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Policy PointsA decade after failing to make it into the Affordable Care Act, the public option reemerged as a health reform goal at both the national and state levels, with polls reporting strong, bipartisan support.A 2020 poll that probed both support for one public option approach (Medicare "buy‐in") and attitudes toward government suggests that differences in these attitudes could plague reform advocates' efforts.Although the COVID‐19 pandemic viscerally highlighted the need for a more coherent health care system—including universal coverage—other recent evolutions in the broader US political context could undermine reform. [ABSTRACT FROM AUTHOR]

The article discusses the outcome of the 2022 congressional election in the U.S. and its impact on health policy. It also mentions that the Republicans have a narrow majority in the House and Democrats maintain a slight majority in the Senate, analyzes the partisan views on health policy and the prospects for future action by the divided Congress.

This essay reviews more than forty years of public opinion polling to look at trust in medicine, the health system, and public health. We use polling data to explore the reasons for the decline and current level of public trust in leaders of medicine and public health, including underlying forces such as the decline in trust in other institutions. Except for the military, none of the efforts to improve public trust in various institutions have been very successful to date. Given the uncertainty about how to restore trust, this essay makes a number of recommendations that might improve public trust in medicine and public health in the future. [ABSTRACT FROM AUTHOR]

Ten years after its enactment, public support for the Affordable Care Act (ACA) still only reaches a scant majority. Candidates for the presidency--and the sitting president--have endorsed health reforms that would radically transition US health care away from the current system upon which the ACA was built. Few opinion surveys to date have captured dominant preferences among alternative health reform policies or characterized attitudes and experiences that might be associated with policy preferences. Using a 2019 nationally representative telephone survey, this article considers how variations in political values, attitudes toward government, and experiences with the health care system relate to competing health reform preferences. Differences between those who favor Medicare for All over building on the ACA largely reflect different levels of satisfaction with the status quo and views of private health insurance. By contrast, differences between ACA supporters and those who would favor replacing it with a state-based alternative reflect sharply different political values and attitudes. Key differences remain significant after controlling for demographic, health, and political characteristics. Overwhelming public support still eludes the ACA, and reaching consensus on future directions for health reform will remain challenging given differences in underlying beliefs. [ABSTRACT FROM AUTHOR]

While the majority of U.S. Christians opposed the Affordable Care Act (ACA) in 2010, opinion was deeply divided by race/ethnicity and denominational group. Using national data from the Cooperative Congressional Election Study, we analyzed variation in ACA support across Christian denominational groups and offered explanations for these differences. We found overwhelming support among African Americans, less unified but majority support from Hispanics, and majority opposition from non-Hispanic White Christians. Among White Catholics and Protestants, ACA support varied considerably, and views toward abortion policy statistically explained much of the difference in likelihood to support the ACA across denominational categories (comparing White mainline versus Evangelical Protestants, and white moderate versus devout Catholics). Differences in anti-Black racial resentment were substantial between White Evangelical and mainline Protestants, and helped explain some of the gaps in ACA support between these groups. We conclude that differences in ACA views by denomination can be explained by firmly held group beliefs that may be difficult to sway, even if the program is a technical success. [ABSTRACT FROM AUTHOR]

Objective: To summarize findings from this Special Issue, which examine reported experiences of discrimination among six underrepresented groups in public opinion research-blacks, Latinos, Native Americans, Asian Americans, lesbian, gay, bisexual, transgender, or queer (LGBTQ) adults, and women.Data Source and Study Design: Data come from a nationally representative, probability-based telephone survey of 3453 US adults, conducted January-April 2017.Methods: We calculated the percent of adults reporting discrimination in several domains, including health care.Principal Findings: In health care encounters, 32 percent of black adults reported discrimination, as did 23 percent of Native Americans, 20 percent of Latinos, 18 percent of women, 16 percent of LGBTQ adults, and 13 percent of Asian Americans. Significant shares also reported experiencing racial, gender, or LGBTQ identity-based violence against themselves or family members, including 51 percent of LGBTQ adults, 42 percent of blacks, 38 percent of Native Americans, and 21 percent of women. At least one in seven blacks (22 percent), LGBTQ adults (18 percent), Latinos (17 percent), and Native Americans (15 percent) reported avoiding health care for themselves or family members over concerns of anticipated discrimination or unfair treatment.Conclusions: Taken together, this polling effort illustrates the significant and widespread level of discrimination against many groups in America today, as well as the complex manifestation of these experiences across different groups and different areas of life. While it is beyond the scope of these results to make specific recommendations for how to end discrimination in each area of life we studied, this Special Issue provides important evidence that more research and practice on discrimination are sorely needed in health services research. [ABSTRACT FROM AUTHOR]

The article focuses on a 2019 national survey conducted in the U.S. which found that seriously ill Medicare beneficiaries experienced financial hardships as a consequence of the illness. Topics covered include evidence of Medicare's popularity among its beneficiaries, and an assessment of medical care costs on seriously ill beneficiaries and their family and friends.

