1 #1546 Minnesota Health Care Opinion Poll Study prepared for: Minnesota Citizens Forum on Health Care Costs prepared by: Market Response International project :: 1546 January 9 :: 2004 ( photo of client product or concept, or related graphic ) This survey was financed in part by grant number G0301MNBS24 from the Department of Health and Human Services, Administration on Developmental Disabilities, under provisions of Public Law 106-402. The content of this survey does not necessarily reflect the position or policy of the Administration on Developmental Disabilities or the Minnesota Department of Administration. 2 #1546 table of contents page 1 :: project overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2 :: detailed findings health care satisfaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 current health insurance coverage . . . . . . . . . . . . . . . . . . . 10 perceptions of health care costs . . . . . . . . . . . . . . . . . . . . . 13 opinions regarding health care services . . . . . . . . . . . . . . . 16 households with a person with a disability . . . . . . . . . . . . . 24 health care attitudes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 3 :: summary of findings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 3 #1546 1 :: project overview 4 #1546 background and objectives The Minnesota Governor's Council on Developmental Disabilities and the Minnesota Board on Aging commissioned MarketResponse International to gather opinions from Minnesotans regarding their current feelings on many key issues related to health care. Specific objectives of this study were to obtain measures such as: - Current satisfaction with health care quality and costs, in general for the U.S. and specifically for Minnesotans based on their own personal experiences. - Current level and types of health care insurance coverage, and related attitudes/satisfaction. - Perceptions regarding changes in health care costs and payment responsibilities. - Attitudes and values regarding a range of health care coverage, costs and social responsibility issues. - Preferences for universal health care vs. private health care insurance, and related trade offs and opinions. research design A quantitative survey instrument was constructed and administered via telephone by professional interviewers to 800 randomly selected Minnesotans. To ensure the sample adequately represented the Minnesota population, a random digit dialing (RDD) list was purchased and utilized throughout the fieldwork process. The questionnaire was administered using computer aided telephone interviewing (CATI), to maximize data collection efficiency and minimize the potential for measurement error. The survey was conducted from November 19th to November 30th, when the chosen sample size, n=800, had been reached. Given a sample size of 800, one can say with 95% confidence that the error attributable to sampling could be as much as 3.5% in either direction. project overview project overview 5 #1546 sample description: respondent profiles Household Income: Respondent Sample Minnesota Population (Base)(n=800) (N=5,064,000) % % Less than $10,000 3 6 $10,000 - $14,999 4 5 $15,000 - $24,999 10 10 $25,000 - $34,999 11 11 $35,000 - $49,999 16 16 $50,000 - $74,999 20 22 $75,000 - $99,999 11 13 $100,000 - $149,999 6 10 More than $150,000 3 5 Don't know / Refused 17 -- Age: Respondent Sample Minnesota Population (Base)(n=796) (N=5,064,000) % % 15 - 19 1 8 20 - 24 4 7 25 - 34 14 13 35 - 44 21 16 45 - 54 23 15 55 - 64 18 10 65 - 74 12 6 75 and older 9 6 Race: Respondent Sample Minnesota Population (Base)(n=800) (N=5,064,000) % % White, Caucasian 92.9 89.4 Black or African American 1.9 3.5 Hispanic .9 3.5 Native American 1.3 1.1 Asian / Pacific Islander .8 2.9 Other .8 1.3 Don't know / Refused 1.5 -.- The random digit dial (RDD) sample was employed in order to include Minnesota households with either listed or unlisted telephone numbers. The RDD sample was drawn in a way that reflects the distribution of Minnesotans across the state. The process of dialing randomly through this sample of phone numbers resulted in a survey sample profile that reflects the profile of the state population, as shown on this page. 6 #1546 questionnaire design The interview took approximately 20 minutes to complete;the questionnaire was entirely structured,with no open-ended questions. Overall health care satisfaction Health care costs Stance on imported prescription drugs issue Attitudinal statements Universal health care issues Classification questions/demographic information 7 #1546 2:: 2:: detailed findings 8 #1546 Minnesotans are generally more satisfied with the quality of health care they receive personally, than they are with the overall US system. However, half of the state's population is dissatisfied with their health care costs. Overall satisfaction, US Health Care Quality Satisfaction with: The quality of health care you receive Total amount you pay for health insurance & health care