Growing concern fuels support for new health care approach

WASHINGTON -- The public's growing unease with the current health-care system has built support for a new approach that would mean care for all Americans and changes in laws governing prescription drugs, a poll suggests.

A sizable majority, 70 percent, said it should be legal for Americans to buy prescription drugs outside the United States, according to the ABC News-Washington Post poll. One in eight respondents said they or someone in their home has done just that. Such purchases can save money but they violate the law.

The poll released Sunday found that more than half of Americans, 54 percent, are dissatisfied with the overall quality of health care in the United States while 44 percent are satisfied. That dissatisfaction is 10 percentage points higher than in 2000 and higher than it has been in the past decade when compared with earlier surveys.

While a solid majority of people tended to be happy with their own quality of health care, the poll found "significant concern with the system more broadly," said ABC pollster Gary Langer, who directed the extensive survey.

Those concerns included worries about future costs, declining coverage and the problems of people who lack insurance.

The poll found that six in 10 people surveyed say they are worried about being able to afford health insurance in the future. More than one in six said they have no insurance. The government says there were 43.6 million uninsured U.S. residents at some point during 2002, accounting for 15.2 percent of the population.

The poll found that 53 percent of those who are insured say they are worried about losing their insurance because of loss of a job. The percentage of those who have health insurance and are satisfied with the cost, 64 percent, has dropped by 9 percentage points since 1997.

By almost a 2-1 margin in this poll, 62 percent to 32 percent, Americans said they preferred a universal system that would provide coverage to everyone under a government program, as opposed to the current employer-based system.

That support drops significantly, however, if universal coverage would mean a limited choice of doctors or longer waits for nonemergency treatment.

When people were asked the question slightly differently in a poll a year ago, they were less enthusiastic. Asked if they wanted a taxpayer-funded, health care system run by the government, fewer than half said yes.

Robert Blendon, a specialist on health care public opinion at Harvard University, said the public's worries about health care have increased this year.

"Health care is really rising as a political issue," Blendon said. "When the economy gets bad and health care costs continue to rise, this becomes an economic issue."

The Democratic presidential candidates are offering various proposals for broadening health care coverage.

President Bush and congressional leaders from both parties have made proposals this year to provide help paying for prescription drugs.

Congress is debating changes in Medicare that would include a prescription drug benefit; lawmakers are divided over the best way to do that.

"I really still feel confident," said Rep. Bill Thomas, R-Calif., who is leading the Medicare talks. "We've never been this close before. And people of good will should not let us fall short," he told ABC's "This Week" on Sunday.

A proposal to allow Americans to buy prescription drugs from foreign suppliers at a fraction of the U.S. cost passed the House in July over the objection of the White House, some GOP leaders and pharmaceutical companies. Backers of that measure hope the proposal or one like it will be agreed to in current congressional negotiations over changes in Medicare.

"The high cost of prescription drugs ends up being just as harmful as the diseases people are fighting," said Rep. Jo Ann Emerson, R-Mo., a co-sponsor of the prescription drug reimportation measure.

Among the poll's other findings:

--Eight in 10 in the poll said it is more important to provide health care coverage for all Americans even if it means higher taxes, than to hold down taxes but leave some people uncovered.

--Almost two-thirds said they think the country is headed toward rationing of health care so that some medical procedures are no longer covered by insurance.

--Almost one-third of those who make less than $20,000 a year were uninsured, compared with 8 percent of those who make more than $50,000 a year.

The poll of 1,000 adults was taken Oct. 9-13 and has a margin of error of plus or minus 3 percentage points.