Poll Shows Americans Less Influenced By Scare Tactics On Health Care Reform

There are two main reasons why conservative scare tactics about health care reform are not as effective now as in the past: many people find the current problems far greater than any scare stories about “socialized medicine” and key groups which opposed health care reform in the past are now backing it. Both of these trends can be seen in the analysis of a poll from CNN.

A new national poll indicates that most Americans are receptive to having more government influence over their health care in return for lower costs and more coverage.

Sixty-three percent of people questioned in a CNN/Opinion Research Corp. survey released Friday said they would favor an increase in the federal government’s influence over their own health-care plans in an attempt to lower costs and provide coverage to more Americans; 36 percent were opposed.

The poll also suggests that slightly more than six out of 10 think the government should guarantee health care for all Americans, with 38 percent opposed.

With Americans no longer being scared about “an increase in the federal government’s influence over their own  health-care plans” attacks based upon “socialized medicine” become much weaker. It is also likely that their attempts to confuse advocacy of changes in the insurance industry with government run health care are becoming less effective.

It is also far from certain that there would be much opposition to an even greater role for government in the financing of health care (which remains far different from government running health care). A recent poll found that Medicare beneficiaries are more satisfied with their health care coverage than those who are in employer paid plans.

Living in a conservative area, I have had several elderly patients mention their fears that Obama is going to subject us to “socialized medicine.” While I generally avoid politics during office visits, I cannot resist pointing out to such patients that they have been in a form of “socialized medicine” for years and question if they are unhappy with their plan. The tend to by happy with Medicare, which is an actual government program, while currently proposed plans would leave those who chose in private plans. There are also millions of uninsured who would love to have the “socialized medicine” which others have under Medicare.

The poll does leave one avenue for conservatives to attack health care reform:

But Americans appear to be split over raising taxes to increase coverage. Forty-seven percent of those questioned support raising taxes in order to provide health insurance to all Americans. An equal amount back the idea of keeping taxes at current levels but not providing health insurance for all Americans.

This contradicts other polls, such as here, which have showed that a clear majority do support higher taxes to pay for health care reform. Those who oppose higher taxes might also reconsider if this means greater security that their insurance plan will cover them when they get sick and if it means lower insurance premiums.

The analysis of the poll provides further insight into why health care reform has a better chance now than in the past:

The poll indicates a partisan split. Democrats overwhelmingly support increased government influence over their health-care coverage in return for lower costs and great coverage for more Americans. Six out of 10 independents feel the same way, but only one in four Republicans agree.

“Opposition to President Barack Obama’s health-care plan is ideological. It comes from Republicans and Conservatives. You are not hearing a lot of opposition right now from the business community and the health-care industry,” Schneider said.

Many in the business community now favor health care reform as they are no longer able to afford to provide coverage for their employees. A growing number of companies are no longer providing coverage while those who do are requiring employees to pay an average of 41% of health care costs. Those of us who work in the health-care industry see first hand how rapidly the current system is collapsing and that their is no choice but to change the system.

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28 Comments

  1. 1
    serena1313 says:

    Ron is correct the system needs to be changed. But the public needs more facts and information. Why aren’t we talking about whether the cost benefits outweigh the expenditures?

    Often overlooked or rather not mentioned is that — if we did nothing about health care — the costs projected to be $2.4 Trillion in 2009 will rise to $4.4 Trillion by 2018;  by 2027: $8.1 Trillion; and by 2029: $9.3 Trillion. These are staggering numbers. They are also unsustainable.

    Equally notable: most don’t realize that the more people who are uninsured, the higher our premiums go.  So do we want pay a little more in taxes or pay higher premiums ?

    Some of the most preventable dis_eases cost the US healthcare system $15.3 billion. New infections cost the US $56 Billion in medical care and lost productivity. The medical costs for treating STD $6.5 billion. And too much is spent on hospital care, but not enough on preventive care.

    Many argue that the government cannot afford it, however, if these estimates are anywhere close to being correct, then we cannot afford not to invest in preventive care: 1) if all elderly people received a flu vaccine healthcare costs would be reduced by $1 billion a year 2) Medicare could save $890 billion over 25-years with effective control over hyper-tension 3) and $1 Trillion by returning to obesity levels in the 1980s.