Your ability to get a doctor's appt. when you want The amount of time you are able to spend w/ your doctor Your ability to see medical specialists, if you ever need one Your ability to get the newest drugs and treatments The quality of your medical provider The kind of advice you get from your doctor regarding the actions you can take to help improve your health Overall satisfaction, US Health Care Costs health care satisfaction 9 #1546 Satisfaction with US health care quality is related to age and income. . . Older Minnesotans tend to be the most satisfied. Younger ones are more ambivalent The higher your income the more likely you are to be very satisfied with US health care quality. Almost 1 in 5 of those in the lowest income bracket are very dissatisfied with health care quality Denotes statistically significant differences at the 95% confidence level. 10 #1546 All things considered, how would you rate your overall health insurance coverage? (Base=758) Excellent 27% Good 46% Fair 21% Poor 7% All things considered, how would you rate your overall health insurance coverage? (Base=758) Excellent 27% Good 46% Fair 21% Poor 7% What type of coverage do you have? (Base=758) Private medical insurance through an employer or self paid 83% Medicare (government health insurance program for people 65 and over 20% Medicaid, Medical Assistance or Minnesota Care (government program for low income families) 7% What type of coverage do you have? (Base=758) Private medical insurance through an employer or self paid 83% Medicare (government health insurance program for people 65 and over 20% Medicaid, Medical Assistance or Minnesota Care (government program for low income families) 7% Do you have some form of health insurance or health care coverage, including either private medical insurance through an employer or selfpaid, or a public program such as Medicare, Minnesota Care, etc.? (Base = 800) Yes 95% No 5% current health insurance coverage Ninety-five percent of the survey respondents report having some kind of health insurance coverage; four out of five of those with coverage have private medical insurance, either exclusively or in combination with public insurance. Based on the overall ratings there appears to be room for improvement in Minnesotans' perceptions of their health insurance ncoverage. ABCNEWS Poll Comparison: National results showed that a greater majority of Minnesotans are insured than those in the national poll. 83% of the national poll were insured and 17% were uninsured. 11 #1546 All things considered, how would you rate your overall health insurance coverage? Percent rating their overall health insurance as Excellent or Good. 67 83 76 74 $100K+ $50-99K $25-49K <$25K Top 2 box ratings for overall health insurance coverage, among Minnesotans who are currently insured, shows that older MN citizens and higher income MN citizens are significantly more likely to give a good or excellent rating of their personal health insurance coverage, as compared to younger and/or lower income Minnesotans. Denotes statistically significant differences at the 95% confidence level. 12 #1546 current health insurance coverage Do you have some form of health insurance or health care coverage, including either private medical insurance through an employer or self-paid, or a public program such as Medicare, Minnesota Care, etc.? The highest proportions of Minnesotans without health care insurance can be found among young adults (ages 18-24), and among lower income households. Higher concentrations of uninsured Minnesotans can be found living in Minnesota's cities. Denotes statistically significant differences at the 95% confidence level. ?? Age Yes No (Base) % % <25 (n=37) 84 16 25-44 (n=275) 95 5 45-64 (n=322) 94 6 65+ (n=162) 99 1 Age Yes No (Base) % % <25 (n=37) 84 16 25-44 (n=275) 95 5 45-64 (n=322) 94 6 65+ (n=162) 99 1 Total annual household income Yes No (Base) % % <$25K (n=136) 88 12 $25-49K (n=221) 92 8 $50-99K (n=236) 99 1 $100K+ (n=67) 97 3 Total annual household income Yes No (Base) % % <$25K (n=136) 88 12 $25-49K (n=221) 92 8 $50-99K (n=236) 99 1 $100K+ (n=67) 97 3 Geographic Location Yes No (Base) % % Twin Cities (n=87) 90 10 Suburban (n=284) 98 2 Small City (n=129) 91 9 Small Town (n=191) 95 5 Rural (n=109) 94 6 Geographic Location Yes No (Base) % % Twin Cities (n=87) 90 10 Suburban (n=284) 98 2 Small City (n=129) 91 9 Small Town (n=191) 95 5 Rural (n=109) 94 6 13 #1546 Thinking about the past few years, does it seem like your employer is paying more, the same or less of the cost of your health insurance? (Base=489) Employer is paying more 24% Employer is paying about the same 37% Employer is paying less 32% Don't know 8% Thinking about the past few years, does it seem like your employer is paying more, the same or less of the cost of your health insurance? (Base=489) Employer is paying more 24% Employer is paying about the same 37% Employer is paying less 32% Don't know 8% AMONG THOSE PRIVATELY INSURED: Employer pays all 