.
Right direction	57%
Wrong track	35%
Don’t know/refused	8%

[top]

Health Care Problems

As I mentioned, the main topic of this survey concerns health care issues facing Coloradans.

2. What would you say is the most important health care problem the governor and state legislature should address in the 2003 legislative session?

.
Cost of insurance	23%
Cost of health care (services, drugs, doctors, hospitals)	19%
Health care insurance/coverage (inadequate/lack of access)	15%
Health care for elderly	9%
Prescription drugs	8%
Medicare/Medicaid issues	4%
Health care for children	3%
Health care for poor	2%
Budget cuts for public health	1%
Disease (cancer, HIV/AIDS, diabetes, heart, obesity, Alzheimers, arthritis, stroke, lung, asthma)	1%
Health care profession (shortage of qualified professionals)	1%
HMO/choice problems	1%
Lifestyle (smoking, exercise, alcohol, drugs)	1%
Other	2%
Don’t know	10%
Refused	0.3%

3. I’m going to read three statements about the health care system overall, would you say...

.
A.	On the whole, the health care system works pretty well and only minor changes are needed to make it work better	19%
B.	There are some good things about our health care system, but major changes are needed to make it work better	56%
C.	The American health care system has so much wrong with it that we need to completely rebuild it	24%
D.	Don’t know	1%

4. For you or your household, if there is one health care issue you are most worried about today what would it be?

.
Can’t afford insurance	27%
Nothing (no worry)	12%
Can’t afford health services needed	9%
Chronic illness	9%
Can’t afford prescription drugs	9%
I need health care	8%
Nursing home	6%
Changes in Medicare/Medicaid	4%
Cut back in insurance benefits	3%
Children/family members need health care	2%
I/family member in poor health	1%
Rising cost of co-payments	1%
Increasing deductibles	0.2%
Smoking related issues	0.2%
Other	4%
Don’t know	6%

[top]

Health Care Satisfaction

5. In general, how do you feel about the health care service you and members of your household have received the last few years? Would you say you are very satisfied, somewhat satisfied, somewhat dissatisfied or very dissatisfied?

.
Very satisfied	37%
Somewhat satisfied	44%
Somewhat dissatisfied	12%
Very dissatisfied	6%
Don’t know	1%

[top]

Health Care Cost

Next let me ask you about health care costs for you and your household members. As I read the following list of medical services please tell if you believe the cost is very reasonable, somewhat reasonable, somewhat unreasonable or very unreasonable for what you receive. If you are unaware of the cost just say so. Rotated

	Very Reasonable	Somewhat Reasonable	Somewhat Unreasonable	Very Unreasonable	Don’t Know	Refused
6. Doctor visits	22%	48%	15%	10%	4%	0.1%
7. Prescription drugs	15%	25%	20%	34%	5%	-
8. Hospitalization	11%	24%	19%	27%	19%	-
9. Health insurance	12%	23%	23%	39%	3%	-
10. Emergency service such as ambulance and paramedics	13%	22%	12%	22%	31%	-

11. Thinking about a visit to a general practitioner doctor in his or her office, about how much do you think a basic visit would cost if you paid out-of-pocket for it?

.
0-$10	1%
$11-50	17%
$51-100	50%
$101-150	13%
$151-200	6%
More than $200	5%
Don’t know	8%

A number of factors have been suggested as reasons for rising health care costs. For each factor I read please tell me if you believe it is a major cause, somewhat of a cause, only a small cause or not a cause of higher health care costs. If you do not know enough about the factor or its effect on health care cost just say so. Rotated

.
	Major Cause	Somewhat of a cause	Small cause	Not a cause	Don’t Know	Refused
Prescription drugs	56%	29%	6%	5%	4%	1%
High tech medical equipment	49%	35%	6%	4%	7%	0.1%
People with unhealthy habits and lifestyles	47%	33%	8%	7%	4%	0.1%
Malpractice insurance	59%	23%	7%	3%	8%	0.2%
Cost of hospital stay	52%	33%	6%	3%	6%	0.3%
Cost of doctors	34%	46%	11%	5%	4%	-
Cost of nurses and other healthcare workers	13%	38%	25%	16%	7%	0.3%
Population getting older	39%	42%	10%	7%	2%	0.2%
People without insurance	55%	26%	7%	7%	4%	0.1%

[top]

Health Care Usage

Next let me ask a few background questions on your recent use of health care services.

