Statewide Survey Highlights Health Policy Concerns of Kansans

9 Min Read

Oct 19, 2006

By

Anthony Wellever

alt=""

Concern about the cost of health insurance, access to health services, and emerging public health issues has captured the attention of the public to a degree not seen in Kansas since the early 1990s. Which issues most concern Kansans, and what do they believe should be done about them? To find out, the Kansas Health Institute commissioned a poll of Kansans across the state to determine their attitudes and opinions about health and health care. Among the findings are:

Major Findings

    • 55% of currently insured Kansans say they are worried they may not be able to afford health insurance in the next six months.

Health Priorities

    • Kansans stated clear preferences for the state’s health care agenda, with 84% saying providing prescription drugs for low-income seniors was extremely or very important; 78% saying funding programs to help small businesses obtain affordable health insurance was extremely or very important; and 71% saying funding programs that help workers with low-incomes pay for their health insurance was extremely or very important.
    • The preferences stated by Kansans for the state’s public health agenda were also clear, with 81% saying that increasing funding for programs that provide immunizations to children was extremely or very important.

Funding Preferences

    • 64% of the public favored increas­ing taxes on alcohol and tobacco products, and 53% favored an increase in state sales tax from 5.3% to 5.8% to help low-income workers pay for health insurance.
    • Similarly, 64% of Kansans favored increasing taxes on alcohol and tobacco products, and 52% favored increasing state sales tax from 5.3% to 5.8% to pay for new public health programs.

Satisfaction With Health System

    • 67% said they were very or fairly satisfied with the Kansas health care system, and 74% said they were very or fairly satisfied with the state system designed to protect the community’s health (public health).

As the cost of health care has grown recently, driven by expenses such as prescription drugs and new technolo­gies, the price of health insurance pre­miums has increased at double-digit rates, causing many employers to shift a greater proportion of the cost of health benefits to employees and forcing some employers to cancel employer-spon­sored coverage altogether.

The percentage of uninsured Kansans has surely grown in the past two years. (10.5 percent of Kansans were unin­sured in 2001.) Many of those who have insurance are worried about losing it, and some are foregoing needed care because they cannot afford the cost of deductibles and co-payments.

Against this backdrop, new health issues have emerged in the form of bioterrorism preparedness and coping with the growing epidemic of obesity and its consequences for chronic dis­eases such as diabetes and heart disease.

To better understand the public’s opinions and attitudes about current health and health care issues, the Kansas Health Institute contracted with Harvard University pollster Robert Blendon to survey Kansans across the state. This Issue Brief is a summary of the major findings from the poll.

Health Priorities

Asked to name in their own words the most important health care issues for Kansas state government to address, 31 percent of Kansans said health care costs (18 percent general health care costs and 13 percent prescription drug costs), and 23 percent said the uninsured and inade­quate health insurance coverage. These priorities are reflected in answers to questions about specific policy proposals. The figure at left shows the percent of the public that said these policies were an extremely or very important pri­ority for the state’s health care agenda.

Depending on the outcome of the ongoing Medicare reform debate, states may have an expanded role to play in assisting low-income seniors to pay for prescription costs not covered by a Medicare expansion. Reflecting concern over health care costs, public support was strong for helping small businesses obtain affordable health insurance for their employees and for helping low-income workers pay for their insurance costs.

The figure at left shows Kansans’ priorities for the state’s public health agenda, which greatly favors pro­grams and policies targeted at children. Various reports have shown that Kansas ranks near the bottom of states in child­hood immunization rates. Many experts believe that rates of adolescent and adult obesity are best controlled by promoting good dietary habits early in life.

Bar chart showing top priorities for the state's health care and public health agendas. Tope priority is providing prescription drug coverage for low-income seniors.

Funding Preferences

A majority of Kansans are willing to increase taxes to help low-income work­ers pay for health insurance and to sup­port public health programs. Specifically, 64 percent of Kansas resi­dents said they would increase taxes on alcohol and tobacco products to fund these policies. A somewhat smaller majority of Kansans (53 percent) favored an increase of one-half of one percent (from 5.3 percent to 5.8 percent) in the state sales tax to help low-income workers obtain health insurance and 52 percent favored an increase in state sales tax to fund public health programs.

