FP 1-11

12/04

 

Abstract

Examining Health Care: WhatŐs the PublicŐs Prescription?

A look at Oklahoma citizensŐ thinking on health care reform

 

Prepared by:         Sue E. Williams, Ph.D.

                              Family Policy & Leadership Development Specialist

                              333 HES

                              Oklahoma State University

                              Stillwater, OK 74078-6111

                              (405) 744-6282

                              sue.williams@okstate.edu

 

Williams, S., Braun, B., Saunders, M.E. (2003). CPPE Report: AAFCS-Kettering health care project. Reported to Center for Public Policy Education, Charles Kettering Foundation, Dayton, OH.

 

IMPLICATIONS FOR COOPERATIVE EXTENSION. These findings provide important insight as to what Oklahoma citizens are thinking about health care policy and reform. OCES professionals need to be aware of citizen priorities and concerns and work to articulate these needs to policy makers. Based on citizen perspectives, policymakers should find ways to provide insurance for all Americans. Limiting malpractice costs, fostering patient responsibility in health care, and coordinating health care system fragments are other policy reform considerations. Engaging citizens in discussions about health care reform is critical in helping policymakers make use of public perspectives in legislating health care policies. If offered the opportunity, citizens can and will engage in deliberation around important issues.

 

 

 

The quality, accessibility, and affordability of health care in America impacts the well-being of our society. As is, health care is of great concern to Americans and in desperate need of reform. In order to effectively address the diverse needs and numerous concerns surrounding health care, policymakers must consider the perspectives of citizens. This summary presents findings from public deliberations on health care policy held in the state of Oklahoma.

 

The Deliberative Process

Deliberative democratic practice involves citizens discussing, not debating, concerns, drawbacks, and tradeoffs of health care policy perspectives with the guidance of a trained moderator. Participants are encouraged to search for a shared sense of direction and agree upon and engage in follow-up actions. The assumptions of this approach are that, given a topic of significance, a non-partisan approach to the issue, a communal public venue, and a skilled moderator, citizens can and will engage in the deliberative process. This engagement around issues full of tension, personal interest, and diverse perspectives allows participants to consider diverse approaches to health care reform.

 

Forum Participants

Gender:        80%  female             12%  male

Race/Ethnicity:

          8%  Native American

        84%  Caucasian

Age:              12%  31-45              48% 46-64

                    32%  65 or older

Residence Type:

                      8%  rural                68%  small town           12%  large city      4%  suburban

Who pays for insurance?

                    44%  employer            4%  Medicare

                      4%  Medicaid         12%  individual            28%  combination

 

Examining Health Care: WhatŐs the PublicŐs Prescription? continued

 

Oklahoma Citizen Voices

The opinions of 25 Oklahomans who participated in one of five recent public forums on health care were collected and compiled. Participants who were thinking differently about health care after participating in the forum said:

á       I have more awareness that will help me to take more responsibility

á       I knew it was complex but it clears up some of the picture

á       Being able to share stories; the overwhelming impact of health concerns on a personŐs life

á       I hope that the input of Americans makes a difference in the health care of the nation

 

Participants suggested that citizens in their communities:

á       Take more responsibility for their own health; resist over charges; understand various perspectives

á       Take a new view of the issue or stop blaming

á       Evaluate how health care partnerships work in our community

á       Become advocates for citizens that cannot advocate for themselves

 

Perspectives on Health Care in America

á       76% of participants strongly agreed with the statement, all Americans should have some kind of health insurance, while 16% somewhat agreed. 

á       60% strongly agreed with the statement, doctors should treat patients as full partners in their health care, while 28% somewhat agreed.

á       64% strongly agreed that huge malpractice awards are driving up the cost of health care, while 28% somewhat agreed.

á       72% strongly or somewhat agreed that, regardless of income, minorities do not receive the same quality health care as whites do. 

á       76% strongly or somewhat agreed that the public should have easier access to information about doctorsŐ mistakes. 

á       68% strongly agreed that patients dealing with many parts of the health care system often have no one to oversee the whole picture, while 28% somewhat agreed. 

 

 

Perspectives on Health Care Reform

á       40% strongly favored and 44% somewhat favored expanding Medicare to include prescription drugs.

á       24% strongly favored and 56% somewhat favored requiring doctors to be retested periodically.

á       52% strongly favored and 40% somewhat favored making people who choose risky behaviors pay more for insurance.

á       60% strongly favored and 32% somewhat favored setting caps medical lawsuits.

á       20% strongly favored and 36% somewhat favored providing health care to all Americans through a government-funded system.

á       36% strongly favored and 52% somewhat favored creating local and regional health care systems to make doctors and hospitals share services and equipment.

 

Perspectives on Reform Tradeoffs

á       80% favored, 12% opposed, and 8 were not sure about health care providers coordinating and sharing facilities and resources, even if patients would have to wait longer for some services.

á       76% favored, 16% opposed, and 8% were not sure about doctors spending more time with their patients, even if it raises the cost of health care.

á       76% favored, 16% opposed, and 8% were not sure about all Americans having access to basic health care services, even if it means cutting coverage of some costly treatments.

 

Suggestions for Policy and Programming

á       Efforts to engage citizens in public deliberation should be supported throughout the state in order to create a representative voice and shared sense of direction among Oklahomans.

á       Policymakers should rely on community organizations and research institutions to gather public perspectives on important policy issues.

á       Community stakeholders should consider ways to engage diverse groups of citizens in deliberation. Policymakers should use citizen perspectives to inform health care policies.