The article focuses on the U.S. health care costs, discussing the rising prices of the U.S. prescription-drugs. It presents the U.S. Public's view's on the issue who states that U.S. President Donald Trump and U.S. Congress top priority is to reduce the prescription-drug prices in 2019. The respondents also opened up on the domestic issues including health care, and talked about the U.S. spending of gross domestic product on health care costs.

This Special Issue of I Health Services Research i on discrimination in America was conducted in the midst of a national debate on the extent of discrimination in the lives of Americans,[[1]] from the perspectives of six under-represented groups in public opinion research on discrimination: nationally representative samples of blacks, Latinos, Native Americans, Asian Americans, women, and lesbian, gay, bisexual, transgender, or queer (LGBTQ) adults. Within health care and beyond it, systemic change is needed to reduce and eliminate discrimination, because it carries such severe economic, social, and health consequences. Further change and research are needed to protect the civil and human rights of minority and marginalized populations, as well as to reduce health disparities and improve their health. 8 Williams DR, Lawrence JA, Davis BA, Vu C. Understanding how discrimination can affect health. [Extracted from the article]

Background Using a survey conducted during the 2013–2014 polio outbreak in Somalia, this study examines attitudinal and knowledge-based threats to oral polio vaccine acceptance and commitment. Findings address a key gap, as most prior research focuses on endemic settings. Methods Between November 19 and December 21, 2013, we conducted interviews among 2003 caregivers of children under 5 years in select districts at high risk for polio transmission. Within each district, sample was drawn via a multi-stage cluster design with random route household selection. We calculated the percentage of caregivers who could not confirm recent vaccination and those uncommitted to future vaccination. We compared these percentages among caregivers with varying knowledge and attitudes, focusing on variables identified as threats in endemic settings, using controlled and uncontrolled comparisons. We also examined absolute levels of threat variables. Results Only 10% of caregivers could not confirm recent vaccination, but 32% were uncommitted to future vaccination. Being unvaccinated or uncommitted were related to multiple threat variables. For example, compared with relevant counterparts, caregivers were more likely to be unconfirmed and uncommitted if they did not trust vaccinators “a great deal” (unconfirmed: 9% vs. 2%; uncommitted: 49% vs. 28%), which is also true in endemic settings. Unlike endemic settings, symptom knowledge was related to commitment while rumor awareness was low and unrelated to past acceptance or commitment. Levels of trust and perceptions of OPV effectiveness were high, though perceptions of community support and awareness of logistics were lower. Conclusions As in endemic settings, outbreak responses will benefit from communications strategies focused on enhancing trust in vaccinators, institutions and the vaccine, alongside making community support visible. Disease facts may help motivate acceptance, and enhanced logistics information may help facilitate caregiver availability at the door. Quelling rumors early may be important to prevent them from becoming threats. [ABSTRACT FROM AUTHOR]

The article discusses the epidemic of opioid abuse in the U.S. It mentions that U.S. President Donald Trump has identified the epidemic as a public health emergency. It outlines the public attitudes regarding the opioid abuse epidemic in the U.S. It suggests the need for the medical and scientific communities to educate the public regarding opioid abuse treatment.