Bar chart showing percent of Kansans favoring increased taxes to help low-income workers pay for health insurance and to fund new public health programs. 64% wanted increased state taxes on alcohol and tobacco products.

While a majority of Kansans favored increasing taxes to pay for high-priority health and health care programs, most opposed reducing spending on other government programs to fund them. The budget tradeoffs receiving the highest support were reducing aid to cities and local governments (44 percent) and reducing spending on state highway programs (supported by 42 percent to help low-income workers obtain health insurance and 39 percent to fund public health programs).

Satisfaction

Two-thirds of Kansans are very or fairly satisfied with the current health care sys­tem, although 50 percent say that insur­ance companies are doing a bad job in serving health care consumers, 45 per­cent say that HMOs and managed care plans are doing a bad job, and 42 per­cent say that pharmaceutical companies are doing a bad job. In contrast, satisfaction with nurses, pharmacists, and physi­cians is relatively high.

This finding seems to indicate that most residents are satisfied with the cur­rent health care delivery system in Kansas and that they have highly favorable opinions of the providers from whom they receive care. Dissatisfaction with the health care system in Kansas appears to be primarily associated with concerns about the cost and availability of health services and insurance.

When asked if they were satisfied with the state system designed to pro­tect the community’s health and stop the spread of disease, 74 percent said they were very or fairly satisfied. Only five percent of the public said that they were not satisfied at all with Kansas’ public health system.

Threats to Access

Despite the high level of satisfaction with the health care system in Kansas, many residents had difficulty paying for or obtaining health care. Forty percent of Kansans without insurance said they did not obtain needed care in the last 12 months because of cost, and 45 percent said they had serious problems paying a medical bill. While those who were continuously insured had significantly fewer difficulties with cost and access than those without insurance, almost one in ten (nine percent) who had insurance said they did not receive needed care in the last 12 months because of cost. Fourteen percent reported they had a serious problem paying a medical bill. Fear of losing health insurance coverage or of not being able to afford care in the next six months is even more of a concern. Fifty-five percent of Kansans who are currently insured say they are very or somewhat worried that they may not be able to afford health insurance in the future, and 30 percent are very or somewhat worried they will lose their health insurance coverage. Forty-four percent of all Kansans say they are very or somewhat worried that they will not be able to afford the prescription drugs they need.

Bar chart showing worries about getting and paying and paying for health care in the next six months. Largest percentage were worried they might not be able to afford health insurance.

Conclusion

The anxiety about the future expressed in the survey is a likely cause of support for public programs to control the cost and improve availability of health services in Kansas. It also may explain the willingness of many people to support tax increases to help assure the continuation of a highly valued benefit that many consider essential to their and their families’ well-being. The opinions expressed by Kansans in this poll provide insight to policymakers contending with these difficult issues.

Information About the Poll

This telephone survey of 1,006 randomly selected Kansas residents, age 18 and older, was conducted by Harvard School of Public Health and International Communications Research between September 22 and September 29, 2003. The data were weighted to reflect the population of Kansas. The margin of error is plus or minus three percentage points.The study team included Robert J. Blendon, Catherine M. DesRoches, Elizabeth Raleigh, and John M. Benson, of the Harvard School of Public Health. Funding for this project was provided by the United Methodist Health Ministry Fund and the Kansas Health Foundation. The Kansas Health Foundation is a philanthropic organization whose mission is to improve the health of all Kansans.

About Kansas Health Institute

The Kansas Health Institute supports effective policymaking through nonpartisan research, education and engagement. KHI believes evidence-based information, objective analysis and civil dialogue enable policy leaders to be champions for a healthier Kansas. Established in 1995 with a multiyear grant from the Kansas Health Foundation, KHI is a nonprofit, nonpartisan educational organization based in Topeka.

Learn More About KHI