Ask Me About Health Reform


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  • This presentation will review the public debate over health care, the results from a recent CA Endowment polling, the goal of our efforts, the public education campaign, and ask how you/your organization can participate. The Endowment’s goal for this campaign is to make implementation of health care reform a success so that Californians have better healthcare
  • Californians learned about health reform through the news and it influenced their views in a very partisan way.
  • Over the last several years, polls have shown that substantial majorities of voters believed that the health care system needed a total overhaul, even if they said they were satisfied with their own health care. So, the reform initiative started with strong support last spring. AND THEN OVER MANY MONTHS…support eroded. Media focused on the “partisan battle” in Congress and the streets, focusing on the intense and angry opposition. Tea parties began shaping the story over the summer of 2009 In this context, voters’ support or opposition to health care reform fundamentally tracked (and still follows) party affiliation. As a result, people understand health reform through the prism of the political process at the expense of understanding what is in the law. Republican messages about a “government takeover of our healthcare”, “rationing health care” and “death panels” worked to decrease support for reform.
  • To see how Californians feel about reform, the CA Endowment completed a poll in mid April. The poll was conducted by Fairbank, Maslin, Maullin, Metz & Associates (FM3). The survey sample was 800 voters with an oversample of 200 Decline to State Voters.
  • While national surveys continue to show pluralities of voters who are ambivalent about health reform, California voters support health care reform by a 49% to 42% margin before hearing any information from the pollsters about the law’s provisions or any of the messages in support or opposition.
  • When you look deeper at how various subgroups of the electorate view reform, you see that the fundamental differences are partisan. Support and opposition can be tracked by party. Democrats and Independents are in support while Republicans oppose. 52% of Democrats strongly support (this measures levels of intensity) reform while 72% of Republicans strongly oppose..the opposition is more intense.
  • As you can see from these numbers, a substantial number of people who will directly benefit from reform don’t think it will directly benefit their families. Clearly, education about the direct benefits to people in these categories makes a lot of sense. These numbers represent the initial question, before information about the law was given. So for example, half of those who had trouble paying for health care in the past 3 years and more than half of those denied coverage for a pre-existing condition didn’t think reform would benefit them.
  • As the chart on the left shows, learning more about the provisions of the law causes a significant shift in support to a 56% majority in support and 40% opposed; essentially widening a seven point margin to a full sixteen points. This majority remains even after additional pro and con arguments. The chart on the right indicates how learning more about the provisions also increases the level of intensity of supporters from 31% to 40%, a full nine points.
  • Over the course of the survey, voters were asked 4 different times whether they support reform: before information, after hearing provisions, after each of the arguments pro and con, and the final ask. This pie chart shows that 85% of the electorate is fairly dug in to their position answering yes or no each of the four times. 15% shifted with information or remained undecided.
  • Now let’s look at who moves to support after hearing more information and examine why they move. There are two basic categories of positive movers: Those without a strong ideological predisposition to support or oppose reform – notably independents and moderates. Those with some specific likelihood to benefit from reform once they understand its provisions – including voters with pre-existing conditions, those who lack coverage, seniors, and some communities of color.
  • These are some of the categories of people who move to support.
  • In the survey, people were read a list of 19 provisions of the new health law in 4 categories, those that relate to expanding access to services, cost & quality of care, insurance company reform, and how health reform will be funded.
  • These are worded in a neutral way, simply explaining what the law does..these are the top rated provisions that received over 60% support.
  • Messages stressing the broad distribution of benefits and insurance company reforms are generally the most compelling. The most important provisions to people depend on their circumstances but it’s also good to let people know about the ones that are most popular so that they get repeated..the key to marketing.
  • What do we want to do? This moment is unique; when was the last time we had such a major reform? There is a wide base of supporters – and the potential for many more Health care has now moved from a cloudy problem to a political issue Health reform will touch everyone. Potential to create a strong constituency empowered to push for more and better health care. Health that expands access to services – has better quality of care – and honestly invests in prevention. Our goal for public education: Leverage this unique moment of health care reform to build a broader and stronger constituency for health, committed to building a health system that improves access and quality of care, and invests in prevention.
  • With the passage of health reform, this high profile moment presents a key opportunity to establish a stronger base of support for health issues and raise the bar for consumers’ expectations of their health care. The key to better healthcare is a more empowered consumer who understands what they have and begins to make demands for higher quality and better value. To change the culture from consumer passivity to active involvement begins with an understanding of the new law. That understanding will be beneficial for all that we want to do. And as implementation rolls out, public education must continue. This year is critical because there are many who want to weaken, repeal and replace the law and we need to meet them and beat them in their attempts to take these benefits away from people. If reform becomes known to people as coverage and benefits rather than framed as a mandate and taxes—each step of the way will become easier for reformers. Empowered consumers can create a game-changing new direction for health in our state.
  • What can you/your organization do to support health care reform in California?
  • Let’s talk about how you/your organization would like to participate. Who are you constituents or members? How would you approach them?
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