Got a point of view about healthcare reform? Solution: Commission a study and load up with some ammo to support your stance.
It's a tried and true formula:
A Gallup Organization study prepared for the Alzheimer's Association last month reported that nine out of 10 American adults believe long-term care should be included in any plan to reform the healthcare system.
"The research clearly shows that nine of 10 American adults accept their responsibility for caring for their loved one as long as they can," said Alzheimer's Association President Edward Truschke. "But there was almost unanimous agreement-96%-
that even responsible families need help."
An American Medical Association survey last December reported that 83% of physicians supported elements of the Clinton plan that would extend healthcare coverage and access to care to more Americans.
However, the same survey said 81% of physicians were opposed to cuts in Medicare and Medicaid, 56% were opposed to the creation of a National Health Board, and 55% were against the creation of mandatory health alliances.
A Gallup Organization survey released last year by the American Health Care Association found that 87% of all Americans believed that Congress and the Clinton administration should focus more on how to finance the cost of nursing home care when debating national healthcare reform.
These and many other surveys recently have been conducted at the behest of special interest groups as the debate heats up over healthcare reform and the future of the Clinton administration's reform package. Groups that have commissioned surveys and then trumpeted the results include healthcare trade organizations and several state and regional healthcare organizations.
The purpose of these surveys, executives contend, is to measure public opinion on many of the key issues affecting reform, such as increasing access to care, restructuring healthcare financing, maintaining quality and preserving consumer choice.
Provider-sponsored surveys also quantify and crystallize data that can be used in the decisionmaking process on Capitol Hill and in state legislatures, as well as to bolster the organization itself.
For example, last September, Phoenix-based Mercy Healthcare Arizona sponsored a national study of healthcare ethics. The effort brought national attention on the subject of ethics as well as on the issue of healthcare reform in Arizona, said Joseph J. DeSilva, Mercy Healthcare's president and chief executive officer
The three-round study polled medical ethicists, physicians, healthcare administrators and insurers on issues such as access, cost, rationing, reform package elements, and societal and individual rights.
"The ethical issues found in the study allowed us to develop a framework to interact with the legislative process to help shape healthcare policy in Arizona," Mr. DeSilva said. "From that perspective, the study was very useful."
However, concern is growing that these types of group-commissioned surveys may be too self-serving.
Coincidentally-or not surprisingly (depending on your degree of skepticism)-many of the conclusions drawn from most of these studies seem to corroborate the organizations' formal positions on the Clinton plan and healthcare reform.
"Yes, there are more and more special interest-sponsored surveys," said John Benson, deputy director of the Harvard Program on Public Opinion and Healthcare. "That's an indication of how easy it is to do polling these days."
While Mr. Benson agrees that this type of surveying does shed light on certain aspects of healthcare reform that otherwise wouldn't be addressed, he is concerned about the growth of "advocacy surveys" that tend to be biased and fail to provide a proper balance on the issues.
Mr. Benson and others recommend that the government establish a national nonpartisan surveying body that could accurately poll the American public on issues such as healthcare reform.
"You can't just look at one poll to answer all of your questions" on a particular subject, "especially when someone uses that poll to push a particular political position on a legislator," he said.
However, proponents of special interest surveying say the majority of surveys remain balanced, and they are generally more informative than biased.
"It is very much a matter of how you write the survey questions," said William E. Wright, senior research associate for the American Association of Retired Persons. "You can easily stack the results in your favor and create a self-fulfilling prophecy, but you won't learn anything that way."
AARP, which surveys members and the general public, doesn't identify itself as a sponsor in its surveys in an effort to maintain objectivity, Mr. Wright said.
While not everyone agrees on the effectiveness of special interest-
sponsored surveying, the trend is keeping the Gallup Organization, which has contracts with about 100 healthcare clients, and Lewin-VHI very busy these days.
Last month, Fairfax, Va.-based Lewin-VHI prepared a study for The Heritage Foundation analyzing mandated employer-based health insurance, comparing elements of such coverage in the Clinton administration's healthcare reform plan with a rival proposal sponsored by Sen. Don Nickles (R.-Okla.).
According to Lewin-VHI's study, employer-based health insurance would cut workers' annual wages by an average of $1,200, increase by 53% the number of families that pay more for healthcare services and result in the loss of 155,000 full- and part-time jobs nationwide (March 21, p. 34).
Lewin-VHI, which has conducted healthcare-related surveys for the American Hospital Association, the American Medical Association and Families USA, late last year released its own independent analysis of the administration's National Health Security Act (Dec. 13, 1993, p. 2).
Interestingly, in that analysis, it referred to the Clinton plan as financially stable.
Lewin-VHI executives insist they retain their objectivity. They said that while the perspective of each study was different, conclusions were drawn from valid information gleaned from research.