14% Employer pays some 64% Employee pays all 22% Approximately 3 out of 4 Minnesotans have private health insurance coverage paid for partially or entirely by their employer; of that population, one-third believe that over the past few years theiremployers have decreased their share of payment for the employees' health insurance coverage. perceptions of health care costs perceptions of health care costs (Base = 628) 14 #1546 IF INSURED: Does it seem to you that your health insurance costs have been going up, going down or staying the same over the past couple of years? perceptions of health care costs Going up 89% Stay same 9% (Base=758) Going down 1% Have they been going up a lot, or somewhat? (Base=671) A lot 58% Somewhat 42% Most Minnesotans perceive that health care costs have been going up in recent years, and over half think they have been going up a lot. These perceptions are equally strong among those from all income categories and most age categories,except the youngest group, under age 25. ABCNEWS Poll Comparison: The results showed that costs have remained more consistent from a national perspective as compared to MN results. Only 66% of national respondents reported an increase in costs.Of the people that believe they are increasing most (51%) believe it is somewhat of an increase. 15 #1546 Are you generally satisfied or dissatisfied with the total cost you pay for yourself and/or family for health care in this country? opinions regarding health care costs opinions regarding health care costs (Base=800) Total annual household income <$25K $25-49K $50-99K $100K+ (Top 2 Boxes) Very and Somewhat Satisfied38% 37% 44% 57% ------- ------- ------- ------- ------- ------- ------- Very Dissatisfied 32% 35% 29% 16% Total annual household income <$25K $25-49K $50-99K $100K+ (Top 2 Boxes) Very and Somewhat Satisfied 38% 37% 44% 57% ------- ------- ------- ------- ------- ------- ------- Very Dissatisfied 32% 35% 29% 16% 16% 32% 27% 26% Denotes statistically significant differences at the 95% confidence level. Satisfaction with health care costs is related to income. Those in the highest income category are most likely to be satisfied, and least likely to be very dissatisfied with health care costs. 16 #1546 Which statement do you agree with more? opinions regarding health care services opinions regarding health care services 82% 82% 18% 18% (Base=796) People have the responsibility not to overuse health care services because it increases insurance costs for everyone else; or People have the right to use as much health care as they want. Age % % <25 68 32 25-44 77 22 45-64 84 16 65+ 89 11 Age % % <25 68 32 25-44 77 22 45-64 84 16 65+ 89 11 Responsibility not to overuse Have the right to use as much as I want Here is evidence of a kind of wisdom that is gained with age. As Minnesotans grow older they are more likely to believe in personal responsibility when it comes to using (and not abusing) health care services. On the other hand, almost one out of five Minnesotans overall feel health care services are a kind of unlimited entitlement. Denotes statistically significant differences at the 95% confidence level. ?? 17 #1546 Which statement do you agree with more? (Base=795) The government should do something to reduce the price of prescription drugs. 81% The government should not get involved in drug pricing issues. 19% Location % % Twin Cities 89 11 Suburb 84 16 Small city 79 21 Small town 80 20 Rural 74 26 Location % % Twin Cities 89 11 Suburb 84 16 Small city 79 21 Small town 80 20 Rural 74 26 Gov't should do something to reduce drug prices Gov't should not get involved There appears to be an interesting relationship between proximity to the Twin Cities and trust in government involvement in prescription drug pricing. Those living in the rural areas are more likely to believe that government should not get involved; however, even there, the majority opinion is that government should do something to reduce the price of prescription drugs. opinions regarding health care services opinions regarding health care services Denotes statistically significant differences at the 95% confidence level. 18 #1546 Have you or anyone in your household ever bought prescription drugs from Canada or from another foreign country in order to get a better price? (Base=800) Yes 7% No 93% opinions regarding health care services While only a relative few Minnesotans (7%) have bought prescription drugs from a foreign country, a clear majority believe it should be legal. Do you think it should be legal or illegal for Americans to buy prescription drugs from Canada, Europe, or other industrialized countries? Legal 87% Illegal 13% (Base=793) ABCNEWS Poll Comparison: At the national level, a higher percentage of respondents (12%) have purchased drugs from a foreign country than in Minnesota. However, more national respondents believe that buying prescription drugs from a foreign country should be illegal (29% v. 13% in Minnesota). 