Want to know how Minnesotans think about the challenges, opportunities and priorities of the health system? The fastest way is to ask them about their politics. It turns out that ideology – not gender, education, employment or any other factor – is the key driver of the divisions on health care policy.
The HealthBasics research reveals that unless Minnesotans are able to bridge the ideological divide on health care, we won’t be able to solve the challenges of affordability and access. Among the major survey findings are the following:
My position on health reform? Just look at my politics
More than two-thirds of Minnesotans see the health system challenges and solutions through the perspective of their political ideologies. Conservatives place cost and quality above coverage, believe these goals are best reached through the marketplace and want the government largely to stay out of health care. Moderates and liberals are more inclined to put affordable universal coverage at the top of their priorities, and believe government is best able to deliver on these goals. Consistent with their views, they favor government action to control costs and compensation paid to executives.
We don’t play the blame game…too much
In spite of the ideological divide on health care, some hot-button issues haven’t reached the boiling point in Minnesota. For example, while a majority think there is too much waste, fraud and abuse in the health system, there isn’t much intensity on the issue. Likewise, health care spending for undocumented aliens or unemployed welfare recipients divides Minnesotans, but sentiment on both sides of those issues generates intense opinions among less than a third of the state’s adults. And while Minnesotans generally think that those who don’t take care of themselves should pay more for health insurance (and believe that those who exercise and don’t smoke should pay less), most of us aren’t willing to deny care in hospital emergency rooms or through public health programs to those who don’t buy health insurance.
We have a pretty good sense of where our health dollars are going…
Minnesotans generally have a good sense of where our health dollars are being spent. We know, for example, that hospitals (about one-third of health care spending) and physician services (about one-fifth) are the major expenses. We do overstate how much is spent on prescription drugs (the estimate is 18 percent versus real spending of less than 9 percent). (NOTE: The actual spending is based on data published by the Minnesota Department of Health in 2013).
…but don’t recognize the overall cost.
A bit less than one-fourth of us recognize that Minnesota spends more than the national average on health care. According to national data compiled by the Wall Street Journal in 2013 (based on 2009 spending, the latest year for which national data were available), Minnesotans spend $7,409 per capita, about 9 percent above the national average. For the money spent, Minnesotans have a health care system that is very highly regarded nationally. In fact, the Commonwealth Fund’s “Scorecard on State Health System Performance” called Minnesota’s health system the best in the nation in its 2014 report. This study is one of the most comprehensive evaluations of state health systems, using 42 indicators to measure access, quality and cost.
We recognize the cost drivers and agree on some solutions.
Minnesotans generally recognize that several trends are driving health costs higher, from an aging population to new drugs and technologies. We tend to place much more blame on hospitals charging too much than Americans in general (compared to a 2014 Kaiser Family Foundation survey). We offer a variety of solutions, and often there is broad consensus. For example, at least seven out of 10 Minnesotans believe limits should be set on prices charged by drug companies and health providers and on the compensation paid to executives in health organizations. We also believe that making available easy-to-understand information on how much hospitals and clinics charge for their services and the success rate of doctors would be effective in controlling health costs.
I’m not the problem. Solutions are for others.
A strong majority of Minnesotans say when it’s all said and done, we don’t want limits placed on our own interactions with the health system. We want whatever treatment is prescribed by a physician; we want to see specialists without referrals; and, we want our health insurance to pay the full cost of care. And never mind the contradictions. For example, while 52 percent agree that doctors often order too many tests and treatments that don’t really improve a patient’s health, only 41 percent agree (and 39 percent disagree) that insurance companies should work with medical professionals to evaluate the effectiveness of expensive treatments and services, then pay only for the ones that are most successful. In fact, 67 percent of us say that insurers should pay for every treatment or service a doctor prescribes.