Contradiction and Consensus

Making Sense of Public Opinion on Healthcare Policy

A recent consumer survey poses a complex analytical chore for policymakers on when, how, and how much government should be involved in healthcare. While a majority of consumers are distrustful of government-managed healthcare, large numbers favor federal intervention on drug pricing and expanded access to Medicare.

When it comes to a preference for more government versus less, consumers are sharply divided in roughly even proportions. Among those who distrust government, there is an interesting crossover when it comes to increased access to Medicare and federal intervention on drug prices. Among those comfortable with government involvement, very few support a full government takeover, often referred to as Medicare for all.

As Congress and the Biden-Harris Administration contemplate huge budget initiatives, public opinion will weigh heavily into the political calculus of what should versus can be done in healthcare. Conflicting opinions among respondents make it difficult to come away with a precise roadmap for healthcare reform. However, there is a broad base of support for the public/private partnership that currently exists.

The eHealth Health Insurance Trends report is based on a May 2021 poll of more than 4,700 consumers on topics ranging from the ACA and Medicare, to drug pricing, privacy and mandatory vaccinations. While sharp ideological differences account for some of the contrast in answers, the contradictions were a surprise.

For instance, only 16% of respondents feel that the government alone should run Medicare. Only and 20% percent believe the government is better than private enterprise when it comes to healthcare innovation. Yet a commanding 74% want the federal government to directly negotiate with drug makers to lower prices. An even larger number of Medicare beneficiaries — 86% — support for government involvement on drug prices.

Also contradicting the majority’s aversion to more government control: 60% of respondents favor expanded access to Medicare — either by lowering access to age 60 or by allowing those over 50 to buy in early.

While privacy is an issue for many consumers, most are willing to share their data with plan brokers if it results in lower costs and better coverage. The eHealth survey shows 54% of respondents and 59% of Medicare beneficiaries would share their claims history with a licensed agent if it helped them find a better plan.

We found similar contradictions in opinions about vaccination policy. While 54% say COVID vaccinations should not be required by law, a roughly equal number — 53% — say proof of vaccination should be required for all domestic and international air travel.

For all the contrast and contradiction, there are constants:

  • Healthcare policy is a complex and highly emotional topic
  • America is defined by a sharp ideological divide marked by high distrust in institutions. However many appreciate access to the ACA and a large majority support Medicare.
  • Americans are deeply and uniformly concerned about the cost of healthcare. Among self-described Democrats, Republicans and Independents, more than 55% identified monthly premiums, prescription drugs, and out-of-pocket costs as their number one concern. Roughly 70% of total respondents say they’ve experienced a “surprise” medical bill, mostly related to prescription drugs.
  • Many distrust both government and the private sector, but a majority of Americans continue to prefer their healthcare system to be managed by a public/private partnership.

From a partisan perspective, the survey results offer fodder for both the left and the right. Conservatives will applaud the small number of respondents who support a full-government takeover of healthcare. Progressives will point to the cross-over majorities that support government pressure on drug prices and Medicare expansion.

Is there a single healthcare solution that both sides can agree on? Probably not. However, there are opportunities where ideologies overlap and a consensus is possible.

Husband, father, CEO at eHealth. Passionate about fitness, privacy, information transparency, and healthcare policy.