21. Would you say your health, in general, is excellent, good, fair, or poor?

.
Excellent	39%
Good	45%
Fair	13%
Poor	3%
Don’t know	0.1%
Refused	0.1%

22. In the past 12 months have you or a member of your family living in the household received medical care from a doctor or some other health care professional or been a patient in a hospital, or have you or members of your household not received medical care?

.
Received care	88%
Not received care	12%
Don’t know	0.1%

23. Is there one doctor, clinic or hospital in particular you usually go to when you are sick or need health care services or not one doctor, clinic or hospital?

.
One doctor (etc) GO TO Q24	82%
Not one doctor (etc) GO TO Q25	17%
Don’t know GO TO Q25	0.3%
Refused GO TO Q25	0.1%

4. IF YES: Where do you usually go? To a doctors office, a clinic, a hospital emergency room or some place else?

.
Doctors office	64%
Clinic	22%
Hospital (non emergency room)(vol.)	7%
Emergency room	5%
Other place	1%
Don’t know	0.4%
(Asked of respondents who have one place to go) - Base 830

25. In the past 12 months, was there any time when you or anyone in your household felt you needed medical care but were unable to get it for any reason?

.
Yes, needed care/didn’t receive GO TO Q26	15%
No, either didn’t need care or received it GO TO Q28	85%
Don’t know GO TO Q28	0.2%

26. IF YES: What was the main reason that you (or a person in your household) did not get the medical help you needed in that particular situation?

.
Can’t afford insurance	27%
Don’t have insurance	17%
Procedure needed not covered by insurance	17%
It cost too much	12%
Could not get an appointment	7%
Did not know a good doctor or clinic to go to	5%
Would have had to wait too long in the doctor’s office or clinic	3%
Co-pay too high	2%
Couldn’t find a doctor who speaks my language	1%
Couldn’t find anyone to take care of the children	1%
Doctor doesn’t accept Medicaid	1%
No easy way to get to the doctor’s office or clinic	1%
Other	6%
Don’t know	1%
(Asked of respondents who needed care but didn’t receive it) - Base 154

27. Would you say the medical situation was serious, or not too serious?

.
Serious	51%
Not too serious	49%
Don’t know	--
(Asked of respondents who needed care but didn’t receive it) - Base 154

[top]

Health Care Insurance

Next let me ask about health insurance.

28. Are you personally now covered by any form of health insurance or health plan or do you not have any health insurance at this time? (A health care plan includes any private insurance plan through your employer or a plan that you purchased yourself, as well as a government program like Medicare or Medicaid).

.
Yes, covered GO TO Q29	90%
No, not covered GO TO Q44	10%
Don’t know GO TO Q46	0.3%
Refused GO TO Q46	0.2%

29. IF COVERED, ASK: Are all the other members of your household covered by health insurance or not?

.
Yes, all covered	82%
No, all not covered	7%
No others in household	9%
Don’t know	1%
Refused	0.4%
(Asked of respondents who have health insurance) - Base 909 GO TO Q30

30. Considering your current coverage which type of health insurance do you now have? Is it a plan through your or your spouse’s employer (or union), a plan you purchased yourself (or your spouse or parents purchased), a government employee plan or are you covered by Medicare, Medicaid or some other government program, or do you get your health insurance from somewhere else?

.
Private plan through your or your spouse’s employer or union GO TO Q31	59%
Purchased plan yourself (or spouse or parents purchased) GO TO Q31	16%
Medicare GO TO Q40	15%
Medicaid GO TO Q40	3%
Other government program (federal, state, local employees; etc.) GO TO Q31	6%
Other GO TO Q31	1%
Don’t know GO TO Q39	0.1%
(Asked of respondents who have health insurance) - Base 909

[top]

Type of Insurance Coverage

Let me ask you about the type of insurance coverage you have. As I read the following statements please tell me if it describes how your current plan works or not. Rotated

