Survey Finds A Political Divide On Health Care Quality

April 02-- Apr. 2--Though the ruinous consequences of high health care costs don't follow party lines, Republicans tend to believe they're getting more for their money than Democrats and independents do, according to the results of a new nationwide survey released today by San Diego's West Health.

The nonpartisan and nonprofit organization created by philanthropists Gary and Mary West worked with market research firm Gallup to poll 3,537 randomly-selected Americans across all 50 states and the District of Columbia, asking questions designed to gauge the impacts of and attitudes surrounding health costs.

West, also known for its work building health care clinics and other resources for seniors, has made health care costs its main policy focus convening its sixth-annual Health Care Innovations Summit in Washington this week.

The survey results come at a particularly polarized moment as the Trump Administration reportedly works behind the scenes with a handful of conservative think tanks to build an Affordable Care Act replacement as it simultaneously pushes forward with plans to have the legislation eliminated. Meanwhile, Democrats are coming forward with their own health reform ideas amid cries of Medicare for all.

sd-no-g-west-poll-01.jpg

While much of the national health care debate tends to revolve around specific proposals that increase health insurance coverage for one group or another, Tim Lash, president of the West Health Policy Center, said the organization thought it was important for policy makers to get a fresh take on how regular Americans are impacted by health care costs, which continue to rise despite already being the highest among industrialized nations.

Pollsters found that 26 percent of the people they surveyed said they did not seek treatment due to the cost of care. That ratio was similar regardless of political party, and that fraction, Lash noted, translates to about 65 million Americans who are actively avoiding needed treatments and medications with price tags they find affordable.

"Republicans, Democrats, independents, the rich, the poor, the middle class, they're all skipping treatments, they're all not filling prescriptions, they're all borrowing money to afford care," Lash said.

And yet, despite suffering these indignities across the board, survey results showed a significant disparity in terms of the perception of American health care quality. According to survey results, 67 percent of Republicans thought their nation's health care system was "among the best in the world" compared with just 38 percent of Democrats and 46 percent of independents.

Academia has long found that America, despite spending the most, does not rank near the top in most broadly based measures of health care outcomes.

"When you look at just about every measure of performance -- we're 28th in life expectancy, 31st in infant mortality, 16th in heart attack mortality -- we're only No. 1 as it relates to cost," Lash said.

These disparities have been studied in depth over the last 20 years by the Commonwealth Fund, a nonpartisan health care think tank which examines 1,200 different health measures across 30 industrialized nations to paint a picture of differences and similarities from country to country.

Dr. David Blumenthal, the fund's president, said Monday that, through those 20 years of research, it's clear that America does not get the kind of health care results that other nations do per dollar spent.

But that disparity, though it has been reported to the public for many years, has not universally affected the average American's perception of health care quality. That probably, experts say, because not everyone sees outcomes like average infant mortality or average life expectancy to be the main measure of quality. Some, Blumenthal notes, are more open to these kinds of stats than others.

"It's very hard to present these kinds of data to people in the United States in ways they find convincing if they're not already critical of the health care system," Blumenthal said. "That may be why Democrats are more prone to accept that information. Their leaders are more prone to talk about it, and, therefore their followers are more likely to be aware of it."

But there is an alternative narrative that explains the political disparity on health care quality.

Lanhee Chen, director of domestic policy studies at Stanford University's Hoover Institution, one of three think tanks rumored to be working with the Trump administration on an ACA replacement, said many Americans think of factors like the ability to choose which provider they want to see and access to cutting-edge treatments when they're asked by a pollster to opine on American health care quality.

"Most progressives, I think, would argue that equity is a paramount value in health care, whereas conservatives might say the important factors are choice, optionality and access to innovative cures," Chen said.

But, regardless of political affiliation, a vast majority of Americans -- 76 percent -- believe that the cost of health care is too high relative to quality delivered.

And here, Lash said, is where West believes the public should focus. He noted that survey results found that only about one in 10 Americans had recently contacted their elected representatives about bringing health care costs down. And that's a shame, he added, because there are several first steps that could be taken to shrink the health care price tag, such as giving Medicare power to negotiate drug prices, mandating that doctors move away from quantity-based payment and requiring health care price transparency.

Lash said the consequences of public disengagement on the issue are stark. He cited a recent study in the Annals of Emergency Medicine, which estimated that 125,000 Americans die every year because they haven't taken prescribed medications, and of those, about two-thirds of those people aren't filling their prescriptions because they're unaffordable.

"That data suggests that roughly 85,000 people die every single year just as a result of not being able to afford their medications. To put that in context, during the entire Vietnam War roughly 59,000 soldiers were killed in action," Lash said. "Where are the protests in the streets over this?"

To start a more regular dialogue on the issue among those outside the world of health care economics, West is planning to launch a new website, healthcostcrisis.org, this week.

___

(c)2019 The San Diego Union-Tribune

Visit The San Diego Union-Tribune at www.sandiegouniontribune.com

Distributed by Tribune Content Agency, LLC.