19 #1546 Which of these do you think is more important? Providing health care coverage for all Americans, even if it means raising taxes 80% Holding down taxes, even if it means some Americans do not have health care coverage. 20% (Base=795) opinions regarding health care services opinions regarding health care services Eight out of ten Minnesotans are willing to pay higher taxes in order to ensure that all Americans have health care coverage. ABCNEWS Poll Comparison: The response was very similar in the national poll with 17% favoring holding down taxes and 80% favoring providing health care for all Americans. 80% 80% 20% 20% 20 #1546 Which would you prefer? (Base=795) A universal system where the government insures that everyone has health coverage; or A private system that relies on individuals and employers to provide for their own health care needs. 56% 56% 44% 44% opinions regarding health care services opinions regarding health care services <$25K $25K to $49K $50K to $99K >$100K Total Household Income 65% 65% 35% 35% 65% 65% 35% 35% 48% 48% 52% 52% 46% 46% 54% 54% Among the Minnesota population as a whole, there is a slight preference for a universal health care system over a private system. Given the sample of 800,one can be 95% confident that estimates such as these are accurate within ± 4 percentage points. Therefore, we can say that somewhere between 52% and 60% of Minnesotans would prefer a universal health care system. Preference for universal vs. private health care system is strongly related to total household income. Among those whose income is lower than $50K annually, two-thirds prefer universal health care vs. one-third preferring a private system. Whereas, among those earning more than $50K, there are slightly higher percentages preferring the private system. Denotes statistically significant differences at the 95% confidence level. 21 #1546 ABCNEWS Poll Comparison: The Minnesota and national surveys yielded similar results from respondents regarding their belief in a universal health coverage system. It should be noted that the more detailed description presented by the ABCNEWS national study may have influenced the higher preference for the universal program. opinions regarding health care services opinions regarding health care services From Minnesota study- Which would you prefer? A universal system where the government insures that everyone has health coverage; or A private system that relies on individuals and employers to provide for their own health care needs. 56% 56% 44% 44% From ABCNEWS national study- Which would you prefer? A universal insurance program,in which everyone is covered under a program like Medicare that's run by the government and financed by the taxpayers; or The current health insurance system in the U.S., in which most people get their health insurance from private employers, but some people have no insurance 62% 62% 32% 32% 22 #1546 56% 56% 44% 44% Which would you prefer? (Base=795) A universal system where the government insures that everyone has health coverage; or A private system that relies on individuals and employers to provide for their own health care needs. TOTAL 45% 55% Age <25 70 30 25-44 51 49 45-64 42 58 65+ 32 68 TOTAL 45% 55% Age <25 70 30 25-44 51 49 45-64 42 58 65+ 32 68 Support Oppose (Base=446) Would you support or prefer a universal health care system if it limited your choice of doctors? TOTAL 59% 41% TOTAL 59% 41% Support Oppose (Base=446) Would you support or oppose a universal health care system if it meant there were waiting lists for some non-emergency treatments? opinions regarding health care services opinions regarding health care services Among those who would prefer a universal health care system, about half would change their minds and oppose the system if it limited their choice of doctors. The level of opposition is related to age; that is, the older you get the more likely you are to insist on your choice of doctors. If universal health care brings waiting lists for some nonemergency treatments, about 4 out of 10 proponents would then become opposed to universal health care. Denotes statistically significant differences at the 95% confidence level. ABCNEWS Poll Comparison: The national survey showed higher support for a universal system than Minnesotans -- even with limited choice of doctors (national 56% support v. 45% in Minnesota) or waiting lists for some non-emergency treatments (63% support v. 59% in Minnesota). Again slight wording differences in the two studies may have impacted results. 23 #1546 If you had to choose, which of the following approaches to universal health care would you prefer? (Base=795) A system completely run by the government; or A system where government insures that everyone has health insurance coverage, but the health care industry would remain in the private sector. 