Most Republicans Think the U.S. Health Care System is the Best in the World, Democrats Disagree

ROCHESTER, N.Y. – March 20, 2008 – 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) and 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 WHO 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%) is 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 on-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."

"Some people say that the United States has the best health care system in the world. Others say that the health care systems of some other countries are better than the U.S. How about you? Do you think that in general the U.S. has the best health care system or are there other countries with better health care systems?"

Base: All Adults

"Specifically thinking about [Canada, France, Great Britain], would you say that overall the United States has a better health care system than [Canada, France, Great Britain] or a worse health care system than [Canada, France, Great Britain]?"

Base: 1026 Adults

"Thinking about the countries I have just mentioned, would you say that in general the United States has a better health care system or a worse health care system than these countries when it comes to [INSERT RANDOM A-D]?"

Base: U.S. Adults

"Would you be more likely or less likely to support a presidential candidate who said the United States health care system should be more like the system in these other countries, or would it not make a difference to your vote?"

Base: 1026 Adults

This survey is part of the series, Debating Health: Election 2008. The series focuses on current health issues in the presidential campaign. The survey design team includes Professor Robert Blendon, Tami Buhr, John Benson and Kathleen Weldon of the Harvard School of Public Health; and Humphrey Taylor, Scott Hawkins and Justin Greeves of Harris Interactive.

This survey was conducted by telephone within the United States among a nationwide cross section of adults aged 18 and over. The survey was conducted March 5 to 8, 2008 among a representative sample of 1026 respondents. Figures for age, sex, race/ethnicity, education, region, number of adults in the household, size of place (urbanicity) and number of phone lines in the household were weighted where necessary to bring them into line with their actual proportions in the population.

All sample surveys and polls, whether or not they use probability sampling, are subject to multiple sources of error which are most often not possible to quantify or estimate, including sampling error, coverage error, error associated with nonresponse, error associated with question wording and response options, and post-survey weighting and adjustments. Therefore, Harris Interactive avoids the words "margin of error" as they are misleading. All that can be calculated are different possible sampling errors with different probabilities for pure, unweighted, random samples with 100 percent response rates. These are only theoretical because no published polls come close to this ideal.

Full data tables and questions can be found at http://www.harrisinteractive.com/news/datatables.asp.

Harvard School of Public Health is dedicated to advancing the public's health through learning, discovery, and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit: www.hsph.harvard.edu

Harris Interactive is a global leader in custom market research. With a long and rich history in multimodal research, powered by our science and technology, we assist clients in achieving business results. Harris Interactive serves clients globally through our North American, European and Asian offices and a network of independent market research firms.

Tracey McNerney
Harris Interactive
585-214-7756

Robin Herman
Harvard School of Public Health
rherman@hsph.harvard.edu
617-432-4752