Jun. 18--California voters of all political stripes strongly believe America's health care system needs fundamental change and overwhelmingly support a plan to allow people to choose between public and private health plans.

But sharp partisan divisions emerge over imposing new taxes so all Americans can have health insurance, according to a new California Field Poll.

The health policy survey of 1,207 registered voters showed that 88 percent of Democrats, 73 percent of nonpartisans and 55 percent of Republicans agree that the health care system either needs significant restructuring or should be completely rebuilt.

"There is bipartisan agreement that the health system needs some fundamental changes, and there is greater impatience that this should be done now," said Mark DiCamillo, director of the California Field Poll.

The poll, funded through a grant by the California Wellness Council, comes as President Barack Obama is calling for overhauling the health care system.

His insistence on a government program to compete with private insurers is infuriating some conservatives, who fear such a plan would drive insurance companies out of business. It is also drawing scorn from some liberals who want a single-payer, government-run program.


But 85 percent of respondents to the Field Poll said they support the general concept of allowing people a choice between privately run and government-run health plans.

"They're not necessarily endorsing the public plan or saying that they would choose it," DiCamillo said. "They just like having alternatives. The introduction of a public plan is supported because it would provide greater choices."

Sixty-nine percent of respondents supported requiring employers to offer health insurance to workers or pay into a government fund to cover uninsured Americans. And 74 percent backed expanding Medicare to cover people between 55 and 64.

But there was a sharp split over potential tax increases.

Asked whether they would be "willing to pay higher taxes so that every American can have health insurance," Democrats said "yes" by a 2-to-1 ratio. Republicans said "no" by a 3-to-1 ratio. And independent voters modestly favored the idea.

More than twice as many Democrats as Republicans strongly favored reducing tax deductions for families earning more than $250,000 to pay for health care.

Dr. Patrick Romano, a professor at the UC Davis Center for Health Care Policy and Research, said voters' view that "the system is fundamentally messed up -- creates an opportunity for advocates of health care reform."

But he added: "The (political) divisions have not changed. This is the problem that the president and Congress confront. The desire for universal coverage is very strong. The willingness to pay for it is not so strong."

Seventy percent of voters surveyed opposed imposing a national mandate for every American to maintain a minimal level of health insurance or be subject to a fine or tax penalty.

"People don't like to be told what they have to do," DiCamillo said. "There is a rub over who is going to have to pay and the requirement that everybody has to have coverage or pay a fine.

"Consumers are going to have to swallow that as a necessary part of the package, and they're not sure they want to."

But more than eight in 10 voters said they would support tax incentives for businesses offering health insurance, and more than two-thirds supported tax credits for moderate income residents buying insurance.

Marti Fisher, a policy advocate for the California Chamber of Commerce, said the poll results reflect voters' sensitivity to health care costs that may be borne by "small to mid-sized businesses that generally are least able to pay."

Only 11 percent of poll respondents said they favored a plan in which costs would be "mostly" paid for by the government. However, 68 percent favored a shared program paid for by individuals, employers and the government.


"What I think is happening is that people say they need something other than the insurance companies as they now exist," said Carolyn Negrete, Sacramento Valley spokeswoman for Health Care for All California, a group promoting a government-paid health system. "They don't yet grasp the idea that you can have a system that makes them (insurers) irrelevant."

The organization that paid for the poll, the California Wellness Foundation, provides grants for health promotion, wellness education and disease prevention. It seeks to address health needs of underserved populations, including rural and low-income residents and ethnic minorities.

Ten percent of respondents in the poll were residents who said they have no health insurance. An additional 44 percent said they were "very concerned" that they or someone close to them would be without health insurance "in the near future."

"I think that means people are hurting or are afraid that if they're not hurting now, they'll be hurting pretty soon," Negrete said.

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Call Peter Hecht, Bee Capitol Bureau, (916) 326-5539.