Health Reform: Are We Screwed Either Way?
Mark Blumenthal | September 17, 2009
Topics: CBS , Health Care Reform , Kaiser Family Foundation
I came across two sets of analysis -- one new today, one that I missed last month -- that help add important perspective to two aspects of the conventional wisdom about public opinion on health care reform: First, that most Americans with insurance are satisfied with it and, second, the related finding that most Americans are skeptical that the proposed reforms will improve either the quality or cost of their own coverage. Surveys yield much evidence supporting both assertions, but the larger context of those results is important and not as well understood.
A new analysis out today from the Kaiser Family Foundation reviews their data on American's satisfaction with their insurance coverage. While most Americans with insurance rate it favorably and express satisfaction with "various aspects of their coverage and care," other measures tell a more complicated story:
[T]he survey evidence also suggests that positive ratings do not necessarily paint a complete picture. First, despite their reported satisfaction, significant minorities of insured Americans have trouble paying for care, put off care because they can't afford it, and worry about the future of their coverage. Second, though most Americans say their insurance is "excellent" or "good" - significant portions of those who rate their insurance positively still say they face problems paying their medical bills or are dissatisfied with certain aspects of their health insurance coverage. And third, satisfaction with coverage is not uniform. Younger Americans, those with lower incomes and those who report being in poor personal health are significantly less likely to say they are satisfied with their insurance than their counterparts.
I wrote something similar back in June (here and here; see also the findings of John Russonello's survey in July), but the Kaiser report is far more comprehensive and well worth reading in full.
The second issue involves the questions that pollsters frequently ask about whether Americans believe the proposed reforms will help, hurt or make no difference. Just yesterday, the Gallup Organization released results showing that "Americans do not expect healthcare legislation to improve the U.S. healthcare system in a number of areas -- including quality, coverage, cost, and insurance-company requirements they would have to meet in order to get procedures covered:"
These results are similar to those obtained by the Kaiser Foundation tracking surveys, including a question about whether health care reform would affect "the quality of your own care" that Kaiser's Drew Altman has long argued "may be more important to watch than any other." In August, for example, Kaiser found that only 29% believe the reforms will make their own care better, 31% believe it will make it worse and 36% say it would stay the same.
Although many pollsters are obtaining similar results, I wonder how much of this pessimism stems from underlying worries about the quality and cost of coverage even without reform. Consider these findings reviewed in the new Kaiser analysis:
Many Americans are also worried about the uncertain future, particularly when it comes to cost. In a March 2009 survey, about half said they were worried about whether their insurance was adequate enough to cover their health care needs, including seven percent who described their insurance as inadequate . . . Those with health insurance also express underlying anxiety about the future of their coverage. In July 2009, a large majority of those with insurance, about two in three (67 percent), said they were worried about having to pay more for their health care or insurance in the future and about half (52 percent) said they were worried about losing their insurance coverage altogether.
In other words, are Americans convinced that their costs will go up and the quality of their coverage worsen either way, regardless whether reforms pass?
I thought it might be interesting to alter the text of the Gallup question and ask Americans whether the quality and cost of coverage would get better or worse if a health care bill does not pass this year. As it turns out, the pollsters at CBS News did something like this in their survey in late August. They asked a series of questions similar to those on the Gallup survey, and found only 18% who believe the current reform proposals will help then personally, 31% who believe it will hurt and 46% who say it will have no effect. They obtained similar results when asking about the costs and quality of care and their ability to see a doctor.
Then, near the end of the survey they asked this question:
What do you think will eventually happen to the nation's health care system if there are NO government reforms right now -- will the health care system get better on its own, get worse on its own, or will the health care system stay the same as it is now?
-- 6% better, 54% worse, 34% same, 6% unsure.
So once again, these attitudes are more complicated than the conventional wisdom might lead you to believe. Yes, Americans have doubts about the costs and benefits of the proposed health care reforms, and yes, when pressed slightly more Americans express opposition to the Obama health reforms than support (on many but not all surveys). While we may be "screwed either way," many clearly prefer the status quo. Still, as the results from the Kaiser Foundation and CBS News show, Americans express considerable fear about what might happen in the absence of reform. Those inclined to just "kill the bill" -- on the Left and Right -- might want to consider those findings more carefully.
By Mark Blumenthal | September 17, 2009 5:14 PM | Permalink | Comments (3) | TrackBacks (0)
Comments
Let me get this straight.
The health care plan will be written by a committee whose head says he doesn't understand it, passed by a Congress that hasn't read it and whose members will be exempt from it, signed by a president who smokes, funded by a treasury chief who did not pay his taxes, overseen by a surgeon general who is obese, and financed by a country that is nearly broke.
What could possibly go wrong?
Members of congress should NOT read bills, i am so sick of hearing the complaint 'haven't read the bill'. The language needed to create a major bill isn't something anyone other than a lawyer who specializes in the field of the bill would be able to fully comprehend.
Instead they have staffers who go over the bill and advise on what the bill contains, they can do it quickly and with much more efficiently.
Many insured who claim to be happy with their health insurance plans have never actually triggered a claim. So the fact that many claim to be happy now doesn't mean healthcare and healthcare insurance reform should be stalled. That's why I hate some of these polls. The only and real polls (elections) we have to take into account is the one that occured on Nov 4 last year. The American people gave Obama a clear mandate to CHANGE and REFORM washington. Period!
Posted on September 17, 2009 9:29 PM