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08 March 2011

NEW POLL: Americans Choose Quality Over Quantity at the End of Life, Crave Deeper Public Discussion of Care Options

Despite pitched rhetoric of health care debate, poll shows little difference of opinion across political affiliations

WASHINGTON, D.C., March 8, 2011 – A national poll released today by National Journal and The Regence Foundation finds that more than 70% of Americans believe enhancing the quality of life – not just extending the length of it – should be a priority at the end of life.
The poll – the first in a three-part series called “Living Well at the End of Life: A National Conversation” – shows overwhelming majorities also want a more open public dialogue about the issues and options surrounding end-of-life care, including palliative care, and that Americans believe such discussions should be fully covered by both Medicare and private insurance.
And at a time when much of the national conversation about end-of-life care has taken on the pitched rhetoric of a political battle, the poll shows notably little difference of opinion across political affiliations.
The poll’s results will be discussed in-depth today at a National Journal LIVE event featuring Rep. Earl Blumenauer (D-OR) and health policy experts. Watch live online at 8:30am Eastern at
“The issues and choices surrounding health care at the end of life have huge implications for our country, on the personal level, in the health care field, and for policy-makers,” said Ronald Brownstein, Editorial Director of National Journal Group. “This poll makes it clear that while Americans are wrestling with these issues in their personal lives, the public conversation simply isn’t keeping up. Americans want to learn more about options at the end of life, and it’s time our national discussion shed less heat and more light.
Added Brownstein: “We also see from the results that, while Americans state a clear preference for options that make the end of life better, not just longer, a majority still believes the health care system should spend whatever it takes to extend life, and they worry about the possibility of diminished treatment. That tension, while not unexpected for such an intricate issue, shows how challenging it will be to craft public policies that balance all of the public’s mixed emotions in this complex arena.”
Nearly two-thirds of Americans have had personal or family experience with palliative care, end-of-life care, or hospice care, but only half of those respondents say they were prepared for the experience. Americans across all political affiliations prioritize quality of life at the end of life and desire a deeper conversation – both publicly and privately – about these complex issues.
“We do Americans a huge disservice by talking about end-of-life issues in a politicized way,” said Kieren Porter, Regence Foundation board chair. “If there’s one thing this first survey has shown us, it’s that for most Americans this isn’t a political issue at all – it’s a personal one – and they want to have meaningful, thoughtful and well-informed conversations about it. Fostering those conversations should be a top priority going forward.”
The National Journal-Regence Foundation poll top-line results can be viewed here (PDF). Key survey findings include:
1.     Americans feel strongly that enhancing quality of life is more important than extending it, but they are divided on how much the health care system should spend to extend the life of a seriously ill patient.
·       By a wide margin, Americans believe it is more important to enhance the quality of life for seriously ill patients, even if it means a shorter life (71%) than to extend the life of seriously ill patients through every medical intervention possible (23%).
·       This result is consistent across all party affiliations – Democrats (71%/24%), Republicans (68%/27%), and Independents (72%/20%).
·       More than half of Americans (55%) believe that the health care system has the responsibility, technology and expertise to offer treatments and spend whatever it takes to extend lives. This is compared to 37% who believe the health care system spends far too much trying to extend the lives of seriously ill patients.

2.     Americans believe palliative care should be a top priority in health care.
·       Americans are unfamiliar with the term palliative care (24% say they are “familiar”), especially compared to end-of-life care (65%) and hospice care (86%).
·       When educated on palliative and end-of-life care, Americans are nearly unanimous in believing these treatments should be a top priority in health care (96% important).
·       Nearly two-in-three Americans (63%) have had personal or family experience with palliative care, end-of-life care, or hospice care.  However, only half say they were prepared for that experience.

3.     People, regardless of political affiliation, want palliative care included in public and private conversations about health care.
·       A strong majority of Americans believe there should be more of an open debate about public policies regarding palliative care options (78% agree). 
·       Respondents agree that educating patients and their families about these issues is important (97%), they think a public dialogue will provide more information about care options (86%), and they think discussions should be fully covered by both private health insurance and Medicare (86% and 81%).
·       Only 12% of Democrats, 26% of Republicans, and 22% of Independents agreed with the concern that an open debate about palliative care and end-of-life care could interfere with personal decisions between families and doctors.
·       A full 81% of Americans believe discussions about palliative care and end-of life treatment options should be covered by Medicare, including 86% of Democrats, 77% of Republicans, and 79% of Independents.
4.     Despite a strong preference for quality of life at the end of life, many Americans worry about potential conflicts between palliative care and doing whatever it takes to extend a patient’s life. This concern surfaces disproportionately among African-Americans.
·       Roughly half (47%) of respondents say they worry that emphasizing palliative and end-of-life care options could interfere with doing whatever it takes to help patients extend their lives as long as possible.
·       Once again, this concern is expressed consistently regardless of political affiliation, held by 45% of Democrats, 48% of Republicans, and 51% of Independents.
·       Significant differences show up here between college-educated (35%) and non-college-educated (57%) respondents, and between Whites (44%), Hispanics (39%), and African-Americans (71%).

Note: This survey was conducted by FD among 1,000 adults 18 years old and above. Survey has a margin of error of plus or minus 3.1 percent in 95 out of 100 cases.