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"Blendon, Robert"
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An Uncertain Public — Encouraging Acceptance of Covid-19 Vaccines
An analysis of multiple polls suggests that much of the U.S. public is currently undecided about whether to take a Covid-19 vaccine. These findings can inform outreach efforts to encourage vaccine uptake — efforts in which physicians can play an important role.
Journal Article
Public Trust in Physicians — U.S. Medicine in International Perspective
Among 29 industrialized countries, the United States ranks high in patients' satisfaction with their own care but low in public trust in the country's physicians. If the U.S. medical profession wants to influence health policy decisions, it must improve public trust.
The U.S. health care reform process is entering a new phase, its emphasis shifting from expanding health coverage to improving our systems for delivering patient care. One emerging question is what role the medical profession and its leaders will play in shaping future national health care policies that affect decision making about patient care.
Research suggests that for physicians to play a substantial role in such decision making, there has to be a relatively high level of public trust in the profession's views and leadership. But an examination of U.S. public-opinion data over time and of recent comparative data on . . .
Journal Article
Medicaid Work Requirements — Results from the First Year in Arkansas
Arkansas was among several states that implemented Medicaid work requirements. Results from surveys of low-income adults suggest that work requirements were associated with a decrease in the number of people in Arkansas with Medicaid coverage and an increase in the number without health insurance.
Journal Article
The Public and the Opioid-Abuse Epidemic
A majority of the U.S. public considers addiction to prescription pain medication a major problem but does not deem it a national emergency. And only about half of the public believes there’s a treatment for prescription-painkiller addiction that’s effective in the long term.
Journal Article
Public Opinion about the Future of the Affordable Care Act
In this analysis of national opinion polls, approval of the Affordable Care Act increased from 42% in 2010 to 49% in 2017. The polls reveal sharply contrasting views of Republicans and Democrats about the future of the ACA.
Journal Article
Three-Year Impacts Of The Affordable Care Act: Improved Medical Care And Health Among Low-Income Adults
Major policy uncertainty continues to surround the Affordable Care Act (ACA) at both the state and federal levels. We assessed changes in health care use and self-reported health after three years of the ACA’s coverage expansion, using survey data collected from low-income adults through the end of 2016 in three states: Kentucky, which expanded Medicaid; Arkansas, which expanded private insurance to low-income adults using the federal Marketplace; and Texas, which did not expand coverage. We used a difference-in-differences model with a control group and an instrumental variables model to provide individual-level estimates of the effects of gaining insurance. By the end of 2016 the uninsurance rate in the two expansion states had dropped by more than 20 percentage points relative to the nonexpansion state. For uninsured people gaining coverage, this change was associated with a 41-percentage-point increase in having a usual source of care, a $337 reduction in annual out-of-pocket spending, significant increases in preventive health visits and glucose testing, and a 23-percentage-point increase in “excellent” self-reported health. Among adults with chronic conditions, we found improvements in affordability of care, regular care for those conditions, medication adherence, and self-reported health.
Journal Article
Trust in Medicine, the Health System & Public Health
This essay reviews more than forty years of public opinion polling to look at trust in medicine, the health system, and public health. We use polling data to explore the reasons for the decline and current level of public trust in leaders of medicine and public health, including underlying forces such as the decline in trust in other institutions. Except for the military, none of the efforts to improve public trust in various institutions have been very successful to date. Given the uncertainty about how to restore trust, this essay makes a number of recommendations that might improve public trust in medicine and public health in the future.
Journal Article
Insurance Churning Rates For Low-Income Adults Under Health Reform: Lower Than Expected But Still Harmful For Many
Changes in insurance coverage over time, or \"churning,\" may have adverse consequences, but there has been little evidence on churning since implementation of the major coverage expansions in the Affordable Care Act (ACA) in 2014. We explored the frequency and implications of churning through surveying 3,011 low-income adults in Kentucky, which used a traditional expansion of Medicaid; Arkansas, which chose a \"private option\" expansion that enrolled beneficiaries in private Marketplace plans; and Texas, which opted not to expand. We also compared 2015 churning rates in these states to survey data from 2013, before the coverage expansions. Nearly 25 percent of respondents in 2015 changed coverage during the previous twelve months-a rate lower than some previous predictions. We did not find significantly different churning rates in the three states over time. Common causes of churning were job-related changes and loss of eligibility for Medicaid or Marketplace subsidies. Churning was associated with disruptions in physician care and medication adherence, increased emergency department use, and worsening self-reported quality of care and health status. Even churning without gaps in coverage had negative effects. Churning remains a challenge for many Americans, and policies are needed to reduce its frequency and mitigate its negative impacts.
Journal Article