18% 18% 82% 82% TOTAL 18% 82% Income <$25K 24 77 $25-49K 24 76 $50-99K 15 86 $100K+ 8 92 TOTAL 18% 82% Income <$25K 24 77 $25-49K 24 76 $50-99K 15 86 $100K+ 8 92 System completely run by gov't System where gov't insures coverage, but health care industry remains in private sector opinions regarding health care services opinions regarding health care services Although a majority of Minnesotans, regardless of income, prefer a universal system where government insures coverage over a system completely run by the government, the preference is more prevalent among those in the higher income categories. Denotes statistically significant differences at the 95% confidence level. ?? 24 #1546 17% 17% Yes Yes 83% 83% No No (Base = 800) Has this disability occurred within the last 6 months or is it more longer term? (n=134) Last 6 months. . . . . . . . . . . . . . . . . 5% Longer term . . . . . . . . . . . . . . . . . . 95% Do you or does anyone in your household have a physical, mental, sensory, or emotional disability? Seventeen percent (17%) of Minnesota households report having someone in the household with a disability. Thirteen percent (13%) of those disabilities occurred at birth. households with a person with a disability households with a person with a disability Did this disability occur at birth, or later? (n=127) At birth. . . . . . . . . . . . . . . . . . . . . . 13% Later. . . . . . . . . . . . . . . . . . . . . . . . 80% Don't know. . . . . . . . . . . . . . . . . . . 6% Are you the person with the disability, or is it someone else in your household? (n=134) Me, respondent. . . . . . . . . . . . . . . . 54% Someone else. . . . . . . . . . . . . . . . . 46% 25 #1546 How serious was the condition or illness? (n=177) Very serious. . . . . . . . . . . . . . . . . 17% Somewhat serious. . . . . . . . . . . . 40% Not very serious. . . . . . . . . . . . . . 27% Not at all serious. . . . . . . . . . . . . . 16% 22% 22% Yes Yes 78% 78% No No Within the last 12 months, have you or a family member delayed any sort of medical treatment because of the cost you would have to pay? (Base = 800) About 1 out of 5 Minnesotans have delayed medical treatment because of cost; in over half of these cases the condition was serious 57% households with a person with a disability households with a person with a disability 29% 29% Yes Yes 71% 71% No No How serious was the condition or illness? (n=39) Very serious. . . . . . . . . . . . . . . . . 23% Somewhat serious. . . . . . . . . . . . 51% Not very serious. . . . . . . . . . . . . . 13% Not at all serious. . . . . . . . . . . . . . 13% 74% Among households with a disabled individual Among households with a disabled individual, more than 1 in 4 have delayed medical treatment because of cost; in almost three quarters of these cases the condition was serious (Base = 134) Among ALL households: ABCNEWS Poll Comparison: The MN results were nearly identical to the national results with the percentage that have delayed treatment (23%). 67% of the national respondents had a (very /somewhat) serious condition. 26 #1546 35 48 Yes No (Base) (123) (625) % % Private medical insurance 73 87 Medicare 23 19 Medicaid, Medical Assistance or MinnesotaCare 14 5 H.H. with individual with a disability? IF INSURED: What type of coverage do you have? Denotes statistically significant differences at the 95% confidence level. % of Households with annual income > $50,000: H.H. with individual with a disability? Denotes statistically significant differences at the 90% confidence level. households with a person with a disability IF INSURED: In regards to your ability to afford the cost of your health care insurance over the next few years, would you say you are. . . Compared to all other households, those with an individual with a disability have lower income; and among those with insurance, there is a higher likelihood the provider is Medicaid or another government program for lower income people. Households with a person with a disability are also more likely to be worried about future health care insurance costs. Yes No (Base) (123) (625) % % Very worried 31 22 Somewhat worried 41 43 Not so worried 15 21 Not at all worried 14 14 Top 2 Box 72 65 27 #1546 Denotes statistically significant differences at the 95% confidence level. ?? Which would you prefer? households with a person with a disability households with a person with a disability A universal system where the government insures that everyone has health coverage; or A private system that relies on individuals and employers to provide for their own health care needs. H.H. with individual with a disability Base=134 66% 34% H.H. with no persons with a disability Base=661 54% 46% Households that have an individual with a disability are more likely to favor universal health care (two-thirds) as compared to all other households (about half). 