Background: Eradication of poliovirus from endemic countries relies on vaccination of children with oral polio vaccine (OPV) many times a year until the age of 5 years. We aimed to determine caregivers' commitment to OPV in districts of Afghanistan at high risk for polio transmission and to examine what knowledge, attitudes, or experiences could threaten commitment.Methods: We designed and analysed a poll using face-to-face interviews among caregivers of children under 5 years of age. The sample was drawn via a stratified multistage cluster design with random route household selection. We calculated the percentage of committed and uncommitted caregivers. All percentages were weighted. We then compared percentages of uncommitted caregivers among those with varying knowledge, attitudes, and experiences, using logistic regression to control for possible demographic confounders.Findings: Between Dec 19, 2014, and Jan 5, 2015, we interviewed 1980 caregivers, 21% of whom were "uncommitted" to accepting OPV. Multiple measures of knowledge, attitudes, and experiences are associated with lack of commitment. For example, compared with their relevant counterparts, caregivers are more likely to be uncommitted if they did not trust vaccinators "a great deal" (54% vs 9%), if they do not know that polio spreads through contaminated water (41% vs 14%), or if they believe rumours that OPV is not halal (50% vs 21%).Interpretation: To enhance OPV commitment, it might be useful to consider a multifactorial approach that highlights building trust in vaccinators, providing facts about transmission, sharing positive messages to overcome key rumours, and strengthening community support for vaccination.Funding: Harvard T H Chan School of Public Health and UNICEF. [ABSTRACT FROM AUTHOR]

The article focuses on the public opinion related to the debate on the proposed replacement of the health care reform Affordable Care Act (ACA) in the U.S. under the administration of President Donald Trump. Topics include the concern on the impact of the repeal of the law, the public values supporting the debate on the role of the government in providing universal health care among Americans, and the various components of the proposed repeal-and-replace bill.

The authors discuss the findings of a study on the opinion of the U.S. public on gene therapy and gene editing in adults and children. The study finds that the public likes the idea of gene editing to improve the health of the person undergoing gene therapy, but opposes to changing human genes before birth to improve intelligence, physical traits or appearance. The authors think that public opinion on gene editing and therapy could change over time as discussions about them continue to evolve.

For decades, public satisfaction with the health care system has been lower in the United States than in other high-income countries. To better understand the distinctive nature of US health system satisfaction, we compared the determinants of satisfaction with the health system in the United States to those in seventeen other high-income countries by applying regression decomposition methods to survey data collected in the period 2011-13. We found that concerns related to "accessing most-preferred care" (the extent to which people feel that they can access their top preferences at a time of need) were more important to satisfaction in the United States than in other high-income countries, while the reverse was true for satisfaction with recent interactions with the health system. Differences among US socioeconomic groups in survey responses regarding access to most-preferred care suggest that wide variation in insurance coverage and generosity may play a role in these differences. While reductions in the uninsured population and the movement toward minimum health plan standards could help address some concerns about access to preferred care, our results raise the possibility of public backlash as market forces push plans toward more restricted access and higher cost sharing. [ABSTRACT FROM AUTHOR]

Under the Affordable Care Act, thirty states and the District of Columbia have expanded eligibility for Medicaid, with several states using Medicaid funds to purchase private insurance (the "private option"). Despite vigorous debate over the use of private insurance versus traditional Medicaid to provide coverage to low-income adults, there is little evidence on the relative merits of the two approaches. We compared the first-year impacts of traditional Medicaid expansion in Kentucky, the private option in Arkansas, and nonexpansion in Texas by conducting a telephone survey of two distinct waves of low-income adults (5,665 altogether) in those three states in November-December 2013 and twelve months later. Using a difference-in-differences analysis, we found that the uninsurance rate declined by 14 percentage points in the two expansion states, compared to the nonexpansion state. In the expansion states, again compared to the nonexpansion state, skipping medications because of cost and trouble paying medical bills declined significantly, and the share of individuals with chronic conditions who obtained regular care increased. Other than coverage type and trouble paying medical bills (which decreased more in Kentucky than in Arkansas), there were no significant differences between Kentucky's traditional Medicaid expansion and Arkansas's private option, which suggests that both approaches improved access among low-income adults. [ABSTRACT FROM AUTHOR]

