Program on International Policy

Americans on Health Care Policy

August 30, 2000

11. Government's Role

In general, a strong majority feels that the government should play a more active role in the effort to control health care costs. A majority favors the government regulating the costs of drugs that are produced under an exclusive patent.

Support for more government regulation of health care in the US is very strong, and that support has remained fairly consistent over the past several years. A Gallup survey from January 2000 found that 77% believed "the federal government should do more to regulate health care costs in this country." Only 20% felt the government should not do more. This is similar to the level of support for regulation found in surveys around the time of Clinton’s health care reform effort, particularly with regard to price controls. In July 1994, an ABC News survey reported that 72% supported (52% strongly) "federal price controls on medical expenses such as doctors’ fees, hospital charges and drug prices." Just 27% opposed price controls. A month earlier, an ABC/Washington Post survey asked the same question and found that 75% supported (57% strongly) price controls on medical expenses.129

The idea that government should step in to combat excessive prices and market control by a few large companies was explicitly and implicitly stated in the focus groups.

I think there is a lot of incredible profits by large companies … and meanwhile the system isn’t covering a large portion of our population… If you’re making the big profits off the medical system, you should be paying into the system in some fashion. (Man, Richmond)

Corporate America should be held accountable, HMOs should be held accountable, drug manufacturers should be held accountable, doctors should be held accountable. I mean, I get a bill and I see forty dollars for a syringe or … seven dollars for one pair of latex gloves. Somebody’s getting milked somewhere along the line. (Man, Cleveland)

There has to be some sort of oversight for these companies and some way to control those costs (Man, Richmond)

For a large majority of the public, a major focus of cost concern is that of prescription drugs, which have risen dramatically in recent years. Many of the most widely prescribed pharmaceuticals are protected by patents, which in effect give the drug companies that sell them a 20-year, government-authorized monopoly.

In the COPA poll, respondents were presented two arguments on the question of whether the government should regulate the price of drugs protected by patents. As shown below, 71% favored government regulation of drug companies "just like they regulate monopolies in gas and electric companies." Only 25% favored the opposing argument, that regulation of drug firms "would discourage them from doing important research on life-saving drugs."

On this issue, there was virtual unanimity in the focus groups. Participants just did not believe that the prices Americans pay for prescription drugs are justifiable, and they strongly favored government action to reduce drug prices.

I think some sort of socialized medicine should be in place if just to control the price of the drugs that are available to us. They always give us the reason that it’s the R and D [research and development] that makes the price of the drug go up. Even that is funded by the government…There’s really no reason for drugs to be that high. (Man, Cleveland)

The drug companies…make billions and trillions of dollars, it seems, like on their drugs, which are developed at public universities and sometimes heavily by taxpayers’ dollars to begin with. I mean, we’re the ones paying for the research and then they go out and get the profits. Let’s get some of that back… (Man, Richmond)

I think profits are probably a little higher than other industries because the consumer doesn’t have the choice to go out and buy a different drug…There’s just too much control of the drug company on the sale of their product. In a competitive market you don’t have that kind of control. (Man, Richmond)

Additionally, a July 2000 Washington Post/Kaiser/Harvard study found that a majority (56%) believed there was "not enough government regulation" of "the cost of prescription medicines." Just 39% thought it was "about right" (20%) or "too much" (19%).130 In 1993, a Yankelovich Partners survey found an overwhelming 84% of respondents favored "limiting the amount of money drug manufacturers could charge for prescription drugs" in order to reduce "waste and inefficiency" in the health care system.131


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