28 #1546 People should not be turned away from necessary medical treatment, even if they are uninsured and cannot afford the treatment I should be able to choose any health care provider I want, including physicians and hospitals We have personal responsibility not to use more health care services than we need in order to keep health care costs affordable Percent Agreement with: Female 77% HH w/ Disblty 81% Age 65+ 80% Inc. < $25K 82% Inc. > $100K 55% Twin Cities 63% Sm. City 82% Inc. < $25K 69% Inc. > $100K 82% Twin Cities 62% Sm. City 75% Female 72% Inc. < $25K 75% Twin Cities 62% Sm. City 76% Top Box Demographics The most agreed to statement was related to choice of providers. This sentiment was particularly strong among women, households with an individual with a disability, senior citizens, lower income households and residents of small Minnesota cities. Personal responsibility was also strongly confirmed, with higher agreement from higher income households and small city residents, and lower agreement from lower income households and Twin Cities residents. Minnesotans believe that people should not be turned away from treatment. Women, low income, and small city residents feel particularly strongly about this. Denotes statistically significant differences at the 95% confidence level. 29 #1546 health care attitudes Percent Agreement with: I think it's a good idea that the government spends money on prevention, early detection of disease, and other community health related issues Female 69% Twin Cities 72% Sm. Town 61% Health care should be available to all citizens regardless of their income or employment status HH w/ Disblty 72% Inc. < $25K 71% Inc. > $100K 55% Twin Cities 74% Rural 60% Individuals whose health has been impacted through no fault of their own should not have to pay higher premiums than others Female 62% HH w/ Disblty 68% Age <25 38% Inc. < $25K 65% Inc. > $100K 46% Twin Cities 54% Sm. City 70% Most Minnesotans felt strongly that the government should be spending money on community health related issues - particularly women and Twin Cities residents. Most Minnesotans also believe that health care should be available to all citizens. Higher income households and rural residents were less likely to agree strongly with this. While most Minnesotans felt strongly that individuals whose health has been impacted through no fault of their own should not pay higher premiums than others;men, residents under age 25, upper income households, and Twin Cities residents were less likely to agree. Denotes statistically significant differences at the 95% confidence level. ?? 30 #1546 health care attitudes health care attitudes Percent Agreement with: People, such are the elderly and the disabled, who need more services than others should get them without paying more Female 62% HH w/ Disblty 69% Age 65+ 63% Inc. < $25K 66% Inc. > $100K 33% Employers should give employees a choice of more than one health plan Female 58% HH w/ Disblty 63% Age 65+ 34% Children's health care needs should take a priority in health care cost decisions Female 55% Sm. City 62% Sm. Town 47% Most Minnesotans believe that those who need more services should get them without paying more - with women, households with an individual with a disability, senior citizens,and low income households feeling particularly strongly about this. Most Minnesotans believe that employers should give a choice of health plans; however senior citizens were less likely to agree strongly with this. Most Minnesotans believe children's health care should be a priority, with females and residents of small cities feeling particularly strongly about this. Denotes statistically significant differences at the 95% confidence level. ?? 31 #1546 health care attitudes Percent Agreement with: Female 55% HH w/ Disblty 60% Inc. < $25K 58% Inc. > $100K 42% Twin Cities 59% Suburbs 42% The government should ensure access to health care providers for rural and low income populations 50 35 6 5 4 Everyone should pay something for their health care, with people paying varying amounts depending on what they can afford 49 35 4 6 6 HH w/ Disblty 58% Inc. < $25K 60% Inc. > $100K 37% It is the government's responsibility to make sure that patients receive safe, high quality medical care 48 28 6 11 8 Inc. < $25K 60% Inc. > $100K 39% Most Minnesotans believe that the government should ensure access to health care providers for rural and low income populations - particularly women, households with an individual with a disability, lower income households, and Twin Cities residents. Minnesotans believe that everyone should pay something for their health care, depending upon what they can afford. Households with an individual with a disability and lower income households had stronger agreement with this statement, while upper income households were less likely to agree strongly with this statement. While most Minnesotans believe that it is the government's responsibility to ensure high quality care , about one in five disagree. Agreement with this statement appears to be inversely related to income. Denotes statistically significant differences at the 95% confidence level. 