Health Care Strategic Initiative:

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Health Care Strategic Initiative Research and
Development



Conducted with the Herndon Alliance Supported
by the Nathan Cummings Foundation, Public Welfare
Foundation, California Endowment, and the
Missouri Foundation September 28, 2006
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Overview of the ProcessValues-Based Policy
Development

• Road Map Segmentation of electorate according to
  values.
• Workshops to distinguish social outcomes from
  policy agenda.
• Strategic Initiative concepts tested and revised
  in 8 focus groups.
• Mini-poll to test initiatives.
• Large survey to be completed by mid-October.

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• Road Map
• A Values-Based, Psychographic Segmentation of the
  Electorate

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The Research

• Survey of 2,500 Americans and 2,600 Canadians
  aged 15 and older.
• Since 1982 in Canada, 1992 in U.S.
• One of the last major in-home survey in the U.S.
  (Roper-fielded)
• Used by Fortune 500 companies from GM to Proctor
  and Gamble

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100 Social Values Trends

• Acceptance of Violence
• Acknowledgement of Racism
• Active Government
• Adaptability to Complexity
• Adaptive Navigation
• Advertising as Stimulus
• American Dream
• American Entitlement
• Anomie and Aimlessness
• Attraction to Crowds
• Aversion to Complexity
• Brand Apathy
• Buying on Impulse
• Celebrating Passages
• Civic Apathy
• Civic Engagement
• Community Involvement
• Concern for Appearance
• Confidence in Advertising

• Discerning Hedonism
• Discriminating Consumerism
• Duty
• Discount Consumerism
• Ecological Fatalism
• Effort Toward Health
• Emotional Control
• Enthusiasm for New Tech.
• Enthusiasm for Consumption
• Entrepreneurialism
• Equal Relationship with Youth
• Ethical Consumerism
• Everyday Ethics
• Everyday Rage
• Faith in Science
• Fatalism
• Fear of Violence
• Financial Security
• Flexible Families

• Joy of Consumption
• Just Deserts
• Largesse Oblige
• Living Virtually
• Look Good Feel Good
• Malleable Self
• Meaningful Moments
• More Power for Business
• More Power for Media
• More Power for Politics
• Modern Racism
• Multiculturalism
• Mysterious Forces
• National Pride
• Need for Status Recognition
• Need for Uniqueness
• Networking
• Obedience to Authority
• Ostentatious Consumption

• Protection of Privacy
• Pursuit of Intensity
• Racial Fusion
• Reverse Sexism
• Question Authority
• Rejection of Order
• Religion a la Carte
• Religiosity
• Saving on Principle
• Search for Roots
• Selective Use of Personal Services
• Sensualism
• Sexism
• Sexual Permissiveness
• Skepticism of Advertising
• Social Intimacy
• Social Mobility
• Social Responsibility
• Spiritual Quest

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AUTHORITY
Traditional Family
United States 1992-2004
Religiosity
Obedience to Authority
Propriety
National Pride
Socio-Cultural Trends
Everyday Ethics
Primacy of the Family
Work Ethic
Duty
Traditional Gender Identity
Meaningful Moments
American Dream
Spiritual Quest
Selective Use of Professional Services
Effort Toward Health
Social Responsibility
Patriarchy
Discerning Hedonism
Emotional Control
Personal Challenge
Social Intimacy
Fear of Violence
Time Stress
Cultural Assimilation
American Entitlement
Search for Roots
Holistic Health
Consistent Self
Protection of Privacy
Discriminating Consumerism
Status Via Home
Concern for Appearance
Technology Anxiety
Look Good Feel Good
Civic Engagement
Discount Consumerism
Celebrating Passages
Confidence in Small Business
Faith in Science
Gender Parity
Confidence in Advertising
SURVIVAL
Aversion to Complexity
Importance of Brand
Personal Expression
Networking
Deconsumption
Mysterious Forces
Strategic Consumption
Xenophobia
Vitality
Advertising as Stimulus
Social Mobility
Voluntary Simplicity
Ethical Consumerism
Community Involvement
Introspection Empathy
FULFILLMENT
Saving on Principle
Sensualism
Adaptive Navigation
Conformity to Norms
Intuition Impulse
Heterarchy
Fatalism
Entrepreneurialism
Sexism
Joy of Consumption
Largesse Oblige
Brand Apathy
Ecological Concern
Parochialism
Attraction for Crowds
Culture Sampling
Confidence in Big Business
Modern Racism
Financial Security
Personal Control
Need for Uniqueness
Reverse Sexism
Ecological Fatalism
Importance of Aesthetics
Importance of Spontaneity
Just Desserts
Personal Escape
Enthusiasm for New Technology
Crude Materialism
Adaptability to Complexity
Rejection of Order
Need for Status Recognition
More Power for Politics
Interest in the Unexplained
Ostentatious Consumption
Enthusiasm for Consumption
Acknowledgement of Racism
Skepticism of Advertising
Active Government
Personal Creativity
Malleable Self
Living Virtually
Global Consciousness
Civic Apathy
Multiculturalism
Pursuit of Intensity
Religion a la Carte
Everyday Rage
Buying on Impulse
More Power for Business
Upscale Consumerism
More Power for Media
Racial Fusion
Anomie-Aimlessness
Flexible Gender Identity
Penchant for Risk
Acceptance of Violence
Rejection of Authority
Sexual Permissiveness
Flexible Families
Equal Relationship with Youth
INDIVIDUALITY
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The Health Justice Map





