People Think Health Reform Will Mostly Help Someone Else
This Gallup poll is, I think, the best window into the public opinion challenge facing health reform:
Basically, people see this as a bill that will take resources from people who have health insurance and give it to people who don’t have health insurance. Since most voters have health insurance, that creates a climate of skepticism.
And this has really been the uphill climb from the beginning. Progressives—ranging from single-payer advocates to centrist technocrats—all have a variety of visions of systematic change we’d like to impose on the system. But most people with private insurance are happy with the insurance they have until they get sick. And most people have insurance. And most non-elderly people are pretty healthy. And the elderly have a nice single-payer system all set up for them already. Under the circumstances, persuading people to be broad-minded and expand these benefits to everyone is a bit of a tough sell. But the polling on health reform, while not great, isn’t so bad anymore.
34 Responses to “People Think Health Reform Will Mostly Help Someone Else”
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March 19th, 2010 at 4:50 pm
Lee Attwater redux…
This is at the crux of a lot of the reactionary right-wing response to Democratic presidents.
The core resentment seems to be the idea that all progressive policies take away from hard working, honest Americans (read: White), for the benefit of lazy, incompetent poor people (read: Black/Latino)…
The Republican party and the conservative movement have always been really, really good at stoking this sort of sentiment…
March 19th, 2010 at 4:53 pm
But most people with private insurance are happy with the insurance they have until they get sick.
Say what? I’m 54 years old, essentially self-employed. My employer doesn’t pay for my insurance. My privately paid for Blue Cross has averaged a 17% increase every year for the last four years. I went to a $4000 a year deductible this year just to keep the premiums down. I basically have catastrophic health insurance. I’m definitely not happy with my private health insurance.
I may misunderstand your statement, but we can agree about one thing: I bet I won’t be happy about it when I get sick.
March 19th, 2010 at 4:56 pm
One question: would the new health insurance plan actually make healthcare cheaper for these families/individuals that already have healthcare? I’ve been somewhat confused on this issue.
If it will make healthcare cheaper for individuals that already have healthcare, why isn’t this point stressed more? Sure, there are some sympathetic citizens that care that the impoverished and other groups do not have healthcare, but for the most part Americans are constantly skeptical of programs that seem to take money from middle-class and working-class families and give that money to those below this (arbitrary) poverty line (which completely divides the poor and destroys working class solidarity, or at least it seems to me). So as nice as it is to know that this bill will allow more people to be covered, doesn’t it make more of a political sense to stress how much cheaper this bill will make healthcare for everyone else?
Sorry, if I’m sounding ignorant about this issue, but I’m a new reader who wants to learn more.
March 19th, 2010 at 5:03 pm
I’m pretty sure the bill will not make insurance cheaper for people with employee provided insurance. My guess is that it will improve the situation for people in the individual market, especially those that qualify for subsidies. That’s my educated guess, but I could be wrong.
March 19th, 2010 at 5:04 pm
One question: would the new health insurance plan actually make healthcare cheaper for these families/individuals that already have healthcare? I’ve been somewhat confused on this issue.
Long story short: For those on the individual market, health insurance gets much cheaper on an apples-to-apples basis. Now, the costs of policies actually sold goes up, but this is just because the cost savings and government subsidies allows consumers to buy better policies than the currently have. (Like if Honda simultaneous gave everyone a $10,000 rebate but lowered the prices of their cars across the board, the pre-rebate price of cars actually bought would probably go up as people bought nicer cars, even though the same car would be cheaper.)
For people in the group market, prices would go down insignificantly.
March 19th, 2010 at 5:05 pm
Just to say, I believe the poverty line created by the means-tested programs in the US seems to have contributed a lot to the FDR regime’s working class coalition falling apart. As Hantu said, I think this leads to racial implications (everyone on welfare is black kinda thing).
March 19th, 2010 at 5:09 pm
LOL, most people don’t have good insurance anymore. Were just waiting for the other “half” to fall of the wagon. It will be a awakening.
March 19th, 2010 at 5:09 pm
No, ObambiCare will not lower premiums.
It does not end rescissions.
It does not guarantee insurance to those with pre-existing conditions.
It does not actually lower the deficit if one honestly includes the costs (like the physician medicaid payments fix)
which are simply shunted into separate legislation.
ObambiCare will deliver less care to more people at greater costs.
The middleclasses in particular will find themselves screwed in this expansion of the welfare state.
