A first-of-its-kind survey asking Texans if health insurance is necessary found an overwhelming majority believe having coverage is critical for them and their families, with 50 percent calling it "absolutely essential."
The Texas Medical Center commissioned Nielsen to survey attitudes surrounding health insurance ranging from its importance, what you would give up to pay for insurance, and whether people with bad health habits should be required to pay more.
The Houston Chronicle obtained advance results from the online poll posed to 1,000 Texans over 18 between Jan. 27 and March 3. The complete results will be unveiled Monday at the Medical World Americas 2015 conference in Houston.
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Most striking was that 83 percent of those surveyed - a rate that held steady across age, race, income, education and insurance status categories - said having health insurance was either "very important" or "absolutely essential." Only 5 percent said it was "not important at all."
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"That includes the all-important 25-to-35 demographic. It flies in the face of those groups who have been saying that young people don't need or want health insurance," said Dr. Arthur "Tim" Garson, director of the Health Policy Institute at Texas Medical Center.
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Health insurance attitudes
The Texas Medical Center commissioned a survey of how Texans feel about health insurance. A sampling of how they answered.
1. How important to you and your family is having health insurance? Absolutely essential, 50%; Very important, 33%; Somewhat important, 12%; Not at all important, 5%
2. What is most important? Having health insurance, 46%; the total cost of health care I have to pay, 27%; ability to see a physician or nurse when needed, 27%; and quality of health care received, 0%.
3. In order for you/your family to have health insurance, which, if any, of the following would you be willing to give up? Expensive/high priced foods, 53%; Eating out at fast-food restaurants, 52%; Other entertainment (e.g., movies), 43%; New car, 38%; Cable TV service, 33%; Cellphone, 12%; Computer/Internet service, 11%; Rent/mortgage, 6%; Child care, 5%; Something else, 1%; Nothing, 16%
About the survey: Online poll of 1,000 adult Texans between Jan. 27 and March 3.
Source: Texas Medical Center, Nielsen
The survey showed that more than three-quarters of those between 18 and 34 wanted health insurance.
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"It reaffirms what we have been hearing on the ground, particularly here in Texas," said Jose Sanchez, 27, Houston-based Southern Director for Young Invincibles, a national public policy organization that advocates for young adults in that age range. "Young Texans value health insurance, but in the past they didn't think they could afford it or did not know how to get it."
Sanchez said his 22-year-old sister amassed $30,000 in medical debt from a chronic back ailment during a time when she did not have insurance.
"As an age group, we have the second-highest rate of visits to the ER after the elderly," Sanchez said.
Currently, Texas leads the nation in the number of uninsured with roughly 22 percent, or about 5.7 million people. And while it is not unusual for people living on the edge to experience periods without insurance, in Texas more than half of uninsured adults have been uninsured for five years or more, including 31 percent of the uninsured who have never had coverage in their lifetime, according to a 2014 Henry J. Kaiser Family Foundation analysis of the state's uninsured.
Surprising finding
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The Texas Medical Center survey also asked which is most important: having health insurance, the total cost of health care, access to a doctor or nurse or the quality of health care received. Having health insurance ranked first with 47 percent calling it the most important.
Cost and access tied at 27 percent and quality of health care came in last, with not one person out of 1,000 ranking quality as most important.
"That is surprising because I can't believe no one cares about quality," said Elena Marks, president and CEO of the Episcopal Health Foundation. She speculated that perhaps people assume they will get good care if the other factors are taken care of.
"Quality is actually very difficult to understand. There are a lot of things that go into quality," Garson said. Still, he added "We have a big job to do in educating the public about quality."
Doing without
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When asked what, if anything, they would give up to afford insurance, 53 percent said expensive food and 52 percent answered eating out at fast-food restaurants. Those surveyed also would give up other entertainment such as going to movies or getting cable or skip buying a new car. Only 16 percent said they would give up nothing.
The majority, 59 percent, also indicated they thought people who had poor health habits such as smoking or not exercising should pay more for insurance.
While he agrees with that finding, Garson wonders if insurance is the correct way to nudge people toward better habits.
"Health insurance should not be used as a blunt instrument," he said.
Garson called the survey results "tremendously important because they point the way to policy change in Texas and perhaps also in rest of the country."
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By Jenny Deam
Jenny Deam is an investigative reporter focusing on abuses in the health care system. She came to the Houston Chronicle in March 2015 from Denver, trading thin air for thick. She is a two-time Loeb Award finalist. Prior to joining the Chronicle she was a special correspondent for the Los Angeles Times based in Denver. She has been a reporter for the Denver Post, the Tampa Bay Times, the Kansas City Star and has written for regional and national magazines. She is a graduate of Washburn University.