    If the public had more facts and information, then we’d be having a different debate, an honest one.

  2. 2
    Fritz says:

    Actually, I wonder… Does it really save money, on a societal basis, for elderly people to get flu shots?  Do any tabulations take into account the cost savings of the elderly dying from the flu rather than dying later from other diseases after more expensive treatments?

    And how are you planning to reduce obesity?  Mandatory exercise?

  3. 3
    Ron Chusid says:

    It is hard to say with flu shots if we are just looking at money and are willing to accept people dying earlier to save money. Without flu shots, more money is spent on routine physician visits, which individually aren’t very expensive but might be significant in total numbers. There would also be far more elderly people developing pneumonia, many of whom would wind up being treated in the hospital. Many would live following hospitalization.

    If looking purely at money, then it isn’t totally clear. As long as we consider longer life a benefit, even if it costs more, then promoting influenza vaccines is beneficial. That is why Medicare has been paying the full charge for influenza vaccines for several years. They even provide 100% coverage regardless of whether someone has met their annual deductible, and with no co-payments.

    While reducing obesity would save money, I agree this will be very difficult to accomplish. I am not certain we can prove financial benefits from programs to promote weight loss as it is not clear how effective such programs will be. Some private insurances do give lower premiums to people who participate in wellness programs which include weight loss. Perhaps there is some data as to whether this really saves them money.

  4. 4
    Fritz says:

    Well, Ron — the statement was that the preventative measure of giving all seniors flu shots would save money.  Honestly, I suspect that is incorrect.   I suspect it would save more money to give them cigarettes.  As you said, though, money is not the only factor here. 

    As far as obesity goes — I’m betting on some environmental cofactors here.  It’s not just input/output — I know too many high-energy swing dancers who are also overweight.  Either something ubiquitous like pthalates or estrogen analogs or chronic viral infection.

  5. 5
    Ron Chusid says:

    Whether flu shots save money depends upon how much is saved from office calls when people get the flu and from hospitalizations for secondary pneumonia. I bet that some estimates on this are available somewhere.

    The high energy dancers are in a different situation from the average obese person. Some people who are overweight but who are physically active are healthier than thinner sedentary people. Of course there are also many other variables. It would be beneficial to encourage weight loss but I’m not sure how cost effective programs to encourage this would be.  Advising weight loss during routine exams doesn’t cost anything. It works in a small number of cases but fails most of the time. More costly efforts might influence more people but it is questionable how cost effective it will be.

  6. 6
    Fritz says:

    Ron, do you think such estimates could possibly include the cost savings of the dead person not having to be treated for whatever he would eventually succumb to later on?  I’d be quite surprised if that were not left out of the cost equation.

  7. 7
    Ron Chusid says:

    Medical literature which looks at the cost benefits is very unlikely to include this. Published articles on the cost benefits of preventive measures would be of value but wouldn’t answer your full question.

  8. 8
    Ron Chusid says:

    Articles on the cost benefits of immunizations could also become more difficult to interpret as often the benefits from a cost perspective are not for the person being immunized. For example, a primary benefit of immunizing young children is to reduce the transmission to their older relatives. The direct cost benefit of preventing a five year old from having the flu are minimal. It does present more value if it keeps older relatives from being hospitalized with pneumonia, or perhaps even if it reduces the loss productivity of parents either getting sick or caring for sick children.

  9. 9
    Fritz says:

    I figure that cost/benefit analysis that doesn’t take into account a potentially significant avoided cost is rather distorted, yes?

  10. 10
    serena1313 says:

    Fritz, while the monetary value is certainly part of the debate, I agree there is a moral issue worth discussing, too.

    Your question would be far better answered by asking a grand child or a daughter or son whether they would rather their grandparent or parent die from the flu or later from a dis_ease that will cost more to treat. 

    Mandatory exercise! LOL No silly! Obesity affects every aspect of a person’s life: mentally, physically and psychologically. The quality of life would vastly improve under the right care and guidance. But first the person needs to know whether it is medical, chemical, diet, over-eating or something else before they can tackle losing weight.   