And yes ObambiCare takes taxpayer money to indirectly fund abortion on demand.
The Left sees these things as good.
Most of America does not.
When they learn the truth the resulting blowback will make Clinton’s Welfare Reform look like largesse.
March 19th, 2010 at 5:09 pm
Until Progressives focus on a discount form of healthcare based on offering “pretty good” care to those in need, we’re doomed.
If instead people who have insurance viewed this as Basic Care, there would be far resentment amongst those footing the bill.
The sad thing, is so few on the left want to admit what can be achieved for those in need without breaking the bank.
March 19th, 2010 at 5:17 pm
Under the circumstances, persuading people to be broad-minded and expand these benefits to everyone is a bit of a tough sell.
Forcing 24 million people to buy insurance on the exchange is now “expanding benefits”?
March 19th, 2010 at 5:24 pm
would the new health insurance plan actually make healthcare cheaper for these families/individuals that already have healthcare?
As others have said, this HCR won’t affect prices much in group/employer type plans, but the security of coverage will improve since there will no longer be lifetime limits, no rescission if you get sick, and if you lose your employer coverage, you can still get insured another way even if you have a pre-existing condition.
March 19th, 2010 at 5:26 pm
Morgan is right, without intending to: the health insurance reform plan isn’t being marketed well.
There should be less resentment amongst those footing the bill, because this is the next step on the road to not getting your health plan screwed up just because you want/have to change jobs. This includes most of the people earning over $200k/year, who – after all – are mostly just wage earners pulling in a few more dollars than I am.
We could have done this more directly, but the fact is that the Senate is designed to protect the perceived interests of the wealthy, and significant blocks of the wealthy don’t want to make this process easy.
March 19th, 2010 at 5:27 pm
Matt’s whoring real hard for this one. But no matter. By the time the bill’s major provisions are scheduled to kick in, Uncle Sam’s piggy bank will be so fucked up it will all be irrelevant.
March 19th, 2010 at 5:31 pm
This is a little like the public’s opinion of Congress. It’s always miserable, and we should vote ‘em all out, yadda, yadda, yadda. However, that opinion usually applies to a generic Congress as a whole, not “their Congressperson”, that one represents them, and will be reelected. Well, in this case, the health reform bill will always cost them, but help that “other person”. It’s emotional, ill informed, and often wrong.
March 19th, 2010 at 5:39 pm
This just in: American public primarily concerned with its own self-preservation. We generally do a poor job in the news media of educating people on the big picture. Just the other day in a mass of tea partiers there was peaceful coexistence between those who want to eliminate income taxes and those who want to preserve Medicare. We’re the worst kind of infants when it comes to policy. Everything for me and I pay nothing in return.
March 19th, 2010 at 5:57 pm
Re: LOL, most people don’t have good insurance anymore.
But most people are healthy and have only small medical bills. And if you have any insurance at all you benefit from in-network pricing (if you use in-network providers of course) which keeps your doctor and Rx bills low even if you have to pay out of pocket because of a large deductible.
Still, if most people are healthy why they should care if HCR takes something away from their own insurance since they seldom use it? Of course it’s not the case that they are losing anything: instead they may well be gaining something since insurers can no longer cap policies (and that starts on day one, not in four years). Moreover most people know people who are either uninsured, suffering with some pre-existing conditon or both. It’s not like this is a problem that exists only in the ghetto, the barrio or on the res. Why don’t people care about their own friends and relatives in such situations? are we really that selfish that we won’t even take a small chance to help our own?
March 19th, 2010 at 5:59 pm
@ ChooChoo, you sound like an eight-year-old.
Your characterization of the political response to the bill is wrong: “the left,” such as it is, doesn’t like this bill at all since it is broadly perceived as a giveaway to the insurance industry. “The left” would much rather see a single-payer system. But many progressives support it because it’s far better and fairer than the current hodgepodge system.
On the whole, though, the bill is moderation incarnate: very similar to the plan Mitt Romney championed in Massachusetts.
And come on, “ObambiCare”? Please, find a blog where such puerile name-calling is welcome. I assure you they exist. This is not one of them.
March 19th, 2010 at 6:02 pm
JonF,
This is 180 degrees wrong.
Call any doctors office ask about any procedure, visit, anything – ask what it costs, then ask what it costs if you pay cash.
It will 25% cheaper, I guarantee it.
March 19th, 2010 at 6:39 pm
Morgan’s above:
Spoken like someone who has never seen a hospital bill get decimated after it was processed by the large-scale payer.
