Tell us what you think about key issues HOW WOULD YOU FIX THE HEALTH-CARE PROBLEMS IN AMERICA TODAY?

(MONEY Magazine) – Scalpels are poised to start operating on the nation's $839 billion health- care system. Although there is no consensus yet on where the knife should fall, it appears increasingly likely that you'll pay more for your coverage. Bill Clinton has made reforming the health-care system one of his top priorities. That's understandable. Health costs have spiraled up at a rate of 10% to 12% a year since 1985. Medicare expenses have risen faster still. Those trends have turned the government's health-care program into one of the leading causes of the $320 billion federal budget deficit. Yet 35 million Americans -- 14% of the population -- have no health insurance. In addition, according to a new study by the General Accounting Office, the congressional watchdog agency, 13% of employers with 50 or fewer workers eliminated coverage for their employees in the past three years. Clinton has endorsed the idea of taxing employer-provided health-care benefits beyond a certain ''essential'' level. Where to draw the line, however, will be the subject of intense discussion. Since the debate has just begun, we'd like to give you a chance to help shape the outcome by offering Washington leaders your views. Please answer the questions in this month's Readers' Poll by circling the choices you prefer -- and feel free to outline your own prescriptions, separately if necessary. Then return the poll to us either by fax (212-522-0119) or mail (MONEY February poll, Room 3238, Time * & Life Building, Rockefeller Center, New York, N.Y. 10020). We will publish the results in an upcoming issue. Thank you for your participation.


1. How would you rate the U.S. health-care system? a) Excellent b) Good c) Fair d) Poor

2. What is the nation's No. 1 health-care problem? a) Soaring medical and insurance costs b) Lack of insurance coverage for everyone c) Declining overall quality of health care d) Other

3. What is your personal No. 1 health-care concern? a) Higher out-of-pocket medical costs b) More limits on treatment and delays c) Declining quality of medical care d) All of the above e) None of the above f) Other

4. Where would you place the greatest blame for escalating health-care costs? (Circle as many as you wish.) a) Rising doctors' fees b) Rising cost of medications b) Rising insurance premiums c) Inefficiency and waste at hospitals e) Frivolous malpractice lawsuits f) Fraud in Medicare, Medicaid or private insurance programs g) Too much government bureaucracy h) Other

5. Which of these elements of a health-care system do you consider essential? (Circle as many as you wish.) a) Being able to choose any doctor or hospital b) Health insurance coverage for everyone c) Prompt access to competent professionals d) Limitless insurance coverage for all medical treatment e) Affordable insurance coverage for basic medical treatment f) The ability to carry your health insurance from job to job g) Low or no deductibles and co-payments h) Other

CHANGING THE SYSTEM 1. There are three leading proposals to revamp America's health-care system: Managed competition, endorsed in principle by Bill Clinton, would mandate that all Americans should have federally prescribed standard coverage either through an employer or on their own. If companies provided more than the essential package, the value of the additional coverage would be taxable. The money raised through that tax would pay private insurers to cover the uninsured. National health insurance would guarantee coverage for all but would be paid for by an annual income tax levy of perhaps $1,000 to $2,000 a person. ) Consumers could choose any doctor or hospital but might face delays for elective surgery, as happens sometimes under Canada's national health insurance system. Pay or play would require employers to provide coverage to all workers or to pay a federal payroll tax of 7% to 9% that would fund coverage of the uninsured. Which of these systems do you prefer? a) Managed competition b) A national health insurance program c) Pay or play d) The current health-care system

2. Do you think that people with employer-provided health benefits should pay taxes on the benefits to ensure that every American has health insurance? a) Yes b) No

3. How much would you personally be willing to pay in extra taxes so that everyone has coverage? a) Nothing b) $5 a month c) $10 a month d) $20 a month e) $50 a month f) $100 a month g) Other

4. Should all employers, including small businesses with fewer than 50 employees, be required to provide health-care benefits for their employees? a) Yes b) No

YOUR COVERAGE 1. Overall, how would you rate the quality of medical care you receive? a) Excellent b) Good c) Fair d) Poor

2. What do you think of your health-care costs? a) Much too high b) Somewhat high c) Just about right d) Somewhat low e) Much too low

3. Were your 1992 out-of-pocket medical costs higher or lower than three years ago? a) Higher b) Lower

4. If higher, by how much? a) Less than $100 higher b) $101 to $500 higher d) $501 to $1,000 higher e) More than $1,000

5. Many health plans now require advance approval of nonemergency hospitalization and treatment. Has anyone in your family suffered because an insurer delayed or refused treatment? a) Yes b) No

6. How confident are you that you could cover costs of a major illness in your family? a) Very confident b) Somewhat confident c) Not very confident d) Not at all confident

7. If you have a company-sponsored health insurance policy, please circle any of the following that apply: In the past year or two . . . a) I have had to start paying part or all of my health insurance premium for the first time. b) My share of the monthly premiums has increased. c) The amount of my deductible or my co-payments has increased. d) My health insurance now covers fewer types of treatment than it used to. e) It has become more expensive to cover other family members.

8. How long does your insurer normally take to reimburse your health outlays? a) About two weeks b) About four weeks c) Longer than that d) Not applicable

9. How does that compare with three years ago? a) Longer b) Shorter

10. Please circle yes or no to the following choices if you currently belong to a health maintenance organization:

I am satisfied with my HMO. Yes No

I often experience long waits at my HMO. Yes No

My HMO fee rose more than 5% in 1992. Yes No

I usually get to see the doctor I want at my HMO. Yes No


Name, age

Your city and state

Home or business phone number

Smoker? (Yes/No) Married? (Yes/No) Do you have children under age 21? (Yes/ No) Household income: (Under $40,000/$40,000 to $80,000/Over $80,000)

Your primary health coverage is (circle one): Commercial insurance through employer Blue Cross through employer HMO-type plan through employer Commercial insurance on my own Blue Cross on my own HMO-type plan on my own Medicare/Medicaid I have no health coverage