Background: Elimination of poliovirus from endemic countries is a crucial step in eradication; however, vaccination programmes in these areas face challenges, especially in regions with conflict. We analysed interviews with caregivers of children living in two polio-endemic countries to assess whether these challenges are largely operational or also driven by resistance or misinformation in the community.Methods: We designed and analysed polls based on face-to-face interviews of a random sample of parents and other caregivers of children younger than 5 years in regions of Pakistan and Nigeria at high risk for polio transmission. In both countries, the sample was drawn via a stratified multistage cluster design with random route household selection. The questionnaire covered awareness, knowledge, and attitudes about polio and oral polio vaccine (OPV), trust in vaccination efforts, and caregiver priorities for government action. We assessed experiences of caregivers in accessible higher-conflict areas and compared their knowledge and attitudes with those in lower-conflict areas. Differences were tested with two-sample t tests.Findings: The poll consisted of 3396 caregivers from Pakistan and 2629 from Nigeria. About a third of caregivers who responded in higher-conflict areas of Pakistan (Federally Administered Tribal Areas [FATA], 30%) and Nigeria (Borno, 33%) were unable to confirm that their child was vaccinated in the previous campaign. In FATA, 12% of caregivers reported that they were unaware of polio, and in Borno 12% of caregivers reported that vaccinators visited but their child did not receive the vaccine or they did not know whether the child was vaccinated. Additionally, caregivers in higher-conflict areas are less likely to hold beliefs about OPV that could motivate acceptance and are more likely to hold concerns than are caregivers in lower-conflict areas.Interpretation: Beyond the difficulties in reaching homes with OPV, challenges for vaccination programmes in higher-conflict areas extend to limited awareness, negative attitudes, and gaps in trust. Vaccination efforts might need to address underlying attitudes of caregivers through direct communications and the selection and training of local vaccinators.Funding: Harvard T H Chan School of Public Health and UNICEF. [ABSTRACT FROM AUTHOR]

Background As public health leaders prepare for possible future influenza pandemics, the rapid spread of 2009 H1N1 influenza highlights the need to focus on measures the public can adopt to help slow disease transmission. Such measures may relate to hygiene (e.g., hand washing), social distancing (e.g., avoiding places where many people gather), and pharmaceutical interventions (e.g., vaccination). Given the disproportionate impact of public health emergencies on minority communities in the United States, it is important to understand whether there are differences in acceptance across racial/ethnic groups that could lead to targeted and more effective policies and communications. Objectives This study explores racial/ethnic differences in the adoption of preventive behaviors during the 2009 H1N1 influenza pandemic. Patients/Methods Data are from a national telephone poll conducted March 17 to April 11, 2010, among a representative sample of 1123 white, 330 African American, 317 Hispanic, 268 Asian, and 262 American Indian/Alaska Native adults in the USA. Results People in at least one racial/ethnic minority group were more likely than whites to adopt several behaviors related to hygiene, social distancing, and healthcare access, including increased hand washing and talking with a healthcare provider (P-values <0.05). Exceptions included avoiding others with influenza-like illnesses and receiving 2009 H1N1 and seasonal influenza vaccinations. After we controlled the data for socioeconomic status, demographic factors, healthcare access, and illness- and vaccinerelated attitudes, nearly all racial/ethnic differences in behaviors persisted. Conclusions Minority groups appear to be receptive to several preventive behaviors, but barriers to vaccination are more pervasive [ABSTRACT FROM AUTHOR]

Non-pharmaceutical interventions (NPIs) are an important public health tool for responding to infectious disease outbreaks, including pandemics. However, little is known about the individual characteristics associated with support for NPIs, or whether they are consistent across regions. This study draws on survey data from four regions-Hong Kong, Singapore, Taiwan, and the United States-collected following the Severe Acute Respiratory Syndrome (SARS) outbreak of 2002-03, and employs regression techniques to estimate predictors of NPI support. It finds that characteristics associated with NPI support vary widely by region, possibly because of cultural variation and prior experience, and that minority groups tend to be less supportive of NPIs when arrest is the consequence of noncompliance. Prior experience of face-mask usage also results in increased support for future usage, as well as other NPIs. Policymakers should be attentive to local preferences and to the application of compulsory interventions. It is speculated here that some public health interventions may serve as 'gateway' exposures to future public health interventions. [ABSTRACT FROM AUTHOR]

This Viewpoint summarizes views measured in national opinion polls about COVID-19 response, national health insurance reform, reforming the US health care system in general, and race and race disparities in health, with a focus on differences between Democrat and Republican respondents and implications of those differences for enacting meaningful legislation. [ABSTRACT FROM AUTHOR]

