"These results show that leaders from all the key stakeholder groups agree: comprehensive health care reform is urgently needed, to rein in costs and ensure that all Americans have access to affordable quality care," said Commonwealth Fund President Karen Davis. "Leaders also agree that offering a range of insurance options, and changing the way we pay for health care are critical steps for controlling the growth in health care spending over the next decade."

Seven of 10 respondents to the survey, conducted by Harris Interactive, support the creation of a national health insurance exchange with the authority to enforce standards of participation by carriers, standardize benefits, set rating rules, and review or negotiate premiums. Two-thirds (65%) say that the exchange should offer a public plan that incorporates innovative payment methods, moving away from traditional fee-for-service and toward bundled payments. Half of opinion leaders (51%) support setting provider payment rates in a public insurance plan either at Medicare levels or between Medicare and commercial plan levels.

Other findings from the survey include:

• Fifty-six percent of respondents believe that, in designing an individual mandate, the required benefit package should be similar to the standard BlueCross/BlueShield option offered in the Federal Employees Health Benefit Program.
• In considering strategies to reduce health costs, opinion leaders express substantial support for new insurance reporting requirements (78%), joint negotiation of pharmaceutical prices (72%) and provider payment rates (61%), and limits to high cost providers and overvalued services (71%).
• Forty-five percent of respondents believe provider participation in the public plan should be linked to Medicare, while 43 percent believe it should not, with the strongest opposition among those working in health care delivery.
• Nearly three quarters of opinion leaders (72%) support ending the two-year Medicare waiting period for the disabled.
• When asked to indicate their support for a variety of approaches to financing coverage expansion, more than three-fourths of survey respondents (79%) support increasing the federal excise tax on alcohol, cigarettes, and sugar-sweetened drinks, and 77% support requiring employers to offer coverage or pay a percentage of payroll to finance coverage (pay or play).

The survey is the 19th in a series from The Commonwealth Fund, and the eleventh conducted in partnership with the publication Modern Healthcare.

Methodology: The Commonwealth Fund/Modern HealthCare Health Care Opinion Leaders Survey was conducted online within the United States by Harris Interactive on behalf of The Commonwealth Fund between June 8, 2009 and July 8, 2009 among 585 opinion leaders in health policy and innovators in health care delivery and finance. The final sample included 208 respondents from various industries, for a response rate of 35.6 percent. Data from this survey were not weighted.

The Commonwealth Fund is a private foundation supporting independent research on health policy reform and a high performance health system.

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