.
	Yes Current plan	No Not current plan	Don’t Know	Refused
31. Your health plan does not require you to have a primary care doctor, and it charges less if you use a doctor from a specific list. You are able to go to a doctor who is not on the list; however, you pay more to do this	61%	35%	4%	--
32. Your health plan requires you to sign up with a primary care doctor or group of doctors who provide all of your routine health care	65%	33%	2%	--
33. Your health plan requires you to have approval before it will pay any of the cost of visiting a doctor who is not on the specific list	54%	37%	9%	0.1%
34. Your health plan requires you to have a referral by a primary care doctor before you can see a specialist	68%	26%	6%	--
(Asked of respondents who have private or government employer health insurance plans) - Base 740

[top]

Change in Insurance Coverage

Let me ask you about changes in your insurance coverage the last 12 months. Please tell me if the item has gone up in cost, stayed the same or gone down in cost. Rotated

.
	Gone up	Stayed the same	Gone Down	Don’t Know	Refused
35. The amount of your co-payment, or the amount you must pay out-of-pocket for a doctor visit	53%	42%	2%	3%	--
36. The amount of your deductible, or the amount you must pay before your insurance takes over and pays	40%	50%	2%	9%	0.1%
37. The type of medical procedures or services covered by your insurance benefits	23%	61%	7%	9%	0.1%
(Asked of respondents who have private or government employer health insurance plans) - Base 740

38. If you have paid insurance premiums during the past 12 months has the amount of your health insurance premium gone up a lot, gone up a little, stayed about the same or gone down?

.
Gone up a lot	38%
Gone up a little	28%
Stayed the same	22%
Gone down	3%
Don’t pay premiums	6%
Don’t know	3%
(Asked of respondents who have private or government employer health insurance plans) Base 740

[top]

Insurance Satisfaction

39. In general, would you describe your insurance plan as a comprehensive plan that covers hospital care, doctors visits, lab cost, x-ray and testing costs; or is your insurance plan a limited benefit plan that covers just a few types of care or pays only a limited portion of the bill and does not cover the cost of every illness or procedure; or is your insurance plan something in between?

.
Comprehensive	82%
Limited benefit	8%
In between	10%
Don’t know	1%
(Asked of respondents who have private or government employer health insurance plans) - Base 741

40. Are you satisfied with your current health insurance coverage or not satisfied?

.
Satisfied GO TO Q42	79%
Not satisfied GO TO Q41	20%
Don’t know GO TO Q42	2%
(Asked of respondents who have health insurance) - Base 909

41. IF NOT SATISFIED, ASK: Why are you not satisfied with your health insurance coverage?

.
Too expensive	42%
Want more comprehensive plan	16%
Treatment needed not covered	10%
Co-pay too high	8%
Doctors on plan not convenient	4%
No choice of doctors	3%
Doctors on plan not good	2%
Too much paperwork	2%
Want an affordable basic plan	2%
Children need coverage	1%
Too many delays for care	1%
Other	2%
(Asked of respondents not satisfied with health insurance) - Base 178

[top]

Recent Lack of Insurance

42. Was there any time in the past 12 months when you or someone in your household were completely without any health plan or medical insurance coverage?

.
Yes, was a time GO TO Q43	12%
No, no such time GO TO Q46	88%
Don’t know GO TO Q46	--
(Asked of respondents who have health insurance) - Base 909

43. IF YES: Why were you or member of your household without coverage?

.
Too expensive, can’t afford	27%
Lost job	19%
Didn’t have job	14%
Job doesn’t offer coverage/stopped offering	12%
Changed status/dependent to independent	7%
No longer covered as student	6%
Changing plans	4%
Changed insurance company	2%
Never thought about it	2%
Payments lapsed	2%
Refused insurance because of poor health, illness, or age	2%
Don’t believe in insurance	1%
Don’t know	2%
(Asked of respondents who were without health insurance in past 12 months) Base 108 GO TO Q46

[top]

Uninsured

44. IF NOT INSURED: Why don’t you have health insurance?

.
Too expensive, can’t afford	42%
Lost job	19%
Job doesn’t offer coverage	15%
In between jobs	12%
Don’t believe in insurance	3%
Changed insurance company	2%
In good health/don’t need it	2%
Job stopped offering coverage	1%
Use emergency room if sick	1%
Other	1%
Don’t know	3%
(Asked of respondents without health insurance) - Base 96

45. During the last 12 months have you received any medical care from a hospital, doctor, lab or nurse—for which you did not have insurance, and were unable to pay?