Introduction: Research is underway to develop an early medical test for Alzheimer's disease (AD). Methods: To evaluate potential demand for such a test, we conducted a cross-sectional telephone survey of 2,678 randomly selected adults across the United States and four European countries. Results: Most surveyed adults (67%) reported that they are "somewhat" or "very likely" to get an early medical test if one becomes available in the future. Interest was higher among those worried about developing AD, those with an immediate blood relative with AD, and those who have served as caregivers for AD patients. Older respondents and those living in Spain and Poland also exhibited greater interest in testing. Knowing AD is a fatal condition did not influence demand for testing, except among those with an immediate blood relative with the disease. Conclusions: Potential demand for early medical testing for AD could be high. A predictive test could not only advance medical research, it could transform political and legal landscapes by creating a large constituency of asymptomatic, diagnosed adults. [ABSTRACT FROM AUTHOR]

The article discusses the public perceptions on federal budget deficit and Medicare spending and costs. In addition, a report in 2011 showed that there has been less public support for policy changes in reducing Medicare spending to lower the federal budget deficit. It says that majority of the senior citizens in the U.S. believe in the efficiency of Medicare for supporting the health of seniors. Moreover, most Americans support the continuing fee-for-service payments of Medicare.

Background A number of expert reports have pointed to serious problems with health care in many Latin American countries and argued the need to reform and improve health-care systems. In addition, the Ministers of Health of the Americas have stated that health systems should be accountable to citizens. Objective This paper examines, in each of 17 Latin American countries, public dissatisfaction with the health care to which people have access, the proportion of people reporting problems with access to and the cost of health care and the factors that are most important in driving public dissatisfaction. Methods Data are drawn from a 2007 Latinobarómetro survey of 19 212 adults interviewed face-to-face in 17 Latin American countries. Results The proportion of people expressing dissatisfaction with their health care varies a great deal by country, as do the proportions reporting problems with access to and the cost of health care. Problems with access to care seem to matter most in trying to explain public dissatisfaction with their health care. More traditional measures of health outcomes and resources seem to matter less as drivers of dissatisfaction. Conclusions For governments trying to improve their citizens' satisfaction with the health care they receive, the highest priority would be improving people's basic access to health-care services. Also, it appears that democratic governments are seen as being more responsive to the public's needs in health care. [ABSTRACT FROM AUTHOR]

A reprint of the article "Implications of the 2012 Election for Health Care — The Voters' Perspective," by John M. Benson and Amanda Brulé that was previously published at NEJM.org on November 28, 2012 is presented. The article presents the results of pre-election and post-election polls as part of a Robert Wood Johnson Foundation project. The results showed that the country is divided politically and that voters selected to maintain the current balance of decision making.

Summary: Background: Many important strategies to reduce the spread of pandemic influenza need public participation. To assess public receptivity to such strategies, we compared adoption of preventive behaviours in response to the 2009 H1N1 influenza pandemic among the public in five countries and examined whether certain non-pharmaceutical behaviours (such as handwashing) were deterrents to vaccination. We also assessed public support for related public health recommendations. Methods: We used data from simultaneous telephone polls (mobile telephone and landline) in Argentina, Japan, Mexico, the UK, and the USA. In each country, interviews were done in a nationally representative sample of adults, who were selected by the use of random digit dial techniques. The questionnaire asked people whether or not they had adopted each of various preventive behaviours (non-pharmaceutical—such as personal protective and social distancing behaviour—or vaccinations) to protect themselves or their family from H1N1 at any point during the pandemic. Two-tailed t tests were used for statistical analysis. Findings: 900 people were surveyed in each country except the USA where 911 people were contacted. There were wide differences in the adoption of preventive behaviours between countries, although certain personal protective behaviours (eg, handwashing) were more commonly adopted than social distancing behaviours (eg, avoiding places where many people gather) across countries (53–89%vs 11–69%). These non-pharmaceutical behaviours did not reduce the likelihood of getting vaccinated in any country. There was also support across all countries for government recommendations related to school closure, avoiding places where many people gather, and wearing masks in public. Interpretation: There is a need for country-specific approaches in pandemic policy planning that use both non-pharmaceutical approaches and vaccination. Funding: US Centers for Disease Control and Prevention and the National Public Health Information Coalition. [Copyright &y& Elsevier]

The article looks at the role of health care-related issues in the 2012 presidential election in the U.S. President Barack Obama and Republican presidential nominee Mitt Romney differ on the implementation of the Affordable Care Act (ACA). They also differ on the effect of spending cuts on the National Institutes of Health, the Centers for Disease Control and Prevention and community health centers. Polls identified health care as the second most important issue in deciding the people's vote.

