This is bad news for the Democratic reform effort: Gallup reports today that, according to its latest polling, more Americans than not think health care reform will hurt their own medical care and make it more expensive...though they think it will improve quality and access nationally.
So on the three main questions of health care--quality, access, and cost--people think President Obama's initiative will make things worse for themselves on all three fronts...and that it will make things better for the nation in two out of three categories.
(There's a fundamental discrepancy here: health care reform can't help the nation across the board, while at the same time hurting most individuals.)
The public narrative, this poll implies, is that health care reform means a tradeoff: is it worth more expenses and worse care for me, the average Gallup respondent, to improve quality and access across the board?
This is specifically not how Obama wanted to paint the health care issue. In speeches and town-hall events, the president has argued that health care is a pressing need for you, that you could lose your health insurance or go broke if we don't pass a reform bill--that it's not about the millions of people without health insurance, per se, but rather about skyocketing costs that make the current system untenable. His reforms are supposed to preserve quality, improve access, and drive costs down.
According to Gallup, the public doesn't believe him--at least on how reforms would affect them personally.
If Gallup's polling is right, the health care issue pits altruism against self-interest in the public mind. And it's a tough day for any initiative when people, on average, think it will hurt them personally, even if they see a solid upside for the rest of the nation.
This is what the President gets for letting the mental midgets on Capitol Hill control the process. I want reform. I have insurance and pay out the nose for individual coverage that doesn't really pay for much of anything. I am at the mercy of BCBS. The watered-down swill circulating on Capitol Hill isn't going to help people like me. More people will have coverage, which is a good thing, but I don't see the system getting any cheaper, more efficient, or better at delivering care. Lame.
Interesting formulation, Chris: "bad news for the Democratic reform effort". I would say: bad news also for the press, because it has not done its job providing accurate information. It's silly to complain that Obama has not been clear when most of what people get to hear is complete nonsense. Not surprisingly, they are confused and scared.
Actually, I don't think the difference is as stark as you make it. Note that the exact same percentage - 34% and 29% respectively - view health care reform as more likely to worsen and become less accessible to "you personally" AND the country as a whole. This is the core of opposition and it seems no different between views of personal status and the nation as a whole. This is, basically, the GOP base. For everybody else, health care reform will either improve things for themselves or not affect them.
On costs, it's striking that people see national costs going up much more strongly than they see their OWN costs going up. In that case, the self-interest argument from Obama is working exactly as it should.
For once, I want Democrats to act a little more like Republicans. Fall into party line and vote on a bill that will actually work.
I couldn't agree less with this analysis. I don't think this poll will have Democrats jumping up and down with glee, but it isn't near the posion pill Chris makes it sound like. In fact, I think it shows that the Obama sales ptich on two of the points is actually working. A plurality of people think that health care reform will improve medical care (44%) and access (47%) nationally. That is a substantial number. More to the point, though, only about a third believe that health reform is going to do more harm than good nationally. I think that means the message has gotten through about what health reform means nationally. Some, most likely conservatives, don't buy it. While a small, but important, minority is skeptical.
I take the biggest issue with your analysis of how people see health care reform impacting them personally. We all know that many Americans like their current medical care. That is why the president has said on numerous occasions that if you like your current plan and doctor you will be able to keep them. Therefore, for many Americans no change in their personal medical care and access to it is GOOD! They don't want it to change. What killed Clintoncare for the public was that too many people feared losing their current level of care. This poll shows only about a third of the public thinks reform will adversely affect them. Again, this group is probably conservatives who hate the overall idea of the reform effort. A majority believe that personally, they will either be helped or not effected by the reform. Based on this poll a majority of Americans believe that healthcare reform will not hurt their personal medical care and their access to it.
Contrary to Chris's analysis, what this poll shows is that the majority of Americans don't believe that they have to chose between altruism and self-interest on access to health care and quality. However, on the question of costs, it seems that there is more of an issue. To be honest I'm not sure what the poll results mean, except that people don't think that reform will cut costs. I might quibble with the wording: what exactly do you mean by "cost"? But, I think it might be borne out of two things: many are skeptical that costs can actually be controlled and the $1 trillion that would be spent over the next 10 years to get the reform up and running.
interesting because every time the president talks about health care he talks about the need to CUT COSTS.
which just makes me wonder where these people are gettign their information...
i mean, a plan that would increase costs would only exacerbate the health care crisis we have and thus be completely counter-productive.
