Most leaders in healthcare and health policy favor reform plans that build on the nation’s current mixed system of public and private group insurance, according to a new survey by The Commonwealth Fund. The mixed system approach is at the heart of proposals put forth by Democrat presidential frontrunners’ Senators Barack Obama, Hillary Clinton and John Edwards.

According to the Fund’s annual survey released Monday, 83 percent of health care opinion leaders said they favor requiring all individuals obtain health insurance and that there be premium assistance for low and moderate-income Americans. Seventy one percent of the respondents said they also support requiring employers offer to pay for coverage of their employees or pay a percentage of their payroll to help finance expanded coverage.

“Support for a pay or play requirement is strong even among opinion leaders in the business community,” the Fund said.

The Commonwealth Fund is an independent foundation working toward health care policy reform. Its annual survey traditionally asks opinion leaders from academia and research organizations, health care providers, business, and insurance and others for their views on the state of the healthcare industry and healthcare policy. This year, the survey focused on the leading presidential candidates’ health care reform proposals. Elected officials and media representatives were excluded from the survey.

The surveyed experts generally were negative on healthcare reform proposals relying on tax incentives that help individuals purchase coverage – the centerpiece of most Republican presidential candidate proposals – labeling them as “ineffective strategies,” for achieving universal health care coverage or containing escalating health care costs.

A majority of those surveyed supported establishing market regulations against risk selection, therefore requiring insurance companies to offer coverage to all who apply at affordable rates, regardless of their health or age. Nearly two-thirds of the experts support allowing public insurance plans to compete with private insurance but a minority – 37 percent – would replace the private market with public insurance.

Harris Interactive conducted the online survey between November 29 and December 31, 2007. Nearly 2,000 opinion leaders in healthcare policy, delivery and finance were invited to participate. The final sample included 221 respondents from various industries, according to The Commonwealth Fund.


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