The objective of this paper is to understand how the public's beliefs in five countries may change as more families have direct experience with Alzheimer's disease. The data are derived from a questionnaire survey conducted by telephone (landline and cell) with 2678 randomly selected adults in France, Germany, Poland, Spain, and the United States. The paper analyzes the beliefs and anticipated behavior of those in each country who report having had a family member with Alzheimer's disease versus those who do not. In one or more countries, differences were found between the two groups in their concern about getting Alzheimer's disease, knowledge that the disease is fatal, awareness of certain symptoms, and support for increased public spending. The results suggest that as more people have experience with a family member who has Alzheimer's disease, the public will generally become more concerned about Alzheimer's disease and more likely to recognize that Alzheimer's disease is a fatal disease. The findings suggest that other beliefs may only be affected if there are future major educational campaigns about the disease. The publics in individual countries, with differing cultures and health systems, are likely to respond in different ways as more families have experience with Alzheimer's disease. [ABSTRACT FROM AUTHOR]

The article discusses a polling review project supported by the Robert Wood Johnson Foundation that examines the overall public opinion on the federal funding of stem-cell research as well as the views of the principal voters in the U.S. presidential primaries in 2012. It says that a majority of U.S. citizens express pro-stem-cell-research views. According to the poll, about 6 in 10 citizens believe that medical research involving stem cells from human embryos is morally acceptable.

This analysis of national opinion polls shows that a majority of Americans support increased spending on public health in general and that they see public health interventions as saving money in the long term. At the same time, many do not favor increased federal spending in a number of areas that public health officials deem important. In addition, polls show striking partisan differences, with Republicans much less supportive than Democrats of additional spending on public health. This split may have political implications for the public health component of the new health reform law if there is a change in party control of one or more houses of Congress after the November 2010 elections. As a result, in order to sustain public support for increased spending, it will be critically important to give examples of cost savings from public health programs and to highlight how they have reduced mortality from major chronic illnesses, such as cancer, heart disease, and HIV/AIDS. [ABSTRACT FROM AUTHOR]

The partisan split in Congress over health reform may reflect a broader divide among the public in attitudes toward the uninsured. Despite expert consensus over the harms suffered by the uninsured as a group, Americans disagree over whether the uninsured get the care they need and whether reform legislation providing universal coverage is necessary. We examined public perceptions of health care access and quality for the uninsured over time, and we found that Democrats are far more likely than Republicans to believe that the uninsured have difficulty gaining access to care. Senior citizens are less aware than others of the problems faced by the uninsured. Even among those Americans who perceive that the uninsured have poor access to care, Republicans are significantly less likely than Democrats to support reform. Thus, our findings indicate that even if political obstacles are overcome and health reform is enacted, future political support for ongoing financing to cover the uninsured could be uncertain. [ABSTRACT FROM AUTHOR]

In the event of a serious pandemic influenza outbreak, businesses must play a key role in protecting employees' health and safety. With regard to pandemic influenza mitigation recommendations requiring social distancing, we examined whether some US employees would disproportionately fail to comply because of job insecurity and financial problems associated with missing work. We used the 2006 Harvard School of Public Health Pandemic Influenza Survey and multivariable logistic regression to determine whether employment characteristics such as inability to work from home, lack of pay when absent from work, and self-employment would be associated with less ability to comply with recommendations. We found that inability to work from home, lack of paid sick leave, and income are associated with working adults' ability to comply and should be major targets for workplace interventions in the event of a serious outbreak. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue, including one by Marsha Gold on factors that influence policy makers' use of health services research, and another by on the efforts of the state of Oregon to use cost-effectiveness research in health care policy decision making.

An individual mandate is an important feature of many recent plans to achieve universal health insurance coverage in the United States, without radically changing the way most Americans get health care and coverage. Using national public opinion data, we find that on its own, an individual mandate does not have broad support across partisan and sociodemographic groups. Policymakers who choose to pursue an individual mandate for policy reasons may expand the base of supporters by incorporating it into a "shared- responsibility" plan that includes requirements for employers, government, and insurers. [ABSTRACT FROM AUTHOR]

An individual mandate is an important feature of many recent plans to achieve universal health insurance coverage in the United States, without radically changing the way most Americans get health care and coverage. Using national public opinion data, we find that on its own, an individual mandate does not have broad support across partisan and sociodemographic groups. Policymakers who choose to pursue an individual mandate for policy reasons may expand the base of supporters by incorporating it into a "shared-responsibility" plan that includes requirements for employers, government, and insurers. [ABSTRACT FROM AUTHOR]