.
Yes, received unpaid care	31%
No, did not receive unpaid care	62%
Don’t know GO TO Q46	6%
(Asked of respondents who have health insurance) - Base 96

[top]

Health Care Philosophy

The next series of questions concerns peoples’ viewpoints on healthcare public policy issues. As I read the following list of statements please tell me whether you strongly agree, somewhat agree, somewhat disagree or strongly disagree with each statement. Rotated

.
	Strongly Agree	Somewhat Agree	Somewhat Disagree	Strongly Disagree	Don’t Know	Refused
46. Everybody, regardless of income, job or insurance status, should have the right to the same amount and same quality of health care service	54%	25%	12%	7%	2%	0.1%
47. Hospitals and doctors should not be forced to treat patients who have no insurance and can’t afford to pay for the cost of the services	8%	13%	28%	47%	3%	0.2%
48. Nobody should be refused health care services that they need just because they can’t pay for it	64%	24%	8%	3%	1%	0.2%
49. Government should make sure everybody has basic health insurance for both doctor and hospital care	49%	24%	12%	12%	3%	0.3%

[top]

Health Care Expansion Proposals

Next, I will read you several different ideas that could increase access to health care for different groups of people. Please tell me for each one if you strongly support, somewhat support, somewhat oppose or strongly oppose it. Rotated

.
	Strongly Support	Somewhat Support	Somewhat Oppose	Strongly Oppose	Don’t Know	Refused
50. Expand neighborhood health clinics	37%	44%	8%	5%	6%	0.2%
51. Offer uninsured Americans income tax deductions, tax credits, or other financial assistance such as reimbursement to help them purchase private health insurance on their own	32%	38%	13%	11%	7%	0.1%
52. Expand state government programs for low-income people, such as Medicaid and the Children’s Health Insurance Program, to provide coverage for people without health insurance	44%	38%	10%	6%	2%	0.1%
53. Create a statewide health plan in which all Coloradoans would get their insurance from a single government plan. It would replace Medicare, Medicaid and all private insurance	14%	19%	17%	38%	11%	--
54. Require all employers, including small businesses, to provide their employees with a basic minimum level of health insurance	31%	28%	17%	21%	2%	0.2%
55. Extend Medicare to cover nursing home and home care costs	49%	35%	7%	4%	5%	0.1%

[top]

Paying For Health Care Proposals


Next, I will read a list of different methods to pay for new health care programs like those we just discussed. Please tell me for each method whether you strongly favor, somewhat favor, somewhat oppose or strongly oppose the method. Pay for expansions of health care programs. . . Rotated

	Strongly Favor	Somewhat Favor	Somewhat Oppose	Strongly Oppose	Don’t Know	Refused
56. from insurance premiums paid by the people covered	14%	39%	19%	18%	9%	0.3%
57. from a special tax paid by employers for each employee	14%	42%	19%	19%	5%	0.1%
58. by increasing taxes generally	10%	36%	20%	31%	3%	1%
59. by raising the taxes on cigarettes by	54%	16%	10%	19%	2%	--
60. by increasing the state sales tax by half a cent	30%	36%	14%	18%	2%	1%
61. by raising the tax on liquor	48%	25%	10%	15%	2%	0.1%
62. by shifting the tobacco settlement funds from education and other state projects to health care for the uninsured	31%	29%	15%	19%	6%	--

[top]

.
Taxpayers pay	45%
We all pay	21%
Cost shifted to people with insurance	10%
Government pays	8%
Doctors/hospitals absorb loss	7%
Entire system pays, (i.e., hospital/doctors, taxpayers and government, business and people with insurance)	5%
Business pays	1%
No one pays/its free	0 .2%
Don’t know GO TO Q66	6%

64. In light of your answer to the previous question do you prefer to continue the present method of paying for people without health insurance or should some other method be used?

