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Health Freedom Watch
December 2007


Americans Favor Private Health-Insurance Options over Mandates
By Sue Blevins

Although many advocates are pushing for national health care, it’s important to acknowledge that more Americans favor private health-insurance reforms over mandatory health insurance or national health care, according to a recent Gallup survey (see below).

Even in the midst of national economic challenges and skyrocketing health-care costs, Americans haven’t lost their preference for individual decision-making and responsibility, over mandates and government control.  The desire for private health insurance remains strong.

Thus, as we move forward with debates about expanding coverage, it’s important for policymakers to examine ways to enhance free-market options.  They should ask:

  • Why is health insurance so expensive for so many people in the United States?
  • Is there a healthy and vibrant market for private health insurance? 
  • What can be done to foster competition, and therefore affordable coverage, in the health-insurance industry?

Let’s encourage policymakers to ask the right questions that lead to helpful solutions for improving access to affordable, private health-insurance plans—plans that ensure citizens’ freedom to maintain private contracts with the providers and services of their choice.  

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Americans’ Views on National Health-Care Reform

When it comes to reforming the U.S. health-care system, expanding access to private insurance is the most broadly supported option.  Gallup recently asked Americans their views on 12 different reform options, from tax breaks and deregulation to mandates and a national health-care system similar to Canada’s and Europe’s. 

The most-favored policy—receiving near-universal support (94 percent)—was tax breaks to small businesses for providing insurance to employees.  The policy most opposed (44 percent) was a mandate for every American to have health insurance.

Gallup notes that the three least-favored approaches (national health care, repealing federal income-tax cuts, and mandatory health insurance) were the only proposals that did not receive bipartisan support.  They are supported by a majority of Democrats but less than half of Republicans. 

“Policy-makers eager to make some progress on healthcare reform might consider focusing their efforts on expanding access to private health insurance, as these proposals tend to receive the highest and most bipartisan support,” stresses Gallup.

Health-Care Reform Policy



No opinion

Give tax breaks to small businesses to allow them to provide health insurance for their employees




Allow American workers to keep the same medical insurance when they change jobs




Require large companies to either offer health insurance coverage to their employees or to pay into a pool that would be used to pay for health insurance




Provide incentives in health insurance plans for those who can demonstrate they live a healthy lifestyle




Reduce government regulation to allow more health insurance providers to compete in the system




Provide government subsidies to help lower-income Americans buy health insurance




Introduce reforms to the legal system that would place limits on the amount of money awarded in malpractice suits against doctors




Provide American families a $15,000 tax credit to allow them to buy private health insurance




Have the federal government help fund state programs that attempt to address the health insurance situation in that state




Establish a national healthcare system funded by the government, similar to the ones in Canada and Europe




Repeal the federal income tax cuts passed in 2001 and 2002 and use that money to pay for new healthcare programs




Require every American to carry some form of health insurance




* Less than 0.5%

Source: Gallup telephone survey of 1,006 national adults aged 18 and older conducted September 24-27, 2007, “Any Healthcare Reform Plan Will Do for Americans: Broadest Support for Plans that Expand Access to Private Health Insurance,” October 25, 2007: (

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Whom Do Americans Trust on SCHIP?

A recent Gallup survey found that more Americans favored President Bush’s position on the State Children’s Health Insurance Program (SCHIP) over the Democrats’ position.  Yet respondents also said they had greater overall confidence in Congress’s handling of the program.

The survey asked:

“As you may know, Congress is considering a bill that would increase the number of children eligible for government subsidized health insurance, but the Democrats in Congress and President Bush disagree on how much to increase the program. How closely have you been following the news about this—very closely, somewhat closely, not too closely, or not at all?”

Fifty-one percent said they followed closely (17 very closely; 34 somewhat closely).  Thirty percent said not too closely; 19 percent reported “not at all.”

Then Gallup asked half the respondents:

1. Whom they had more confidence in on the issue, President Bush or the Democrats in Congress.  Fifty-two percent said the Democrats, while 32 percent said Bush. 

2. Which side they favored: the Democrats, who want to qualify a family of four earning about $62,000 for the program, or Bush, who wants most of the increased money to go to families earning less than $41,000. Fifty-two percent said they sided with Bush, while 40 percent sided with Democrats.  Three percent said neither, and 4 percent had no opinion. 

3. “How concerned are you that expanding this program would create an incentive for middle-class Americans to drop private health insurance for a public program, which some consider to be a step toward socialized medicine?” Fifty-five percent said they were concerned (22 very concerned; 33 somewhat concerned).  Twenty-five percent were not too concerned; 17 percent were not concerned at all; and 2 percent had no opinion.

Gallup’s review of health-care polls notes that “A key to understanding the public's [view] on healthcare is to comprehend that Americans want government intervention that goes just so far."


  • USA Today/Gallup telephone survey of 1,009 national adults aged 18 and older conducted Oct. 12-14, 2007, “Both Parties Have Strengths in ‘SCHIP’ Debate: Democrats Generally Preferred, But Bush's Counterarguments Have Support,” October 17, 2007: (
  • “Gallup's Pulse of Democracy: Healthcare Costs,” website accessed December 11, 2007: (

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Health Freedom Watch is published by the Insitute for Health Freedom. Editor: Sue Blevins; Assistant Editor: Deborah Grady. Copyright 2007 Institute for Health Freedom.