A recent survey by the Harvard School of Public Health (HSPH) and Harris Interactive, as part of their ongoing series, Debating Health: Election 2008, finds that Americans are generally split on the issue of whether the United States has the best health care system in the world (45% believe the U.S. has the best system; 39% believe other countries have better systems; 15% don’t know or refused to answer) and that there is a significant divide along party lines. Nearly seven-in-ten Republicans (68%) believe the U.S. health care system is the best in the world, compared to just three in ten (32%) Democrats and four in ten (40%) Independents who feel the same way.
This poll was conducted during a period of debate over the comparative merits of the U.S. health care system and the health care systems in other countries. President Bush and other prominent political figures have claimed that the U.S. has the best system in the world. At the same time, the World Health Organization and other organizations have ranked the U.S. below many other countries in their comparisons, while Michael Moore presented a similarly negative assessment of the U.S. health system in a popular format with his film Sicko.
So how might this issue impact how Americans vote in the upcoming presidential election” When asked if they would be more likely to support or oppose a presidential candidate who advocates making the U.S. health care system more like health systems in other countries, specifically Canada, France, and Great Britain, only one in five (19%) Republicans say they would be more likely to support such a candidate. This is compared to more than half (56%) of Democrats and more than a third of Independents (37%) who say they would be more likely to support such a candidate.
Though many Americans view the health care systems of other countries as better than the U.S. in general, the survey shows that they do not identify as better those countries that have been most frequently compared to the U.S. In head-to-head comparisons with health care systems in Canada, France and Great Britain, a large percentage of Americans are not sure how the U.S. compares overall. Over half (53%) of Americans say they don’t know how the U.S. generally compares to France and four in ten (40%) say they don’t know if the U.S. system is better or worse than Great Britain’s. A quarter (26%) are not sure how the U.S health care system compares to the Canadian system.
The view that the U.S. health care system lags other countries seems largely driven by the view that the U.S. is behind in controlling health care costs and providing affordable access to everyone. In comparing how the U.S. stacks up against other countries in specific areas, a slim majority of Americans believe that the U.S. health care system is better in terms of the quality of care patients receive (55% believe the U.S. is better than other countries) and shorter waiting times to see specialists or be admitted to the hospital (53% believe the U.S. is better than other countries). However, very few believe that the U.S. has the edge when it comes to providing affordable access to everyone (26% believe the U.S. is better than other countries) and controlling health care costs (21% believe the U.S. is better than other countries).
Once again, there are contrasts in how Republicans view the United States’ standing on these elements and how Democrats and Independents rate the U.S. As an example, four-in-ten (40%) Republicans believe the U.S health care system is better than other countries when it comes to making sure everyone can get affordable health care, compared to just one-in-five Democrats (19%) and Independents (22%) who share that belief. On each of the four elements tested, Independents are within a few percentage points of agreement with Democrats, and both are significantly separated from Republicans.
“The health care debate in this election involves starkly different views of the U.S. health care system,” says Robert J. Blendon, Professor of Health Policy and Political Analysis at the Harvard School of Public Health. “One party sees it as lagging other countries across a broad range of problem areas while the other party sees the system as the best in the world with a more limited range of problems.”