WASHINGTON, Feb. 26 (UPI) -- Nine out of 10 Americans want healthcare reform, but they are divided over how much, what kind, and who they trust to do it, a new UPI/Zogby poll says.
As campaign season begins to pick up steam, an equal percentage of respondents, 45 percent, said they supported major reform and minor reform. They were similarly split between wanting market-based and government-based solutions.
Less than one-third said they trust President Bush to handle healthcare issues, but the Democratic Congress, at 45 percent, did not have the trust of a majority of voters either. One in five of those surveyed said they do not trust either of them.
What that means, many experts say, is that successful reform proposals will reach across the political spectrum to incorporate both government and private-sector reforms.
"People want change, they just don't agree about it," Harvard health policy professor Robert Blendon told United Press International.
"The momentum for reform is not enough to make something happen," he said. "There has to be a hybrid proposal and political leadership.
"They're not wedded to the way experts and parties have defined the debate."
The poll's results support that theory: 56 percent of those surveyed said they support a plan enacted in Massachusetts and a similar proposal in California that require individuals, the government and employers to all chip in to cover the uninsured.
While the public will not support purely government-funded reforms, Blendon said, they are also not enthused about Bush's plans to lower costs through tax reforms and greater consumer responsibility. That is because they are concerned about the "pocketbook issue" of being able to afford insurance, not the broader social problem of rising overall healthcare costs.
"Consumers are saying, 'Help me pay for healthcare,' not, 'Give me a plan with a $2,000 deductible to hold down healthcare costs,'" Blendon added. People see Bush's proposal as a "smaller vision in a world that's about to have a larger debate. Republicans are likely in 2008 to talk more broadly than just the president's plan."
The division between those who prefer government-based and market-based plans is not new, said Ron Pollack, executive director of Families USA, a healthcare consumer advocacy group.
What is new is the willingness to compromise, he told UPI, as evidenced by unlikely coalitions of labor unions, employer groups, insurance companies and healthcare provider associations to cover the uninsured.
"People have found virtue in a second-favorite approach rather than nothing. Before, every group came in with a top-priority proposal, and if it wasn't possible, they walked away from the table."
The poll data also obscure an area of remarkable consensus, he said, around making sure all children have health insurance -- an issue Congress will have to address this year when the State Children's Health Insurance Program comes up for reauthorization.
That new spirit of compromise, however, may not make it into the next election, Pollack said.
"During the campaign season is not the time when you get thoughtful compromise. You try to attract and motivate different constituents.
"But concern about healthcare has been catapulted to the top of the agenda. Any thoughtful candidate who wins will have to do something that involves a mix of approaches to get reform through Congress."
The public's range of opinion, combined with the upcoming election season, could also open up an opportunity for voters to learn more about the various plans on the table, James T. Kahn, professor of health policy at the University of California, San Francisco, told UPI.
"The new crew of politicians have an option to look at everything on the table and see what works best. This is a chance to act on the flexibility the public is giving them," Kahn said.
"There is an educational process even in the politically charged election season. The public wants to know whatever choice there is will make them do as well or better."
The downside of election season is that some groups may try to sway the public away from the center, he said. "These policies are hard to understand, and political groups may try to influence the public one way or the other."