U.S. health care leaders are moderates when it comes to health care policy. They are generally deferential to the status quo.

They don't want to see the Patient Protection and Affordable Care Act (PPACA) scrapped, but they definitely aren't interested in a Bernie Sanders-style single payer system.

That's according to a quarterly poll conducted by Modern Healthcare of 86 executives at hospitals, insurance companies, and other health-related organizations.

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Two-thirds of the respondents said they were against repeal of the PPACA. Among the others who were open to the concept, nearly all said that their embrace of such a dramatic proposal would depend on the specifics.

Similarly, three-fifths signaled outright opposition to abolishing private insurance in favor of a "Medicare for all" approach to health care. Nine percent favor the idea, and 29 percent say it depends how it would be put in place.

Tom Priselac, president and CEO of Cedars-Sinai Health System in Los Angeles, explained to Modern Healthcare that supporting the concept of single payer does not necessarily lead a responsible health leader to endorse the approach in the U.S., given the many political and systemic obstacles.

"A single-payer system, once defined sufficiently so that the pros and cons can be understood, will only be politically feasible once it is sufficiently socially acceptable," Priselac said. "Americans still place a very high value on choice.

Only a third of the health care leaders surveyed said they wanted to see the PPACA marketplace expanded, through additional subsidies, to achieve greater coverage. Fifteen percent were opposed, and nearly half said it depends how it is done.

One area of consensus: The move away from the fee-for-service system of reimbursement towards one that focuses on value or outcomes. Eighty-four percent say they want such efforts, from Medicare, Medicaid, and private insurers, to continue.

Should insurance companies be allowed to sell policies across state lines? Half said yes, 20 percent said no and a quarter said it would depend on the details of the new law.

On whether to create high risk insurance pools for those with preexisting conditions, an idea floated by Speaker Paul Ryan as an alternative to requiring all health plans to accept those with illnesses, only 16 percent express outright opposition. Forty-three percent support the idea and 36 percent say they'd need to know more about the idea.

The poll results did not reveal differences of opinion among the health leaders based on profession or industry. Those who work in medicine likely have a different take on issues than those in insurance. It would be interesting to see those differences highlighted in the future, although a much larger sample size would be necessary to get statistically reliable results for each sub-group. 

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