32 #1546 The government should provide education and incentives to help people make wise choices regarding their health 44 33 6 9 9 health care attitudes health care attitudes Agree Neither Agree Disagree Strongly nor Disagree Strongly Percent Agreement with: Top Box Demographics Health insurance should pay for any kind of medical treatment, regardless of the cost 39 28 7 17 9 Female 41% HH w/ Disblty 51% Inc. < $25K 54% Inc. > $100K 18% Twin Cities 28% Sm. Town 44% If they can afford it, some people should be able to have a health care plan that covers more medical services than other health care plans 35 35 8 12 10 HH w/ Disblty 42% Inc. < $25K 43% Inc. > $100K 27% Sm. City 40% Rural 26% The cost of treatment, along with the chance of success,is a factor that should be considered in decisions regarding treatment 33 39 9 11 8 Three-fourths of Minnesotans believe that the government should provide education and incentives to help people with decisions regarding their health While Minnesotans tended to agree that health insurance should pay for any treatment - upper income households were more likely to disagree. People generally felt that if you can afford it you should be able to have more health care insurance coverage. Minnesotans, particularly Households with individuals with a disability, lower income households, and residents of small cities feel most strongly that cost of treatment and chance of success should be considered. Denotes statistically significant differences at the 95% confidence level. ?? 33 #1546 health care attitudes health care attitudes Agree Neither Agree Disagree Strongly nor Disagree Strongly Percent Agreement with: Top Box Demographics People should pay lower premiums for making healthy choices, such as exercising frequently 33 38 9 12 9 Age < 25 19% Inc. < $25K 27% Inc. > $100K 43% Our health care system should spend as much money as necessary to try to save a person's life 34 28 14 15 9 Female 37% HH w/ Disblty 43% Age < 25 43% Age 65+ 41% Inc. < $25K 47% Inc. > $100K 19% Suburbs 30% Sm. City 41% Male 41% HH w/o Dsblty 33% Inc. < $25K 27% Inc. > $100K 46% Twin Cities 16% People should pay higher premiums for bad habits, such as smoking or not exercising, that impact the cost of health care 31 31 10 14 14 Younger Minnesotans and lower income households were less likely to agree strongly that people should be rewarded for making healthy choices. Men, upper income households, and suburban residents were less likely to agree strongly with this statement. Six out of 10 Minnesotans believe the health care system should have no spending limits when it comes to saving a life. Men, households without an individual with a disability, and upper income households were more likely to agree strongly that people should be punished for bad habits. Denotes statistically significant differences at the 95% confidence level. ?? 34 #1546 health care attitudes Agree Neither Agree Disagree Strongly nor Disagree Strongly Percent Agreement with: Individuals or families who are likely to use more health care should be expected to pay higher premiums than others 13 26 9 25 27 If I want to smoke, drink or just not take good care of my health, that's my business. I shouldn't be penalized with higher health care costs 15 18 10 22 35 People should be denied health care if they make unhealthy lifestyle or behavior choices 9 15 10 33 34 Bottom Box Demographics Female 30% HH w/ Disblty 38% Inc. < $25K 38% Inc. > $100K 15% Twin Cities 32% Rural 19% Male 41% Age <25 19% Age 65+ 36% Female 37% Sm. City 43% Rural 29% Minnesotans were inclined to disagree with paying more for higher use of health care, particularly women, households with an individual with a disability, lower income households and Twin Cities residents. Here is a divisive issue for Minnesotans - while a third believe in privacy and/or the sanctity of free choice when it comes to personal health care, another third disagree strongly. Men, senior citizens,and upper income households were less concerned with the privacy of health decisions -- tending to believe that people who don't take care of themselves should be penalized with higher costs. The lowest rated statement was related to denying health care to individuals who make poor choices. Women and residents of small cities disagreed most strongly with this statement. Denotes statistically significant differences at the 95% confidence level. ?? 35 #1546 3 :: 3 :: summary of findings 36 #1546 While most Minnesotans are satisfied with the quality of health care in the US, well over half are dissatisfied with its costs. • Citizens of this state are more satisfied with US health care, as compared to the general US population, as measured in an ABCNEWS/Washington Post poll conducted in October 2003. • Older Minnesotans and those with higher incomes are most satisfied; whereas, almost 1 in 5 of those in the lowest income bracket are very dissatisfied with the quality of health care in the US. • Minnesotans are generally more satisfied with the quality of health care services they receive personally than they are with the overall US health care system. Summary of findings Ninety-five percent (95%) of Minnesotans have some form of health insurance. • A greater majority of Minnesotans are insured than those in the ABCNEWS national poll (95% Minnesotans v. 83% national respondents.) • While 73% rate their coverage as good or excellent, these positive ratings are more prevalent among older and higher income Minnesotans. • The highest proportion of Minnesotans without health care coverage can be found among young adults, ages 18-24, 16% of whom are not insured. • And 12% of those in the lowest income category (<$25K) do not have health insurance coverage. 