I'm sorry, to my view this appears to be a less than subtle attempt to "seed the sample". These poll results only reflect the current stage of the dis-information battle. Publishing them with the implied , "ooooh, see, PEOPLE don't like the idea..." is infowar 101 in the atttempt to manage subsequent opinion surveys. A poll concerning what a sample group thinks about how a still undefined program, MIGHT impact costs or level of care, to an individual, or "the U.S" is, at best dubious analysis. Calling it "bad news" is an attempt to manufacture groupthink.
The attempt to characterize this data in a specific light is further illustrated by the fact that it could just as reasonably been presented as "51% of respondents believe that their personal costs will remain unchanged or reduce", or "55% see care improving or remaining the same". This type of commentary is neither productive nor honest.
With 50 MILLION Americans without ANY form of coverage, and another 100 MILLION with coverage so inadequate, a single hospitalization event will push them into bankruptcy at the first billing statement, let's agree that SOMETHING needs to be done, and not try to demonize the good faith attempt to to help everyone.
srt
Since those numbers have no bearing on reality, it's hard to buy that this is a "good faith attempt."
And you feel that the correct, reality based numbers should be....?
Uninsured Americans: 86.7 million: Study finds third of Americans under 65 had no health insurance at some point in the past two years....
http://money.cnn.com/2009/03/05/news/economy/health_uninsured/index.htm
This all depends on how voters will reward/punish policy makers for their decisions. If the voter says, "whatever policy they enact, it must improve upon the status quo," that's one thing. If she says, "as long as they don't make things worse, it's worth a shot," that's quite another. If the latter case is so, then we should combine the "improve" answers with the "not change" answers and do our comparisons again:
(all figures reflect worsen/not worsen breakdown)
Costs - Personal: 34/52
Costs - National: 45/44
Quality - Personal: 34/55
Quality - National: 34/55
Access - Personal: 29/60
Access - National: 29/60
Three things emerge. First, public pessimism about the plan is pretty low. Second, there is no area in which people think they will be worse off personally than the nation will be as a whole. Third, the only area where there is a difference is in cost, which people think will be worse on a national level than on a personal level; but it's a near split between those who think it will be more expensive nationally and those who think it won't be.
Is that the sort of discrepancy we see in polls where a majority of respondents say that they are satisfied with their own health care but dissatisfied with health care in America overall?
(Or where people have a low opinion of Congress as an institution but a high opinion of their own Representative and vote to reelect them over 80 percent of the time?)
I don’t think that discrepancy is hard to explain – people have been told for years by the sort of people pushing this legislation about how we have horrible health care in our country but most people probably have gotten pretty good care so they just assume that if health care is bad, it must mean that it’s bad for someone else.
But yes they probably are right in that Obamacare will hurt the majority of people who have health insurance or need health care. Contrary to what many people think Obama promised, you aren’t going to be able to keep your private health insurance under his plan in any meaningful sense. In reality, if Obamacare passes, the federal government will, by gutting ERISA, within five years rewrite everyone’s plan through a “national exchange” that will force you to buy a plan that covers certain benefits and place limits on the amount of your bill (co-pays, deductibles, co-insurance) you are responsible for (which means that you likely won’t be saving up to $2500 on your premiums). You might still have a “private health insurance plan” (if you don’t become one of the tens of millions whose employer dumps you to go on the government plan) but it’s going to be private in name only since it will essentially be required to duplicate the government plan.
And no, we already have the CBO scoring to know that the plan won’t pay for itself by “bending the curve.” It will cost hundreds of billions (more likely more than a Trillion more) in just the first ten years. And that’s even after Congress fudged the numbers by phasing it in over the first few years to minimize the sticker shock. It will be financed through a combination of higher taxes that will hit American workers and businesses (most of whom will be surprised to learn that they are now the “wealthy”) and deficit spending. Also since a large part of the “public option” consists of expanding Medicaid eligibility and Medicaid is half-financed by the States – expect your State taxes to go up as well.