March 19th, 2010 at 7:06 pm
Again,
Call any hospital find out fee schedule, ask about paying cash… yours is a misnomer.
Until you’ve actually called, don’t talk.
March 19th, 2010 at 7:52 pm
Most hospitals are willing to talk cash discounts now. This used to be rare.
That said, an unisured wanting to see a doctor (in our two large multi-specialty groups) has to pony up a $100 cash deposit to get in the door.
Hospitals likely have a rough road between now and 2014. I expect the for-profits are in better shape with their lower burden of uninsureds. In my town the nonprofit gets 4 uninsureds for every 1 the for-profit takes.
http://stateofthedivision.blogspot.com/2010/03/will-nonprofit-community-hospitals-make.html
March 19th, 2010 at 8:10 pm
“Basically, people see this as a bill that will take resources from people who have health insurance and give it to people who don’t have health insurance.”
So… they’re right about that, right? Generally, people who have health insurance are people who work. WHo happen to be the people who pay taxes. And the one real progressive angle of the bill is that it will subsidize the purchase of insurance for people who can’t afford it.
Meaning… people the government will take resources away from people who have health insurance, and give those resources to people who don’t.
That’s kind of the whole point, isn’t it? Or is there some versionof Progressivism that doesn’t take resources from people who have resources and redistibute those resources to people who don’t?
March 19th, 2010 at 8:20 pm
You simply can’t poll people using the question that Matt wants to ask. If you say, “Are you satisfied with your health insurance?” They will say “yes.” Why, because they probably aren’t sick and they probably are grateful to have it available. However, if you ask, “How would you describe the cost of your health insurance.” Most would say “Too expensive”. If you asked only those that had a substantial, long-term illness or injury “How would you assess the quality of your health insurance”, most would say “poor”.
Most people are desperate for better, cheaper health care in this country, and this includes a large percentage enrolled through an employer. Instead, we get a reform that does next to nothing to lower cost, and actually includes a tax on our benefits that will reduce the quality of care over time.
The interesting part is that if most people with insurance understood that this would happen, most Democrats wouldn’t support this bill. No union should have EVER have supported this bill. People are going to get angry over the mandates, but the excise tax is going to be another AMT dilemma by 2016.
March 19th, 2010 at 10:31 pm
[...] Matthew Yglesias » People Think Health Reform Will Mostly Help … [...]
March 20th, 2010 at 1:46 am
I think this poll isn’t very bad, especially if it’s a floor from which the bill gets more popular. Most people think the bill will make their situation better, or it will be a wash for them. And a larger of people think it will help the poor and the uninsured. If those majorities overlap to a large extent, then you’ve got a solid majority or plurality saying it will make needy people better while making themselves no worse off. That sounds like a policy that would be even more popular if people weren’t so focused on their own economic pain as they are right now.
March 20th, 2010 at 6:33 am
Meaning… people the government will take resources away from people who have health insurance, and give those resources to people who don’t.
That’s a loaded assertion. Pay your premiums for 20 years, get sick, lose your job, can’t afford COBRA, don’t meet the state Medicaid criteria, and you’re fucked: say goodbye to whatever savings and unprotected assets you have, and hello to bankruptcy court. Hit an annual or lifetime maximum, and you’re also fucked. Work in one of those sectors where your health is at risk because people like paying $4 for an omelette with a $1 tip, and you’re equally fucked.
(Unless you’re Sam M, the one guy in America who knows a guy who knows how to get the hospital to write off your surgery by asking nicely.)
So yeah, it’s redistributionist, to a degree: it’s taking health resources from the healthy and directing them to the sick. It’s making a watered-down attempt at removing some of the worst cruelties and injustices of the non-system of healthcare in the US. But if you’re implying that it’s set up against “people who work. WHo happen to be the people who pay taxes” then you’re vastly oversimplifying things. — not that I don’t think that’s become a common misconception over the past year, which is reflected in the polling.
March 20th, 2010 at 8:13 am
«the poverty line created by the means-tested programs in the US seems to have contributed a lot to the FDR regime’s working class coalition falling apart»
I have a darker reading of that: that coalition was largely white irish, italian and jewish (that is, non-WASP) working class, and excluded blacks, with segregated unions; and even most original New Deal programmes excluded blacks; it was a programme largely to the benefit of poor white immigrants and their families.
Note the large number of irish, italian and jewish family names among the elite of the democratic party.
