Public Questions Digital Fix For Health Care

A chart of the poll findings.

There's a big disconnect between American opinions about fixing the health care system and the view of experts and politicians, according to a new poll by NPR, the Kaiser Family Foundation and the Harvard School of Public Health.

The poll shows several areas of possible conflict as Democrats in Congress and the Obama administration forge ahead with their plans to reform the health system.

Last week, for example, President Obama said health care is a "pillar" of economic recovery, with electronic medical records at the center of his health plans. A system of electronic medical records would link doctors, hospitals and other health care providers so they can share medical records. Obama argued that putting records online would "save money and lives and reduce medical error." The new poll shows that many Americans accept the president's argument, but only to a point.

Robert Blendon, who runs polling programs at the Harvard School of Public Health, says people in the poll accept the president's argument that if medical records could be shared online, the quality of health care would improve. "The fact that one physician would be able to have all the information that another had entered, that appears to make a lot of sense to people," Blendon says.

In the poll, 72 percent said if records were computerized, their own doctors were likely to do a better job of coordinating their care; 67 percent believed that the overall quality of medical care in the country would be improved; and 53 percent say there would be fewer medical errors.

But Blendon says there are key points where Americans don't agree with Obama — primarily on the cost and privacy. "The overwhelming majority of Americans don't think an electronic medical record will either save their family or the country money," says Blendon. In fact, more of those polled said they expect to see costs go up, not down.

The poll also showed that Americans doubt such records would remain confidential. Seventy-six percent said it's at least somewhat likely that "an unauthorized person" would get access to records placed online.

Still, most Americans say the country probably should have electronic medical records.

Mollyann Brodie, the Kaiser Family Foundation's polling director, thinks that's because Americans have a lot of experience now with computerized information — and accept it with all its risks.

"People do their banking," she says. "They certainly do shopping these days by electronic means, and so in any of those cases you find people concerned about their privacy, but people are still doing it. They see enough of an upside for the convenience or for any other reason."

Who Prescribes?

There are other areas — the poll suggests — where people aren't so ready to go along with changes in health care, such as who decides which treatment is best for a patient. The poll shows that people have a lot of trust in their own doctors. Blendon says nearly two-thirds responded that their doctor is already taking steps to keep down the cost of their medical care.

The expert community advising the president and Congress disagrees, says Blendon. That group believes "there's a lot of evidence that people receive treatments that they don't benefit from and they receive treatments or tests that are more expensive when there are other alternatives," he says. "At the moment, this doesn't resonate with the general public; that's not their experience with their own physician."

The stimulus bill approved by Congress in February included more than $1 billion for research to compare how well specific drugs, medical devices, surgeries and other treatments work. A panel of experts would make recommendations, for example, about whether surgery or physical therapy is the best way to treat a certain kind of back pain, or if one cancer treatment is better than another.

In the NPR/Kaiser/Harvard poll, a majority supports such a panel — until the pollsters suggest the members would be appointed by government.

Then, says Kaiser's Mollyann Brodie, people worry that their doctors would lose control over their health decisions. "People are really trusting of their individual doctors, and a lot of experts might say that that's, you know, misplaced trust, that the doctors don't have all the information they need. But it is the individual doctors that the public most trusts to make these decisions."

Sixty percent of people polled said their doctors often tell them the reasons for the recommended treatment, and about half said their doctors talked to them about the scientific evidence for that treatment. Opponents of health care change can often play off the public's fear of losing that kind of personal relationship with doctors. Brodie says the new poll suggests that to win over the public, any change in health care will have to keep a patient's own doctor at the center of decisions about treatment.

Skipping Treatment

The poll also found that many Americans report they are experiencing the rise in health care costs personally, and that often they go without the care they need in order to keep their costs down. About 45 percent said that in the past year, they've taken some action to reduce the cost of their health care, including 32 percent who said they skipped dental care, 21 percent who didn't fill a prescription, and 20 percent who skipped a medical test or treatment that had been recommended by a doctor.

Even people who have health insurance worry that it's not good enough: Nearly half of the insured say they worry that if they get sick, their problem won't be covered by their insurance.

Among people who said they had no health insurance: Nearly 4 in 10 said it simply cost too much and they couldn't afford to pay for it. An additional 22 percent said they lost insurance because they are unemployed or lost a job.

Brodie says people in the poll want government to help them pay less for good health care. "We definitely are seeing that people are being hit hard by the cost of health care," she says. "It's something that bothers people; it worries them. It is the key element of the public's agenda for any kind of health care reform: They want to see their own health care costs go down."

Copyright 2012 National Public Radio. To see more, visit http://www.npr.org/.