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Three-Quarters of Americans and Industry Leaders Want Health Care Reform in President-elect Obama's First Term

Yet New Polling of Americans and Industry Thought Leaders Finds Competing Priorities

WASHINGTON, Nov. 20 /PRNewswire-USNewswire/ -- Three-quarters of Americans (75 percent) and health industry leaders (79 percent) expect major health care reform legislation to be passed in the first term of Barack Obama's presidency, according to findings of new polling released today by the National Association of Children's Hospitals and Related Institutions (NACHRI) and PricewaterhouseCoopers LLP (PwC). Approximately one-half of Americans polled are fearful they will not be able to afford health insurance (57 percent) or seek medical attention (52 percent) when they need it. Reducing costs in health care reform is the first health priority Americans want President-elect Obama to address, while expansion of health care coverage is the first priority among health care industry leaders.

The PwC/NACHRI polling "Perspectives on Priorities: A Survey of American Consumer and Industry Influencers on Health Care Reform Under the Obama Administration" asked the opinions of 1,000 American adults and more than 800 health industry influencers, including policy makers and executives from hospitals, insurance companies, pharmaceutical companies, associations and other major employers.

"It's clear that Americans and health industry leaders have reached a tipping point toward major health care reform," said Lawrence McAndrews, president and CEO of the National Association of Children's Hospitals and Related Institutions (NACHRI) "Yet these groups don't always agree on priorities. The two agendas -- reducing costs and expanding access -- may compete unless cost containment strategies are put in place and greater public-private collaboration is sought."

The release of the new survey findings corresponds with a national town hall meeting Proposals to Policy: A National Conversation on Health Care Reform taking place in Washington, D.C., today involving health policy experts. Sponsored by NACHRI and PwC, the meeting will bebroadcast live to locations across the country where children's hospitals and PwC offices will co-host local town hall meetings focusing on the impact of health care reform at the grassroots level. Hundreds of leaders from business, local government and the health care industry will participate in cities including San Francisco, Cleveland, Dallas, Miami, Philadelphia, Boston and New York.

The survey found demand is high for both cost reduction and expansion of coverage for the uninsured, but there is a difference of opinion about which should come first. When asked which should be the first priority for the new administration -- increase access, reduce costs or improve quality, slightly more than half (51 percent) of American consumers said reduce health care costs, 34 percent said expand coverage to the uninsured and 15 percent said improve the quality of care. The same question asked of health industry influencers found their first priority is to expand coverage. Sixty-one percent of industry influencers said expand health insurance to the uninsured, 25 percent said reduce health care costs and 14 percent said improve the quality of care

"The health system has been broken for a long time and can no longer pass around its flaws and inefficiencies in a market that is simultaneously demanding universal coverage and cost reduction," said David Levy, M.D., principal, health industries advisory practice, PricewaterhouseCoopers. "The good news for patients is that the chances for real reform are better than ever now. New consumer expectations, innovations in medical science and disruptive market forces are quickly changing the way that health care is financed and delivered. Like virtually all other industries, the health care value proposition will be reinvented around the needs of those it serves."

There is clear agreement among American consumers and industry leaders that covering uninsured children should be a top priority. A majority of Americans (67 percent) and health industry influencers (92 percent) would like President-elect Obama to expand health insurance from some children to ALL uninsured children in the United States. Among just health industry leaders, 70 percent support a proposal requiring all parents to provide health insurance for their children. "For a great nation like ours to have still so many uninsured children is unacceptable. Americans and health leaders understand that it is time to cover all uninsured children," said McAndrews.

Other key findings of the survey of American consumers include:

  • Nearly half (49 percent) of Americans surveyed that there are some good things about the U.S. health care system, but major changes are needed. One-third (34 percent) of Americans believe there is so much wrong with the health system that it needs to be completely rebuilt.

  • Three-quarters (75 percent) of Americans said that all of the health reform proposals made during the campaign are still not sufficient to address the fundamental problems in the U.S. health care system.

  • When asked whether government would do a better or worse job than private insurance companies in managing and paying for health insurance coverage, 40 percent of those surveyed said the government would do a worse job while 59 percent said it would do the same or better.