The white irish, italian and jewish working classes have become wealthier, and property owning (shares, houses) middle classes, and they have decided they no longer feel poor, and that the poor, which are now mostly coloured, no longer deserve help, and that the interests of the descendants of the irish, italian, jewish working classes supporting the New Deal are now aligned with those of the WASP elites their fathers were fighting 50 years ago.
March 20th, 2010 at 8:33 am
«“Meaning… people the government will take resources away from people who have health insurance, and give those resources to people who don’t.”
That’s a loaded assertion.»
No, it is completely wrong, as this part of the debate is distorted by a a very big misunderstanding, that it is about (private) health insurance plans.
What most people don’t know is that for many years it has been impossible to buy private health insurance in the USA (and most other countries).
The health account industry is selling credit, not insurance, products, because it is industry practice that every account must be profitable *on its own* over its lifetime (instead in insurance most accounts are profitable, but a few are very unprofitable, the latter being those for which the risk happens, consider fire insurance).
Since so-called “health insurance” is actually a credit facility, the companies selling those credit facilities primarily assess customers as to their credit risk (whether they can repay in full the costs incurred).
When you pay a “premium” into one of these credit facilities, you are just building up credit, not putting money into a risk pool; the risk pool is yourself, you are just saving up towards your future health bills, and if these happen and look to be higher than your creditworthiness, the seller of the credit facility shuts it down. That is why all these things happen:
«Pay your premiums for 20 years, get sick, lose your job, can’t afford COBRA, don’t meet the state Medicaid criteria, and you’re fucked: say goodbye to whatever savings and unprotected assets you have, and hello to bankruptcy court. Hit an annual or lifetime maximum, and you’re also fucked.»
Again, all these issues happen because it is impossible to buy health insurance as an individual. Your account vendor expects you to be able to refund every dollar they advance for your healthcare expenses, and if it looks like you won’t be able to, your credit facility gets closed.
But the difference between a credit and an insurance product is well beyond (it is a boring detail) the attention span even of many professional economists, however important it is, so no hope that the debate happens on what actually happens, and the “nigger nigger” Atwater style of politics wins.
March 20th, 2010 at 11:12 am
What I don’t understand about the price-tag panic over HCR is the disregard of how universal-care systems work in economies similar to that of the U.S. Granted, the U.S. poses problems because of its size and diversity relative to West European countries, so I doubt we’ll ever get health care as cheaply as they do — but does anybody really think the differences will keep us paying more than double what they do, and for less thorough and more vulnerable policies, as we do now? For the two years after HCR takes effect, most of us are going to hate, hate, hate it (meanwhile, it’ll save lives and be a godsend to maybe one-quarter of us). After three years, we’ll be giving it grudging acceptance, and after five years, we’ll cling to the new system as tenaciously as residents of other countries do theirs. Americans aren’t some alien species whose needs are off-the-charts different from the needs of other nationalities. The only major difference here is the titanic financial power of insurers, who are throwing everything they have into the game to preserve their inelastic market.
So why are many Democrats hedging now? Because many of them will never be rewarded for backing HCR. Voters will rebel in November, and a few years from now after everyone settles into the new system they’ll have forgotten what the fuss was about. Republicans will be able to spin their 2010 opposition. (”Oppose health care reform? Us? No, we just wanted to make it BETTER.”) The good news is, the Democrats will have accomplished the most important thing, and the country will be better able to withstand another round of Republican malfeasance.
March 20th, 2010 at 12:17 pm
I broke both hands in a bicycle accident two years ago. Thankfully, as a graduate student and recipient of federal funding, I had insurance to cover the vast majority of the ~$30K required to cover the two surgeries, ambulance and emergency room visit.
But I wasn’t always a graduate student, and I wasn’t always covered. Just lucky, I guess.
March 20th, 2010 at 3:55 pm
[...] Matthew Yglesias » People Think Health Reform Will Mostly Help Someone Else [...]
March 20th, 2010 at 5:55 pm
[...] redistribution of wealth that’s intended to take their money away and use it to give healthcare to someone other than them, namely, black people, illegal immigrants, (pssst! … Mexicans!!!) people who don’t [...]
March 20th, 2010 at 7:32 pm
Anyone who thinks that health care reform is some zero-sum game between those with insurance and those without should take a look at this.
This is as much about what people – and the government – get for their money as anything else.
March 26th, 2010 at 8:11 am
[...] Matthew Yglesias » People Think Health Reform Will Mostly Help … [...]