Will people on the “public option” actually get better care? I doubt it since a large part of the “savings” consists of cutting reimbursement to providers even further. We already have seen that every time Congress does this, more and more providers refuse to take on (more) Medicare patients for the pittance the government pays and the additional risks that come with getting in bed with the federal government. If they really thought that they could squeeze 30 percent savings from what we spend on Medicare without affecting quality by duplicating the Mayo and Cleveland Clinic models throughout the nation, then they should be able to do it as a standalone bill. Instead what we’re likely going to see is (a) more people enrolled on a government program with (b) fewer doctors or hospitals willing to accept them at patients.
The one area where they will likely reduce (or slow down) the growth in health care spending is through supply rationing. One of Obama’s advisors on health care reform, Gregg Bloche taught a CLE I had to attend on the future of health law pointed out that one of the primary cost drivers in health care spending is innovation. New technology in the form of drugs, devices, treatments, etc. is expense when you’re the country developing it and American consumers like to demand the latest and greatest. But, as he pointed out, they’re less likely to demand something if it doesn’t exist. He admitted during the Q & A that the most feasible way to slow health care spending with the least resistance would be to try to slow the rate of innovation. That way they could (technically) truthfully say they have reduced spending without reducing quality because they haven’t taken away any new drug, device or treatment because it hasn’t been invented yet.
So no, I don’t think a plan that consists of the federal government taking over or displacing tens of millions of Americans who are satisfied with the private health insurance from their private health insurance, would results in hundreds of billions to Trillions in additional spending, be financed through new borrowing and higher federal and State taxes on American workers and businesses, encourage more providers to drop Medicare patients, and try to find “savings” by stifling innovation is a good idea at all.
I read this a little differently. Precisely the same percentages of people think it will worsen medical care, and access to care, nationally and personally. But there is a huge chunk of people who, though they believe that reform will help on a national level, have despaired of any hope that reform will benefit them personally.
In the future, any blogger who posts about healthcare reform, should be required to disclose whether they have employer-provided health insurance, health insurance under some other group plan that did not require an individual application, or insurance under a government program. I suspect that one's perception of the system, and the need for reform, would split radically along those lines, with virtually everyone in America who is forced to try to purchase an individual policy strongly behind reform.
Have to agree with buzz. During the campaign, the dems fought over what universality means. Cost was not an issue. The Administration needed to take the bull by the horns after January 20th and talk about cost and get off the 'health care as a civil right' thing. Wasted lots of time getting caught in nonsensical comparisons with other countries (most of which where devastated after WW2 and needed the government to intervene in h.c. pronto). Messaging awful. How many people hear 'public plan' and think of cost expansion vs. reduction, even though the added competition may be the one thing that could reduce costs in the long run.
Altruism has nothing to do with it. Too many writers confuse their own interpretations with the thinking of the public.
To agree with, and reinforce Jeff in LA's point: one's opinion on this topic is shaped by the funding source of one's medical coverage, and more dramatically shaped by the experience of having had to actually use one's medical coverage.
I have employer based coverage, and a minor (nothing found, no issues needing ongoing treatment) hospitalization left me with several thousands of dollars of uncovered expenses. We are a two income family, with both earners grossing more than six figures, and were severely impacted, by a health SCARE. The same event, for someone less well off, simply would have been catastrophic.
As the national population ages, the issue of coverage for all citizens becomes one that will affect everything and everyone.
People have every right to be scared. In Canada, we've seen what this kind of "health care" can do to people's health -- and lives!
People are waiting for months or years for treatment, surgeries, etc., and some even die before it's their turn.
More recently, we also heard that even cancer patients are now put on waiting lists for chemo therapy. By the time they receive the treatment, their cancer will have spread so extensively that chemo won't help anymore.
The Gallup polling is flawed in its methodology and especially in its analysis. Check out what former Gallup pollster David W. Moore has to say about how skewed this poll is here: http://www.beaconbroadside.com/broadside/2009/08/david-w-moore-gallups-anti-health-care-bias.html
Read more here: http://www.beaconbroadside.com/broadside/2009/08/david-w-moore-gallups-anti-health-care-bias.html