Payment Trends

Many voters oppose giving government authority to set all healthcare prices

January 9, 2020 3:27 pm
  • Most voters oppose implementing broad government price setting to control healthcare costs
  • Most voters want policymakers to improve the current healthcare system instead of attempting radical changes.
  • Their leading healthcare priority was for policymakers to cut out-of-pocket costs.

A plurality of voters opposes giving the government broad authority to set all healthcare prices, and instead supports more movement toward value-based care, according to new poll.

The national poll of nearly 2,000 registered voters, which was sponsored by the Bipartisan Policy Center, asked how they preferred to address increasing healthcare costs. Among respondents, 44% opposed allowing “the government to set prices for healthcare goods and services” as a solution. Only 35% supported that approach.

Republicans strongly opposed broad government rate-setting by a 23-point margin, while Democrats favored it by a 4-point margin.

A bipartisan majority (60%) backed a broad shift to value-based payment as a preferred way to address increasing healthcare costs.

The findings followed a renewed bipartisan effort by policymakers and several legislators to get federal policymakers to consider mandating broad hospital rate cuts.

The reform that voters want

The poll asked voters about which one of three broad directions they supported to address problems with the healthcare system and found the following levels of support:

  • Improving the current healthcare system: 39%
  • Repealing and replacing the Affordable Care Act (ACA): 23%
  • Single-payer: 22%
  • No preference: 16%

“There’s been years of ‘repeal and replace’ and ‘Medicare for All’ being used by the relative parties, and despite there being years of messaging on those, neither of those received majority support in this poll,”   Caroline Bye, a managing director for Morning Consult, which conducted the poll, said in a call with reporters.

Improving the current system drew support across party lines, including:

  • 46% of Democrats (leading choice)
  • 38% of independents (leading choice)
  • 32% of Republicans (second choice)

“Seeking common ground, the bipartisan route forward seems to be improving the current healthcare system, not ‘repeal and replace’ or ‘Medicare for All,’” Bye said.

The survey also identified the areas of healthcare policy on which voters want policymakers to focus. When voters were asked to prioritize three leading healthcare initiatives, the top responses included:

  • Reduce out-of-pocket costs (64%)
  • Reduce prescription drug costs (57%)
  • Improve the quality of care provided (44%)

Significance for the 2020 election

The findings reflect some of the ongoing shifts in the presidential race and congressional elections, said pollsters.

Mollyann Brodie, executive director of public opinion and survey research with the Kaiser Family Foundation, said the healthcare discussion surrounding the Democratic presidential primary race started with the high-profile single-payer proposal of Sen. Bernie Sanders (I-Vt.) and “Medicare for All” legislation introduced with more than 100 Democratic congressional cosponsors. But Democratic voters seem to be moving away from that.

As the candidates have these conversations with voters, as they see the reactions of people like [in] this [poll] and other [polls], they start seeing that the support [for ‘Medicare for All’] is not deep,” Brodie said.

For Trump and congressional Republicans, the poll indicates they will need to rethink their push to replace the entire ACA.

“The plans they put forward on ‘repeal and replace’ became problematic and they haven’t figured out how to solve those problems yet,” Brodie said. “They have to talk about these issues of concern to families, the healthcare costs and family caregiving that are really personal to people.”

Anthony Carroll, associate state director for advocacy for AARP Iowa, cited the proposal by President Donald Trump to allow foreign importation of drugs as a way for Republicans to make that case.

The poll, conducted in December, had a margin of plus or minus 2 percentage points.



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