Health care has taken center stage in Washington, and a new pollconducted by Zogby International and commissioned by S. Ward Casscells, MD, a public policy expert at The University of Texas Health Science Center at Houston, gives unique insight into how Americans feel about this hot-button issue. This interactive survey of nearly 4,000 adults nationwide is among the largest and most comprehensive polls on health care issues in America to date. Due to the complexities of the issue, Dr. Casscells and I have decided a discussion format would help to further explore some of the survey findings and possible implications. We each have different takes on this incredibly complex issue, but agree that something must happen when it comes to health care in the U.S.

Dr. Casscells: We conducted this poll in the hopes of overcoming the problems we've had with other health care polls -- they're notoriously fickle, personal, complex, wording dependent, and often sponsored by passionate partisans. But they influence Congress and they've been volatile. In the past, such as in1993, support for health care reform waned as deadlines approached. We asked about health care reform again in this latest survey, and we decided to do it by conducting the largest poll done to date. Of 3,862 respondents we found 84% are satisfied with their health care, although 79% believe rising health care costs are hurting businesses. We also found that 53% believe health care to be a human right and 46% support President Obama's belief that you need a public plan to "keep insurance companies honest". We found that 44% believe the government should have an expanded role in health care.

John Zogby: My years of collaboration with the University of Texas Health Science Center goes back to 2003 and we're so glad to be working together on this survey at such a critical time in America. A word about the methodology, this is an online poll -- this is the wave of the future and the future is now. We invited 60,000 people at random from our panel of 500,000 adults nationwide and over the course of five days 3,862 responded, which is a good response rate. We've had 11 years of experience doing these and we've had a very good record polling Americans online.

Dr. Casscells: We also designed this survey to probe the American public on their feelings about how to best promote quality care. We gave respondents quite a few choices, and the top choice was to promote patient incentives for prevention, that is to say wellness programs such as weight control, vaccinations and cancer screenings. Number two was more government investment in basic research and among the other choices we found support for ranking doctors, more government investment in bedside research, and paying physicians for better outcomes, rather than the number of payments they see. The survey findings provided a strong indication that many Americans are willing to modify their unhealthy behaviors for the right incentive. We asked respondents if for $1,000 a year they would stop smoking or not start, lose 10 lbs., exercise 30 minutes three times per week, and get vaccinations and cancer screenings -- around 60% said yes. If they would hold to it, that would reduce health care costs.

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