37 #1546 Nine of ten Minnesotans believe their health care costs have been rising in recent years. • Over half believe costs have been going up a lot. • The perception of increasing costs appears to be stronger in Minnesota when compared to Americans in general. According to the ABCNEWS poll, 2/3 believe they are going up versus 89% of Minnesotans. Summary of findings Satisfaction with health care costs is related to income. • Those in the highest income category are most likely to be satisfied with the amount they pay for health care. • Among those whose total annual household income is less than $50k, one out of three are very dissatisfied with their health care costs. While only a relative few Minnesotans (7%) have bought prescriptions drugs from a foreign country, a clear majority (87%) believe it should be legal. • Four of five believe the government should do something to reduce the price of prescription drugs; only one in five believe government should not get involved in these issues. • Nationwide, a higher percentage (12%) have purchased foreign drugs; however, according to the ABCNEWS poll, more Americans believe it should be illegal (29%) compared to 13% of Minnesotans. 38 #1546 Summary of findings Most Minnesotans (4 of 5) believe all Americans should have health care coverage, even if it means raising taxes. • This response was very similar to that received in the ABCNEWS poll. Among the Minnesota population as a whole, a slight majority (56%) would favor a universal system where the government ensures that everyone has health coverage over a private system that relies on individuals and employers to provide for their own health care needs; however, the strength of the preference is questionable: • about half of the proponents would change their minds and oppose the universal health coverage system if it limited their choice of doctors; • and if the universal health coverage system brings waiting lists for some non-emergency treatments, then 4 of 10 proponents would then become opposed to it. • Most believe the best approach to a universal health care system would have government ensuring that all Americans have health care coverage, but the health care industry would remain in the private sector. Seventeen percent (17%) of Minnesota households report having someone in the household with a disability. • These households have a lower percentage of incomes over $50,000 (35% vs. 48%), and they are more likely to be worried about future affordability of health care insurance. . . . . . . . . . . . . . . . . . . . 39 #1546 Summary of findings Minnesotans showed very strong agreement (>90% agree strongly or somewhat) with the following health care concepts: • Ability to choose providers • Personal responsibility to keep health care affordable • People should not be turned away from the health care system • The government should provide money for prevention • Availability of health care shouldn't depend on income or employment Minnesotans showed strong agreement (>75% agree strongly or somewhat) with the following health care concepts: • Individuals with higher needs or special needs (elderly, disabled, low income, rural) should have access to needed health care • Everyone should pay something for their health care • The government has a responsibility to provide access, education, and ensure high quality care 40 #1546 Summary of findings Minnesotans showed agreement (50 - 75% agree strongly or somewhat) with the following health care concepts: • Health insurance should pay for any kind of treatment • Some people should be able to have better health care if they can afford it • Cost of treatment should be a factor in treatment decisions • People should pay lower premiums for healthy choices and higher premiums for bad habits • The system should spend as much as necessary to save a person's life Minnesotans showed disagreement (>50% disagree strongly or somewhat) with the following health care concepts: • Paying higher premiums for health care based on expected usage • Not being penalized (through higher costs) for not taking care of oneself • Denying people health care based on unhealthy lifestyles or behavior choices Demographic differences seen in these concepts were strongest related to income - with higher income households believing more in self-reliance and less government involvement