Healthcare: If It's Broke, Fix It

Healthcare: If It's Broke, Fix It

In partnership with Americans for Health Care, the Center for American Progress presents our progressive response to Americans' demand for major health care reform. Taken from the latest polling data, the plan proposes real changes that will more effectively care for our nation.

• Executive Summary (PDF)
• Top Lines (PDF)
• Presentation Slides (Flash)

Americans are intensely dissatisfied and are hungry for change - not incremental or symbolic change but fundamental policy changes that challenge long-held assumptions and focus on outcomes rather than process and politics. No domestic issue stirs these passions more than health care. Health care costs are seen as the primary threat facing our country's economy, but more importantly, by a margin of nearly 2-to-1, they are identified as the number one threat facing the economic well-being of individual Americans. With American families feeling increasingly helpless in the face of skyrocketing costs and stagnant wages, they are desperate for real reform.

Given this starting point, it is still startling that 86 percent of Americans say they support 'reforming our current health care system to provide affordable health care for all Americans.' We would point out that this language secures significantly higher initial support than we have historically seen for the more common phrase 'universal health care.' Support for the proposition is broad, including at least 80 percent of those in virtually every demographic group and every region of the country; even 76 percent of Republicans agree. The language used is critical to securing this broad support, with two key reassurances included:

• 'Reforming our current health care system' - this is not a big-government takeover of the health care system
• 'Provide affordable health care for all Americans' - this is about affordable health care, not a free government handout, and government working with private interests to reduce costs and ensure all Americans have access to that essential piece of economic security, in turn making them more likely to save for retirement or education or to buy a home.

While this broad level of support is unprecedented in our research, strong support for some form of 'universal coverage' has been present for more than a decade, and voters have consistently indicated a strong preference for progressive policies and proposals on virtually all issues related to health care. So why have progressives failed to translate these advantages into meaningful reforms to the health care system.

Previous research has consistently found that doubts about efforts to extend health coverage to all Americans revolve around two primary fears - big government and higher taxes.

When both of these concerns are introduced separately - in an attempt to provide the most difficult test possible - 49 percent of Americans remain solidly in support of reforming our health care system to provide affordable care for all Americans, with 37 percent withdrawing their initial support based on one or both of these concerns. This is a significant drop, which underscores the difficulty of overcoming deep-seated reservations on these issues. But the fact that nearly half of Americans remain solid in their support despite these concerns is testament to not just the profound public dissatisfaction with our current health care system but the strong popular support for extending coverage to all Americans. After hearing arguments from both sides of this debate, overall support remains at 84 percent, with the number who remain steadfast in their support even if it requires higher taxes and a much larger government role rising to a majority (52 percent).

Since the defeat of the Clinton health care plan in 1994, the health care debate in Washington has been diminished into a series of minor skirmishes over important, but relatively small, changes within the current system that have done nothing to change the underlying dynamic= But the health care debate in America remains focused on two essential issues - first, the growing gap between health care costs and the ability of most Americans to meet those costs and second, the fundamental unfairness of a system that denies the basic security of needed medical care to nearly 46 million Americans while delivering record profits for insurance and pharmaceutical companies. Americans are eager for a health care debate that goes straight to the heart of the problem.

Americans understand intuitively what the problems are with the current health care system, but it is the contrast between the struggle of working families to maintain coverage and the anti-consumer behavior of insurance and drug companies which most powerfully illustrates the skewed priorities in health care today:

Over the past 5 years, health insurance premiums for workers have grown by 73 percent while wages have grown by only 15 percent. (60 percent very serious problem, 91 percent serious problem)
Rising insurance premiums have left nearly 46 million Americans uninsured, yet health insurance companies have experienced record profits. (59 percent very serious problem, 94 percent serious problem)

But Americans know that it is not just working families that are being dragged down by the current system. American businesses paying rising premiums for their workers are losing ground to foreign competition, with small businesses the hardest hit. It is clear from this survey that the public understands the broader economic implications of the health care debate on our economy, and they want to see employers playing an active role as partners in the effort to expand health coverage to all Americans.

The reasons for the extremely broad initial support for extending coverage to all Americans are varied but are based largely on the belief that all Americans deserve a minimal level of security when it comes to their health and the health of their families. Yet 3-in-4 Americans, including 63 percent of Republicans and 62 percent of those who voted for Bush in the last election, feel the Bush administration and Congress have failed to address the growing health care crisis in our country, "helping health insurance and drug companies but leaving America with higher costs, fewer benefits, and millions more uninsured."

The strategic importance of this issue for progressives can not be overstated. With presidential and congressional job approval numbers near record lows, Americans want leaders who are willing to reject the broken status quo and offer bold new solutions to the core challenges facing our country. Health care is identified as the primary threat facing both our country's economy and the economic well-being of individual Americans. And real health care reform, that expands affordable health coverage Americans, resonates with a majority of Americans, including those that do not self-identify as progressives.

Read Complete Executive Summary (PDF)

Updated: January 25, 2006