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May 19, 1993

Bridging the Gap Between Expert and Public Views on Health Care Reform

Author Affiliations

From the Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass. Dr Blendon is a nonstockholding director of Fortis Holdings Inc, New York, NY, a Dutch-American firm that owns two health insurance companies.

JAMA. 1993;269(19):2573-2578. doi:10.1001/jama.1993.03500190117056

AMERICANS consider reform of the health care system to be one of the most important initiatives for the new administration. A March 1993 opinion poll ranked "reforming the health care system" second highest as a priority for the federal government, ahead of stimulating the economy, a middle-class tax cut, and a variety of other efforts.1 Eighty-eight percent of the public believes it would be a serious failure if President Clinton does not keep his promise to control health care costs, while 69% would consider it a serious failure if he breaks his promise to ensure that everyone has health insurance coverage.2

However, a more in-depth reading of these opinion surveys suggests a note of caution for our nation's leaders. They may be misdiagnosing the reasons behind this high level of public interest in health care reform. Policymakers rely on health care economists and policy experts to help define