AUTHORITY
Proper Patriots
Marginalized Middle-Agers
SURVIVAL
FULFILLMENT
Drifters
Mobile Materialists
Autonomous Idealists
Young Achievers
INDIVIDUALITY
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Top 10 ValuesThe Health Justice Base

• Social Responsibility
• Fear of Violence
• Primacy of the Family
• National Pride
• Culture Sampling
• Personal Expression
• Ethical Consumerism
• Propriety
• Time Stress
• Voluntary Simplicity

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13 of population, 15 of electorate The Health
Justice Base



Demographics Politics 67 Female 65 Likely
Voter 32 Male 40 Great Deal Attn to
Politics 55 White 54 Democrat 16 African
American 15 Republican 15 Hispanic/Latino
16 Independent 77 Over 35 70 Kerry 38
Over 55 24 Bush 6 Nader 85 HS Grad 23
College Grad 38 5,6,7 Liberal 17
Retired 37 Self/Family Union Member 26 Under
20K 66 Under 50K 100 For
Comprehensive Health Care 50 Privatize All
Possible Services 37 Suburbs 84 Vote Against
Any Tax Increase 40 Small Town/Rural 63
Welfare Breeds Dependency

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Top 10 ValuesCOO1 Proper Patriots

• National Pride
• Everyday Ethics
• Personal Expression
• Meaningful Moments
• Work Ethic
• Traditional Family
• Primacy of the Family
• Holistic Health
• Civic Engagement
• Religiosity

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34 of population, 40 of electorate Proper
Patriots




Demographics Politics 53 Male 67
Likely Voter 75 White 34 Great Deal
Attention to Politics 38 35-54 30
Democrat 29 Over 55 36 Republican 21
Independent 26 College Grad 18 White
Collar 41 Kerry 39 Executive/Professional 5
4 Bush 17 Retired 54 3,4,5
Conservative/Liberal 1-7 49 35K-80K 71
Own 84 For Comprehensive Health Care 61
Welfare Breeds Dependency 38 Suburban 44
Small Town/Rural 11 Plains 20 South Atlantic
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Top Ten ValuesMarginalized Middle-agers

• Upscale Consumerism
• Community Involvement
• Acceptance of Violence
• Anomie-Aimlessness
• Acknowledgement of Racism
• Modern Racism
• Reverse Sexism
• Everyday Rage
• Enthusiasm for Consumption
• Sexism

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17 of pop., 15 of electorate Marginalized
Middle-Agers



Demographics Politics 68 Female 51
Likely Voter 62 White 24 Great Deal
Attention to Politics 16 Hispanic/Latino 10
African American 39 Democrat 6 Asian 24
Republican 15 Independent 29 18-34 37
35-54 52 Kerry 44 Bush 22 College
Grad 3 Nader 24 White Collar 20
Retired 50 3,4,5 Conservative/Liberal 1-7 47
Under 35K 83 For Comprehensive Health
Care 25 Central City 53 Privatize All
Possible Services 18 Midwest 82 Vote Against
Any Tax Increase 20 Pacific 65 Welfare
Breeds Dependency



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Top Ten ValuesMobile Materialists

• Fear of Violence
• Reverse Sexism
• Technology Anxiety
• Celebrating Passages
• Active Government
• Status via Home
• Buying on Impulse
• Obedience to Authority
• Acknowledgement of Racism
• Look Good Feel Good

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13 of population, 12 of electorate Mobile
Materialists



Demographics Politics 52 Female 52
Likely Voter 60 White 32 Great Deal
Attention to Politics 17 African-American 14
Hispanic/Latino 42 Democrat 23
Republican 41 Under 34 16 Independent 23
College Grad 10 Post Grad 62
Kerry 35 Bush 55 Work Full Time 43
Manager/Executive 36 Self/Family Union
Member 22 50K-65K 25 Self/Family NRA
Member 52 35K-80K 85 For
Comprehensive Health Care 33 Central City 81
Vote Against Any Tax Increase 22
Midwest 18 Mid Atlantic



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What We LearnedWorldviews at a Glance




Proper Patriots Focused on personal
responsibility, everyday ethics and national
pride. Marginalized Middle-Agers Looking for
help and status. Mobile Materialists Most
extreme in asserting self-interest. Thus, we
re-crafted SI concepts with eye toward Proper
Patriots
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• Findings from 8 Focus Groups and Initial Polling

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Research FindingsSolve Consumer Crisis First