    Meanwhile

    1) educate the public

    2) better paying jobs (too many eat at fast foods and/or buy processed foods because many  cannot afford to buy healthy foods)

    3) encourage buying produce from local farmers

    4) promote exercise

    are a few of the things that the government can do among other things.

    Ultimately it is up to each individual, if they want a better quality of life, to decide what works best, but a healthy combination is more likely to produce better results.

    I think it is worth asking: do we value human life as much as the quality of life?  Because the way I see it, preventive care is not only cost-effective it improves the quality of our lives. The latter is a moral issue that has been sorely missing from the discussion.

  11. 11
    Fritz says:

    Serena — you were the one who asserted that medical costs would be reduced by having universal flu shots for seniors.  I just gave a reason for believing that that that might not be actually true.

  12. 12
    Ron Chusid says:

    Fritz,

    I’m afraid you would be disappointed in the types of cost-benefit analysis I read in medical journals. Such articles tend to see keeping people living longer as a positive result. It has only been in a rare political argument that I’ve seen the question raised as to the actual long term costs independent of seeing prolonging life as a benefit. Of course there is far more published, especially outside of the medical literature, which deals with the economics of health care and perhaps somewhere there exists the literature you are looking for.

  13. 13
    Fritz says:

    I’ve spent the day sorting papers and paying bills, so perhaps I am being more sardonic than usual.

  14. 14
    Mike says:

    Ron- I keep finding more and more common ground with what you say, it is starting to worry me. Like your line: “It would be beneficial to encourage weight loss but I’m not sure how cost effective programs to encourage this would be.”  and we already have a form of socialized medicine in existance.  While I’ll be quick to admit I’m pretty much clueless on what the problem is or how to fix it.  This is one area I know that the government is already so entwined that I look for government to do something, rather than my typical line of , the less government the better.  But when it comes to Serenas list of more things the government can do, I say no,no, no.  That is just more government expansion.   What ever individuals are inspired to do, be it encouraging an obese neighbor to go out and walk with them, or come up with slick advertising for local farmer’s markets, great!  Having the government do something is virtually by definition making the unwilling pay to change the unwilling.   What I mean is, if you think trash on the beachs is a problem, encourage a group of people to go clean up a beach with you.  Don’t make Joe pay Sally with his tax dollars to have Sally come on the T.V. to tell Joe he needs to go out there and pick up the trash.   Have the government do more Encouraging, promoting, and educating than they already do? No, no, and no again.  As to the government making “better paying jobs”, I think I’ll leave that one alone for now.

  15. 15
    Eric D. Rittberg says:

    I wonder how it is you can continue to masquerade as a “libertarian-leaning” liberal website, when you come out so strongly for Nazi-like government health care?

    It’s not the conservatives who oppose socialized health care so much. They’ve been rather soft on the issue.  It’s us libertarians. 

    And you have the audacity to claim some allegiance to libertarian views? 

    This is not about practicallity.  This is about ideology.  What right does the government have to be in the health care business in the first place?  Medicare and all government health care, with the possible exception of the VA, should be abolished, and now!

  16. 16
    Eclectic Radical says:

    The programmed efficiency and social Darwinist movements of the Progressive Era attempted to make cost studies of health care that took into account the health care costs saved when patients were simply allowed to die and attempted to balance the social costs of the death of sick people against the medical costs of giving them care. Whether more modern versions of such studies have been done today, in the US or the West, I couldn’t say.  I do know China’s health care system is based on those socially deserving of medical care and those undeserving, but no one is arguing that China is the health care model for the US to follow.

    Speaking in the most baldly utilitarian terms, the most ‘cost effective’ system would provide health care for everyone with a job and cut Medicaid and Medicare entirely. It would also refuse medical service to anyone unable to pay and sick people who were poor and uninsured would simply be allowed to die. This is the real ‘free market’ solution to health costs, but regardless of the financial benefits the social and moral costs would be fairly significant. It would also be a complete violation of medical ethics as I understand them, though Ron could comment on that better than I can.