Health industry influencers were asked about specific reform proposals made during the campaign and whether they would be effective at reducing costs, expanding coverage or improving quality. Key findings include:

  • Health industry leaders were in close agreement on how to expand access, their top reform priority for the president-elect. Nearly three quarters (74 percent) support a mandate for all employers to offer health benefits or contribute to the cost of a public program to expand access. Seventy-eight percent believe that a mandate would help expand access and 18 percent think it would reduce costs.

  • Industry leaders are nearly unanimous (98 percent) in their support of investing in prevention programs for chronic illnesses and federal funding toward adoption of electronic medical records and other health information technology (87 percent). Many believe these investments are important for improving the quality of care (40 percent for chronic illnesses, 72 percent for technology).

  • When asked about ways to reduce costs, industry leaders point to the promotion of competition and individual choice among insurers by allowing insurance to be sold across state lines (55 percent) and the adoption of malpractice reforms (77 percent).

  • 78 percent of industry influencers support the provision of government subsidies to encourage small businesses to offer health insurance and 22 percent believe it would help to reduce health care costs.

  • 87 percent of industry influencers support the creation of a new national health program that would give individuals and small businesses the choice of buying affordable, portable health care coverage, and nearly one-quarter (24 percent) think that this would help reduce health care costs.

  • Nearly three quarters (74 percent) of industry influencers believe that pay for performance would improve the quality of healthcare, they are split on whether they support this kind of reimbursement reform.

The organizations that co-sponsored the polling and national town hall event, respectively, have issued resources to help inform priorities of health care reform from their perspectives.

The National Association of Children's Hospitals' Principles for Children's Coverage in Health Care Reform is available at

The PricewaterhouseCoopers's Health Research Institute report Healthcare Policy in an Obama Administration: Delivering on the Promise of Universal Coverage is available at

To view the national broadcast of Proposals to Policy: A National Conversation on Health Care Reform, go to at 1 pm ET, November 20.

Methodology and Demographics

The PwC/NACHRI online survey of 1,000 Americans was conducted between November 5 and November 10, 2008. Polling of 843 industry influencers was conducted online between October 10 and November 13. Industry influencers represented executives from hospitals, insurance companies, pharmaceutical companies, associations, policy leaders and other major employers in 13 U.S. metropolitan areas including Boston, Cleveland, Dallas, Detroit, Los Angeles, Miami, New York metropolitan area, Oakland, Palo Alto, Philadelphia, Seattle, St. Petersburg, Washington D.C.


The National Association of Children's Hospitals and Related Institutions (NACHRI) is a membership organization of children's hospitals with more than 218 members in the United States, Canada, Australia, China, Italy and the United Kingdom. NACHRI promotes the health and well-being of children and their families through support of children's hospitals and health systems that are committed to excellence in providing health care to children. It does so through education, research, health promotion and advocacy.

About PricewaterhouseCoopers' Health Industries Group

PricewaterhouseCoopers' Health Industries serves as a catalyst for change and the leading advisor to organizations across the health continuum, including payers, providers, health sciences, biotech/medical devices, pharmaceutical and employer practices in the public, private and academic sectors.

PricewaterhouseCoopers' Health Industries' clients include both 40 of the top 100 hospitals in the U.S. and 16 of the 18 best hospitals as ranked by US News & World Report; all 20 of the world's major pharmaceutical companies; all of the top 20 commercial payers in the U.S.; municipal, state and federal government agencies; and many of the world's preeminent medical foundations and associations.

About PricewaterhouseCoopers

PricewaterhouseCoopers ( provides industry-focused assurance, tax and advisory services to build public trust and enhance value for its clients and their stakeholders. More than 155,000 people in 153 countries across our network share their thinking, experience and solutions to develop fresh perspectives and practical advice.

"PricewaterhouseCoopers" refers to PricewaterhouseCoopers LLP or, as the context requires, the PricewaterhouseCoopers global network or other member firms of the network, each of which is a separate and independent legal entity.

SOURCE National Association of Children's Hospitals and Related Institutions; PricewaterhouseCoopers
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