The article examines the role of health care in the 2008 U.S. presidential election. The public's perceptions of the state of health care and the importance relative to that in previous elections are examined. The views of supporters of U.S. presidential candidates John McCain and Barack Obama are compared. Data from 11 national opinion surveys was used. The state of the U.S. health care system at the time of the election was rated as fair or poor by the majority of respondents. The priority of health care for those voting for Obama is compared to those voting for McCain. The majority of voters favored an overhaul or major changes to the U.S. health care system. Views on health care spending and costs are also presented.

This study examines public opinion about the new health reform law in Massachusetts at four stages, from the beginning of the debate in September 2003 through June 2008, two years into implementation. We find that the favorable political environment in Massachusetts likely encouraged leaders to act and also contributed to the shape of the legislation as a "shared responsibility" compromise plan. Despite perceptions by some that the law is not helping the uninsured, support for it remains high--even for the individual mandate, the law's most controversial feature. There is little interest in repealing this legislation. [ABSTRACT FROM AUTHOR]

We report the results of a national survey conducted to help public health officials understand the public's response to community mitigation interventions for a severe outbreak of pandemic influenza. Survey results suggest that if community mitigation measures are instituted, most respondents would comply with recommendations but would be challenged to do so if their income or job were severely compromised. The results also indicate that community mitigation measures could cause problems for persons with lower incomes and for racial and ethnic minorities. Twenty-four percent of respondents said that they would not have anyone available to take care of them if they became sick with pandemic influenza. Given these results, planning and public engagement will be needed to encourage the public to be prepared. [ABSTRACT FROM AUTHOR]

This 2007 Harvard School of Public Health/Robert Wood Johnson Foundation survey of 4,334 randomly selected U.S. adults compared perceptions of the quality of physician care among fourteen racial and ethnic groups with those of whites. On each measure examined, at least five and as many as eleven subgroups perceived their care to be significantly worse than care for whites. In many instances, subgroups were at least fifteen percentage points more negative than whites. This was true for Central/South Americans, Chinese Americans, and Korean Americans on five of seven measures. Many of the differences remained after socioeconomic characteristics and language skills were controlled for. [ABSTRACT FROM AUTHOR]

This article focuses on the issue of health care as discussed in the 2008 U.S. Presidential Primaries. Noting the competitiveness of the presidential race--neither party has an incumbent candidate--the article examines various public opinion polls on how the issue of health care will affect the choice of voters. An overview of the polls and the method of their statistical analysis is provided. Results concerning the attitudes of voters towards the issue of health care in the U.S. differ depending on political affiliation, especially in regards to stem cell research and abortion, with health care remaining a top priority for voters affiliated with either party. Results also found that Democratic supporters are more dissatisfied with current health care policies.

Background Fifteen years ago, public opinion surveys in Spain showed substantial dissatisfaction with the health-care system. Since that time, health-care in Spain has undergone significant changes, including a decentralization of the system, an increase in spending and a change in the way the system is financed. Objective This study examines how Spanish citizens rate the performance of their health system today, both as compared with other sectors of society and as compared with earlier time periods. Methods Data are drawn from nationally representative telephone surveys of the non-institutionalized adult Spanish population (age 18 years and over). The study was carried out in two phases: October–November 2005 ( n = 3010) and January 2006 ( n = 2101). Results The majority of the Spanish population thinks the health system needs to be changed. The problems cited relate mostly to long wait times to get health-care. Nevertheless, over the last 15 years, the proportion of people who have very negative views about the health system has decreased by half. The majority believes that not enough money is spent on health-care, but few people would support an increase in taxes to provide additional funding. The survey finds the National Health System’s institutions and health professionals to be more highly trusted than other institutions and professional groups in the country. Conclusions Government policy-makers in Spain face a dilemma: the public wants more health spending to decrease wait times, but there is substantial resistance to increasing taxes as a means to finance improvements in the system’s capacity. [ABSTRACT FROM AUTHOR]