.
Current system GO TO Q66	16%
Other method GO TO Q65	66%
Don’t know 1GO TO Q66	18%
Refused GO TO Q66	0.3%
(Asked of respondents who expressed view on cost shifting) - Base 947

65. IF OTHER METHOD, ASK: What other method do you think should be used?

.
Use government program	18%
Taxpayers should pay	12%
Entire system should pay, (i.e., hospital/doctors, taxpayers and government, business and people with insurance)	5%
National health plan	5%
Use cigarette taxes	5%
User should pay	5%
We should all pay	3%
Doctors/hospitals should absorb loss	2%
Employers should pay	2%
Use liquor tax	2%
Expand Medicaid/Medicare	1%
If can pay shouldn’t get treatment	1%
Shift cost to people with insurance	1%
Single payer plan	1%
Other	4%
Don’t know	32%
Refused	0.2%
(Asked of respondents who want a different method) - Base 626

[top]

Health Care Program For Uninsured

66. Many people who are uninsured make too little money to afford to buy insurance coverage on their own or are not offered coverage they can afford where they work. Would you be willing or not willing to pay more taxes to help these people afford coverage?

.
Yes GO TO Q67	49%
No GO TO Q73	40%
Depends on the amount GO TO Q67	8%
Don’t know GO TO Q73	3%
Refused GO TO Q73	1%

IF YES OR DEPENDS, ASK: How much more would you be willing to pay in taxes each month to help pay for the cost of insurance for individuals and families that cannot afford the insurance on their own? As I read the following amount of taxes please tell me whether you would support or oppose the tax increase. Alternate from top down and bottom up.

	Support	Oppose	Don’t Know
67. $1 to $4 dollars per month	50%	49%	1%
68. $5 to $9 dollars per month	26%	73%	1%
69. $10 to $14 dollars per month	23%	76%	1%
70. $15 to $19 dollars per month	15%	83%	1%
71. $20 to $24 dollars per month	12%	86%	1%
72. $25 to $50 dollars per month	17%	81%	2%
(Asked of respondents who are willing to pay more taxes) - Base 573

[top]

	Top Priority	Second Priority	Low Priority	No Priority	Don’t Know	Refused
73. Treatment for chronic illness such as diabetes, asthma	59%	22%	10%	7%	1%	1%
74. Routine doctor office visit	52%	31%	14%	2%	1%	1%
75. Prescription drugs coverage	67%	21%	8%	2%	1%	1%
76. Transplant coverage	34%	27%	23%	13%	3%	1%
77. Pre-natal coverage	25%	6%	5%	63%	0.4%	1%
78. Childbirth coverage	25%	5%	5%	64%	0.2%	1%
79. Emergency room coverage	68%	24%	5%	1%	1%	1%
80. General hospitalization coverage	65%	28%	5%	1%	1%	1%
81. Treatment for catastrophic care such as cancer	76%	17%	4%	2%	1%	1%

ALSO,See the media release and key results

SURVEY FACTS

Telephone survey conducted by Ciruli Associates from November 11 to November 18, 2002 for the Rose Community Foundation on health care issues. Telephone survey of 1,010 adult residents of Colorado who are registered voters. Selected by random digit dialing with a random sample of statewide area telephone exchanges that gave all Colorado residential telephone numbers, listed and unlisted, an equal chance of being included. The most recent birthday method was used to randomly select members of the household to interview. Telephone interviews were conducted by a professional, supervised interviewing service. Pre-testing was conducted to enhance reliability. A multiple callback procedure was employed to reduce non-response. Calls were made at different times of day and included weekdays and weekends to increase response. The questionnaire was developed after extensive input from health care professionals and policy makers. Questions wording was reviewed and adjusted to enhance clarity, validity and reliability. The order of questions was rotated in question series with same responses categorized to reduce question-order bias. Statistical range of accuracy in 19 out of 20 cases is ±3.1 percentage points for a sample size of 1,010. Sample tolerances for subgroups are larger. For example, the confidence interval for a subgroup of 500 respondents is ±4.4 percentage points. Due to rounding, not all totals equal 100 percent. The number of respondents is indicated in questions involving less than the entire sample of 1,010 respondents. Survey results can be affected by other factors in addition to sampling error such as question wording and order. Ciruli Associates is a non-partisan research, communication and public policy firm providing consulting services to Colorado and national organizations since 1976.

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