• Consumer Frame is dominant
• High costs understood as function of profiteering
  by drug companies and insurers
• Intuitive solution is to protect health care
  consumers by restraining drug companies and
  insurers
• Solving consumer crisis leads to generosity, not
  indifference
• Covering uninsured is not feasible until insured
  Americans feel secure about their own coverage
• Inciting fear of loss of coverage leads to
  smaller, zero sum calculations, not larger,
  comprehensive solutions

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Research FindingsNew rules, not new services

• Confidence in government is at an all time low
• Katrina, Social Sec. debate, Medicare part D
  drive belief that government things that dont
  work.
• Resulting cynicism does not translate to demand
  to fix problems but rather cynicism that
  government can be counted on to do anything
• Some roles inspire more confidence than others
• Restrictive not generative
• Rules and laws, not programs and services.
• Enforcement not dependent on government

Voters are looking for simple and enforceable
rules not new services or programs.
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Research FindingsVoters need help sorting
deserving from undeserving

• Zero sum reasoning plus lack of confidence in
  government suspicion of undeserving
• Fear suspicion of other
• Extending care to more people more demand
  higher cost and less care
• Cynicism about government low confidence that
  government can distinguish deserving from
  undeserving
• Voters need rules
• Working
• Taking care/being responsible for ones own
  health
• Paying something -- sliding scale

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Four New Strategic Initiatives on Health and
Health Care




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Strategic Initiative Candidate 2.0Healthy
Generation

• We can create healthiest and strongest
  generation of children ever. We must
• Restore P.E.
• Demand higher quality school lunches.
• Ban junk food ads.
• National advertising campaign to promote good
  eating, less TV, physical activity, family
  dinners.
• Cover all American children who currently lack
  health coverage.

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Strategic Initiative Candidate 2.0Universal
Cancer Screening




We have an obligation as a country to make sure
that all Americans even those Americans who
dont have enough insurance get screened for
cancer before its too late Everyone would have
a choice of getting this screening from their own
doctor, health provider, or any publicly funded
health clinic.
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Strategic Initiative Candidate 2.0Health Care
Bill of Rights

• Essential services, preventative care.
• Keep insurance if move or change jobs.
• No patient charged higher price than others for
  same service.
• Cant deny insurance because of a pre-existing
  condition.
• No discrimination on age or health.
• Insurance companies must get approval to raise
  rates above inflation.

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Strategic Initiative Candidate 2.0Guaranteed
Choice




Every American would have guaranteed access to a
choice of standard, affordable health plans,
either buying it from a private insurer, or from
a public plan provided by an independent
non-profit agency... Everyone would have a choice
of plans, private and public, that would be
affordable to them based on a sliding scale.
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Full DescriptionHealthy Generation




We need a national commitment to creating the
healthiest and strongest generation of children
we have ever had the Healthy Generation. The
Healthy Generation initiative would restore
physical education to every grade in every school
and improve the nutritional quality of the school
lunch program. It would ban junk food
advertising to children and instead create a
national advertising campaign to help parents and
children learn good eating habits, reduce TV
watching, and be more physically active. To make
sure every child gets the basic health care and
preventive care they need to stay healthy,
existing health insurance programs would be
expanded to cover all American children who
currently lack health coverage.
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Full DescriptionUniversal Cancer Screening




Getting a cancer screening should be easy, not
hard. And no American should be denied the right
to get screened for cancer. We have an obligation
as a country to make sure that all Americans
even those Americans who dont have enough
insurance get screened for cancer before its
too late. Not only do cancer screenings save
lives, they also save money. Every American
should have easy access to being screened for
cancer in his or her community. Everyone would
have a choice of getting this screening from
their own doctor, health provider, or any
publicly funded health clinic
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Full DescriptionHealth Care Bill of Rights




We need a Health Care Bill of Rights for all
Americans that would guarantee the following five
things Your health insurance will cover at
least a core package of essential health services
and preventive care that everyone needs. You can
keep your insurance if you move or change jobs.
No patient will be charged a higher price than
other patients for the same service. You cannot
be denied insurance because of a pre-existing
health condition. And insurance companies would
have to get approval from an independent
oversight agency before they could raise your
rates above the rate of inflation. A Health Care
Bill of Rights would ensure that every American
is guaranteed the health coverage they are paying
for, no hidden loopholes.
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Full DescriptionGuaranteed Choice




Health insurance companies should be required to
offer a standard, comprehensive health plan so
that everyone knows what they are getting and
that their health care needs will be met. Every
American would have guaranteed access to a choice
of standard, affordable health plans, either
buying it from a private insurer, or from a
public plan provided by an independent non-profit
agency. Employers and insurers could choose to
offer more coverage beyond the standard plan, but
all plans would have to cover at least the
standard package of benefits. Everyone would have
a choice of plans, private and public, that would
be affordable to them based on a sliding scale.
This approach would put consumers and families in
control of their health care and make sure every
American has access to affordable health coverage
that meets their needs.
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