal or reduction of government subsidies to HMOs and, again, he has a majority of Americans on his side. Just under seven in ten are opposed to the government subsidizing HMOs to encourage private competition with Medicare.

Running against the pharmaceutical companies may work for Senator Kerry. Over a half of all Americans view President Bush’s health care policies as doing more to benefit prescription drug and health insurance companies, compared to just under a quarter who see his policies as primarily of benefit to ordinary people. In contrast, four out of ten Americans view Kerry’s proposals as benefiting ordinary people and only 16% see them as benefiting private health and prescription drug companies. A larger percentage of Americans also believe the new Medicare drug bill will benefit prescription drug companies (49%) than benefit Medicare recipients (25%).

Coverage for the Uninsured and Medical Malpractice

Senator Kerry may have greater difficult in selling the public on other aspects of his health care proposals, however. He has advocated expanding health insurance coverage by allowing individual Americans and employers to buy into the Federal Employees Health Benefits Program (FEHBP). In contrast President Bush has proposed tax credits to help the uninsured purchase private health insurance. And Bush has a slight edge on this issue, with a somewhat greater percentage of Americans favoring tax credits (47%) over expanding access to the federal health insurance program (41%).

The public is also more evenly divided over what to do about rising medical malpractice insurance costs. George W. Bush has argued for a cap on medical malpractice awards whereas John Kerry has urged for a reduction in frivolous lawsuits but no cap on award amounts. The public tends to favor Kerry’s position by a slight margin (37%) over the position endorsed by Bush (32%).

Methodology

The poll was conducted between February 18 and March 8, 2004 by the Stony Brook University Center for Survey Research. 863 adults were interviewed from across the nation. The poll is based on an RDD nationally representative sample of telephone numbers drawn from blocks with at least one-listed residential number. Up to 7 contact attempts were made at each selected household and individuals were selected at random within households. Findings are weighted using post-stratification weights for age, gender and census region in accordance with 2003 national Census statistics. The margin of error is plus/minus 3.3 percentage points for the entire sample.

Q04 Do you approve or disapprove of the way George W. Bush is handling HEALTH CARE policy? 

Q11 Thinking ahead to this year's presidential election in November, how important will the candidates' position on health care be in deciding who you vote for?