The public favors reducing jury awards in malpractice lawsuits and allowing drugs to be imported from Canada, but ranks them relatively low on a list of 12 health care priorities for President Bush and Congress to address this year, according to a new post-election survey conducted by the Kaiser Family Foundation and the Harvard School of Public Health.
Just over a quarter (26%) of the public cite reducing malpractice jury awards as a top priority for the President and Congress, ranking 11th on the list, just ahead of increasing federal funding for stem cell research (21%). Just under a third (31%) cite allowing drugs to be imported from Canada as a top priority, ranking eighth on the priority list.
At the top of the list, almost two thirds (63%) of U.S. adults cite lowering the costs of health care and health insurance as a top priority for the President and Congress, followed by making Medicare more fiscally sound for the future (58%) and increasing the number of Americans with health insurance (57%).
Overall, U.S. adults rank health care issues third when asked to name the single most important priority for the President and Congress to address. Fewer Americans cite health care issues (10%) than the war in Iraq (27%) or economic issues (17%). Terrorism/national security (10%) tied with health care as the third-most cited issue. The survey is based on a nationally representative sample of 1,396 adults and was conducted from Nov. 4-28, 2004.
Malpractice reforms
The survey finds that the public sees malpractice lawsuits as a significant factor in rising health care costs and generally sees the number of lawsuits as a bigger problem than the size of jury awards.
“The public isn’t pushing hard for malpractice reform, but will be happy to have it if the lawyers, doctors, Administration and Congress can agree to a plan,” Foundation President Drew E. Altman, Ph.D., said.
Almost a third (32%) of people say that the most important factor in causing rising malpractice insurance rates is too many lawyers filing unwarranted lawsuits, while 15% say it is the high profits of malpractice insurers, 14% say it is too many patients making unwarranted claims against doctors, and 11% say it is too many doctors making mistakes. While most of the policy debate has focused on putting caps on jury awards, 9% cite “too many juries making excessive awards” as the most important reason malpractice costs are rising.
More than seven in 10 (72%) people say they would favor legislation to prohibit people from filing medical malpractice lawsuits unless a qualified independent medical specialist reviewed the claim and thought it was reasonable. More than six in 10 (63%) say they would favor legislation that would limit the amount of money that can be awarded as damages for pain and suffering to someone suing a doctor for malpractice.
Among the 63% who support a cap on damages for pain and suffering, most favor a relatively high cap; 30% of this group favors a cap of $1 million or higher, 23% favor a $500,000 cap, 16% favor a $250,000 cap, and 15% favor a cap of less than $250,000. (The remaining 17% say they either don’t know or wouldn’t say what cap they would favor.)
Most of the public also believe that both damage caps and requiring independent medical review would have at least some impact on the overall cost of health care in the United States. About seven in 10 say that a law limiting pain and suffering awards would help a lot (32%) or some (37%) in reducing the overall cost of health care, while a quarter (25%) say it would not help much or not at all. Similarly, about three-quarters say that a law requiring independent medical review of claims would help a lot (32%) or some (43%) in lowering overall health costs, while about a quarter (23%) say it would not help much or not at all.
Republicans (37%) are more likely than Democrats (17%) to say that reducing jury awards in malpractice lawsuits should be a top priority, and they are also more likely to favor various malpractice reforms and to think that these reforms would help in reducing the overall cost of health care in the U.S.
Health care costs
Lowering the cost of health care and insurance was named as a top priority for the President and Congress by 63% of the public, and by an equal share of Republicans (61%) and Democrats (61%). Asked about the causes of rising health care costs, 29% of Americans say that high profits made by drug and insurance companies are the most important factor, while 22% say the number of malpractice lawsuits and 15% say the amount of greed and waste that occurs in the health care system. In comparison, 7% cite the costs of medical technology and drugs, a factor many health care experts cite as a major driver of higher health care costs.
Specific proposals to lower prescription drug costs
The survey finds that the public continues to support two prominent policy proposals for lowering the cost of prescription drugs: allowing the importation of drugs from Canada, and having the federal government negotiate with drug companies for lower prescription drug prices for people with Medicare.
Almost three quarters (73%) say they favor changing the law to allow Americans to buy prescription drugs imported from Canada if they think they can get a lower price, with nearly as many (69%) agreeing that the change would make medicines more affordable without sacrificing safety or quality. Seven in 10 (70%) disagree that allowing imported drugs from Canada would lead U.S. drug companies to do less research and development, and more than half (57%) disagree that it would expose Americans to unsafe medicines from other countries.
Eight in 10 (80%) say they favor changing the law to allow the federal government to use its buying power to negotiate with drug companies to try to get a lower price for prescription drugs for people with Medicare.
Majorities say that such a change would make medicines more affordable for people on Medicare (77%), and that it makes sense because the government already negotiates prices for the Departments of Defense and Veterans Affairs (67%). While 54% say such a change will mean government price controls on prescription drugs, a smaller share (29%) say it would lead U.S. drug companies to do less research and development.