The American public and the next phase of the health care reform debate.
نویسندگان
چکیده
10.1056/nejmp0906394 nejm.org e48(1) and, if enacted, sent to the Pres ident for his approval and signa ture. Previous research suggests that public opinion will play an important role in the outcome of this process. Experience suggests that although the final legislation is likely to be complex, the pub lic will form an overall view lead ing it either to support or to op pose enactment, but this view can change substantially over time. Multiple factors may contribute to the public’s judgment, includ ing the popularity of major policy elements of the bill, its perceived effect on the country, and its po tential effect on their own future health care. Under a contract with the Kaiser Family Founda tion and with a grant from the Robert Wood Johnson Founda tion, we sought to identify the factors most likely to have the greatest impact on public views about the final legislation. We did this in part by comparing the public’s response to the Clinton health plan in the final months of the 1994 debate with percep tions about the current reform debate. We examined data from 30 nationwide public opinion polls (see box; polls cited parentheti cally hereafter by organization and date, if needed) to assess the issues that leaders inside and out side government need to focus on if they want to influence pub lic opinion about the legislation. Table 1 shows the level of sup port at the time of the two health care debates for changing the U.S. health care system, the public’s assessment of each president’s handling of health care policy, and public approval of the pro posed health plans. Table 2 com pares Americans’ expectations, in April 1994 and October 2009, of the ways in which health care re form will affect them. The tables show responses from the two eras to questions that are as similar to one another as possible. In the final phase of the Clin ton debate, polls showed that Americans still wanted health care reform: 85% of the public believed that the U.S. health care system needed to be fundamen tally changed or completely re built (Harris) (see Table 1). Near ly two thirds (63%) knew that the Clinton plan provided health insurance coverage for all Amer icans,1 a goal considered very important by 82% of Americans at the time (NYT). In addition, major elements of the Clinton plan had widespread support, in cluding a requirement that health The American Public and the Next Phase of the Health Care Reform Debate
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عنوان ژورنال:
- The New England journal of medicine
دوره 361 21 شماره
صفحات -
تاریخ انتشار 2009