Americans favor universal health care but aren't sure how to achieve it
While three-quarters of Americans support adoption of a national health care system, the largest segment, nearly 40%, think that neither the Republicans nor the Democrats would do the best job in bringing about reform. According to the Novalis National Healthcare Survey, "The State of American Healthcare," 36.8 percent of Americans believe the Democrats would do the best job reforming health care and 23.5 percent would trust reform to the Republicans.
Seven in ten Democrats surveyed said they are confident that their own party would do the best job, while a somewhat lower proportion of Republicans, 58.4 percent, think their party is best for making changes. Among those Independents who expressed a preference, the Democrats are favored two to one overthe Republicans. Half the Independents have no party preference for health care reform.
Overall, the majority of Americans, regardless of party affiliation or demographic factors, favor a national health care system. However, the Novalis survey found significant differences in the level of opposition to a national health care system. Republicans are two and a half times more likely to oppose national health care than are either Democrats or Independents.
The survey was conducted in January by Fact Finders, Inc., an independent research firm headquartered in Albany, New York. Albany-based Novalis Corporation is an integrator of managed care technologies for health maintenance organizations (HMOs), preferred provider organizations (PPOs), third party administrators, and insurers. One thousand randomly selected adults in 50 states were interviewed by telephone. The survey was designed to explore how the uninsured, the privately insured, and those covered by government programs view the U.S. health care system, health insurance, and various national health policy alternatives.
The survey found that Americans tend to be very satisfied with both the health care they receive personally and with their own private health insurance. Ninety-three percent rate the quality of care delivered by their own doctors as good or excellent. Ninety percent of the 198 million privately insured Americans express satisfaction with their private health insurance.
Despite these high levels of satisfaction with their own personal medical care and health insurance, Americans give the overall health care system very low marks. Fifty-four percent say that the U.S. health care system is either "fair" or "poor"; only 7.9 percent rate it as "excellent."
"The significant difference in the way Americans rate their own personal health care versus the system in general may be best explained by looking at their commitment to universal access," says Stephen Ribner, president of Fact Finders, Inc. The Novalis survey found that two-thirds of all Americans support unlimited access to health care services. "Americans seem to be keenly aware that many in the nation don't enjoy the full benefits of our health care system," Ribner says.
While Americans say they want a national health care system and universal access to services, only two in ten think the government would do a better job managing it. Three times as many (60 percent) think private industry would do the better job. Support for the private sector is strongest among those who are currently insured. However, across all population segments, support is higher for private management of health care. Even among the uninsured, 80 percent of whom support national health care, only three in ten favor a government-run system.
The survey also measured potential support for managed health care as a part of a national program. Managed health care, which includes HMOs and PPOs, has attracted considerable national attention as a potential cost containment feature of any national health plan that is adopted. Managed care organizations offer comprehensive health care programs that encourage appropriate use of services in the most cost effective settings.
To keep health care affordable for all Americans, a majority of those surveyed support being required to use cost effective doctors and hospitals if expensive medical care is needed. Among the uninsured, support for managed care is even stronger. Seventy percent support required use of cost effective health care providers and nearly 70 percent support required use of a personal doctor who would decide what care they receive. "This suggests that there is significant receptivity among Americans to including managed care in any health care reform package," says Chester E. Burrell, president and CEO of Novalis Corp.
The survey also found that those who said they were in "poor" health were receiving services in about equal numbers, regardless of their health insurance status. However, among those in "fair" health, the uninsured seek services at a rate 50 percent less than that of the insured. "Those who are uninsured may be postponing needed treatment until their health problems grow much worse," Burrell says.
Study finds microbreweries to be a solid success
According to a study by Packaged Facts, the New York-based research company, the microbreweries market grew 28% (in terms of volume) last year, to reach sales of 568,800 barrels. 1992 growth is projected at 25%. The study projects that annual growth will continue to decline, hitting 13% percent by 1996, when barrel sales will total 1,352,040.
"These statistics are somewhat illusory, however," says David A. Weiss, president of Packaged Facts. "In the microbreweries market, individual corporate success can actually make sales go down." This is because, by definition, marketers selling more than 15,000 barrels are no longer considered microbrewers. Thus, marketers (Anchor Brewing Company is an example) can grow themselves out of the category causing a sudden drop-off in total sales. "But," Weiss says, "the bottom line is, microbreweries are a solid success."
But though their success is clear, exactly what microbreweries are is a somewhat fuzzier matter. For instance, the fastest gaining segment in the market is contract brewers, whose sales increased by 40% in 1991 to a total of 204,400 barrels. But contract brewers are, in fact, not breweries at all, despite the fact that their number includes some of the best-known names in the category, such as Samuel Adams Boston Lager (manufactured by the Boston Beer Company), and Brooklyn Lager (made by the Brooklyn Brewery). These marketers devise a product, then hire another brewery to manufacture it for them. This reduces startup costs and creates the flexibility that has allowed the segment to lead the category in growth.
The number two-gaining segment last year, brewpubs (up 34%, to hit 110,700 barrels), does indeed brew its own beer, which is served on premises. But, unlike conventional breweries, brewpubs often do not package beer to drink at home. This is usually due to local restrictions. Some 20 states still do not allow brewpubs to operate at all.
The largest segment in the market is known as "microbrewery," virtually the same title as the category as a whole. Catamount Brewing Company of Vermont, the Widmer Brewing Company and Hood River Brewing Company, both of Oregon, are some of the better known marketers in this segment. They are, as one might assume, small breweries that brew and package beer to be sold at various outlets. In 1991, the microbrewery segment (not to be confused with the category as a whole) gained 18%, to hit 253,700 barrels.