This 2006 survey of 4,157 randomly selected U.S. adults compared perceptions of health care disparities among fourteen racial and ethnic groups to those of whites. Findings suggest that many ethnic minority groups view their health care situations differently and, often, more negatively than whites. A substantial proportion perceived discrimination in receiving health care, and many felt that they would not receive the best care if they were sick. Most differences remained when socioeconomic characteristics were controlled for. The variety of responses across racial groups demonstrates the importance of examining ethnic subgroups separately rather than combined into a single category. [ABSTRACT FROM AUTHOR]

Objectives. The purpose of this article is to look at how prepared people in communities outside the main areas devastated by Hurricanes Katrina and Rita thought they were for those storms and for major hurricanes in the near future, what factors were related to why people did not evacuate, and what concerns people had in communities that took in evacuees from the hurricanes. Methods. Telephone interviews were conducted with randomly selected adults in Baton Rouge, Houston, Dallas, and Mississippi/Alabama (excluding the immediate Gulf Coast) to assess respondents' knowledge, attitudes, and behaviors about hurricane preparedness and response to Hurricanes Katrina and Rita. Results. The surveys found a sizeable proportion of respondents who might not, for a number of reasons, comply with future orders to evacuate. A substantial proportion reported that they were not prepared for another major hurricane and indicated a desire for more information about how to prepare for future hurricanes. In communities that reported taking in large numbers of evacuees, residents expressed concern about the impact of the evacuees on their community. Conclusion. Evacuating communities involves a number of concrete problems that were not adequately addressed in the cases of Hurricanes Katrina and Rita. Responses to these surveys indicate a need for more comprehensive hurricane disaster planning. [ABSTRACT FROM AUTHOR]

For more than two decades, polls have shown that Americans are dissatisfied with their current health care system. However, the public's views on how to change the current system are more conflicted than often suggested by individual poll results. At the same time, Americans are both dissatisfied with the current health care system and relatively satisfied with their own health care arrangements. As a result of the conflict between these views and the public's distrust of government, there often is a wide gap between the public's support for a set of principles concerning what needs to be done about the overall problems facing the nation's health care system and their support for specific policies designed to achieve those goals. [ABSTRACT FROM AUTHOR]

Countries worldwide face the threat of emerging infectious diseases. To understand the public's reaction to the use of widespread quarantine should such an outbreak occur, the Harvard School of Public Health, with the U.S. Centers for Disease Control and Prevention, undertook a survey of residents of Hong Kong, Taiwan, Singapore, and the United States. A sizable proportion of the public in each country opposed compulsory quarantine. Respondents were concerned about overcrowding, infection, and inability to communicate with family members while in quarantine. Officials will need specific plans to deal with the public's concerns about compulsory quarantine policies. [ABSTRACT FROM AUTHOR]

Opinion surveys conducted in 2006 show that health care is an important but second-tier issue in terms of priorities for government action. Americans' top health care concerns are mostly related to economic insecurity: rising costs and the problems of the uninsured. The biggest perceived health threats are cancer, HIV/AIDS, and avian flu. Although most Americans do not think that the health system is in crisis, the public remains dissatisfied with both the country's health care and public health systems. These attitudes are likely to create a climate that is supportive of increased health spending and substantial policy changes. [ABSTRACT FROM AUTHOR]

An important question for physicians in the aftermath of the Terri Schiavo case is whether the effort of elected officials to intervene was a one-time anomaly or signals a future trend of elected officials being involved in cases where patients are in a vegetative or long-term comatose state. To try to answer this question, we used results from 12 national opinion surveys conducted in March and April 2005, when the Schiavo case was being debated. A review of these survey results showed that efforts by elected politicians to intervene in the Schiavo case were opposed by the majority of Americans. However, the public was more divided on the question of whether Schiavo’s feeding tube should be removed. Opposition to removing Schiavo’s feeding tube was associated with opposition to abortion. The results suggest that issues involved in cases like Schiavo’s are not likely to disappear from the political agenda. [ABSTRACT FROM AUTHOR]

Polling taken during the 2004 influenza vaccine shortage found a high level of public concern but no consensus on who should be responsible for solving the problem. A substantial minority questioned whether the vaccine should be reserved for high-risk groups, while a majority thought that care providers should be responsible for allocating it. Many people did not seek vaccination for reasons beyond the shortage, including concerns about safety and efficacy and the perceived low risk from influenza. Although some have suggested that this might have been a successful case of health care rationing, it might not be generalizable to shortages of vaccines for other diseases. [ABSTRACT FROM AUTHOR]