    I’m personally opposed to the ‘Logan’s Run Health Plan’, but there is another extremely cost efficient system. I think most of us posting or commenting here would be dead if it were put into effect, however.

    While I believe elements of universal health care policy would save costs in basic ways that conform to the laws of economics (most notably the cost-sharing principle behind health insurance is best realized if everyone pays a dedicated health care tax instead of people buying into hundreds of private health plans and no longer having to subsidize roughly half of the nation’s health care costs would greatly benefit American business), I don’t believe that the hard cost of medical treatment would be greatly reduced in the long run. The costs we would see affected would primarily be ‘soft costs’ generated by the insurance market in the interest of maximizing profit. Assuming everyone makes best use of their health care, we might see less working time lost to illness, but this is a much more difficult call. Some people only see the doctor when absolutely necessary, regardless of the quality of their coverage.

    The argument over costs is very murky and unclear and it is important not to pretend otherwise, but it is also important to remember that there is an artificial cost created by the desire for maximum profit and minimum service inherent in our current system. That artificial cost can be addressed, even if real costs cannot or might even rise.

  17. 17
    Obama is the Messiah says:

    have any of you quantified the cost saving of getting rid of the anchor baby policy and refusing all but emergency care to illegals ?

  18. 18
    Fritz says:

    Eclectic — as you know, there are artificial costs inherent in a bureaucratic system also.  The goal there is to perform something that passes for the job with as many people in your empire as possible.   The analysis of that pattern in the Royal Navy was what got Parkinson into the studies that led to his famous book.

  19. 19
    Ron Chusid says:

    Obama hater and xenophobe,

    “have any of you quantified the cost saving of getting rid of the anchor baby policy and refusing all but emergency care to illegals?”

    Probably not practical or cost effective. If you deny all other avenues for health care, then people will go to the emergency room where they cannot be turned away. The ER is not a very cost effective way to provide routine care. Limiting routine and preventive care will also increase the chances of true emergencies occurring.

    If we are looking at cost effectiveness, then it would be far more cost effective to increase avenues for citizenship so more aliens are productively contributing to the economy and are paying taxes on their earnings.

    Of course we are all influenced by our personal biases. As I physician I am biased towards providing health care to all who need its. Xenophobes have different biases.

  20. 20
    Eclectic Radical says:

    Fritz, I believe that the artificial costs in a government bureaucracy can be more effectively managed than the artificial costs in a corporate bureaucracy. If standards of care are set, then they must be met in order to ‘perform something that passes for the job.’ Likewise, operating policies giving doctors and patients the power to make decisions without bureaucratic interference are more legitimate in the case of a government paid system than in a private system, though of course I feel basic standards must be improved regardless of the final shape reform takes.

    However, it is also important to note that ‘single-payer’ does not mean nationalization of hospitals. If patients make their own health decisions with the help of their doctor, instead of government OR corporate bureaucrats making those decisions, then multiple problems are solved that have nothing to do with cost and which are more serious than cost for the majority of people already covered. They benefit as well as people like myself who cannot afford private coverage, but do not have a job that provides such coverage. Working for myself is VERY satisfying, but there are sacrifices entailed therein too. 🙂

  21. 21
    Ron Chusid says:

    Eric,

    Masquerade? The name of this site is Liberal Values, not Libertarian Values. To say one is has leanings towards a viewpoint is also stating that one rejects aspects of that viewpoint, otherwise I would just say libertarian as opposed to libertarian-leaning. I have also explicitly stated that, while philosophically I agree with libertarianism in many areas, I have rejected it as an overall philosophy as it fails to respond to problems such as health care which require government involvement.

    If we want to speak of a masquerade, you are the one who is repeatedly bashed by libertarians for pretending to be one while promoting views which are opposite to libertarianism. You have advocated what amounts to a military dictatorship with suspension of civil liberties, including freedom of speech and the press, to wage the war against what you ridiculously call “Islamo-Fascism.”

    You do have a habit of grabbing onto Nazism when you attack those you don’t agree with. Besides repeating “Islamo-Fasicism,” a term which only an utter moron from the far right would use, you make the absurd claim that health care reform to give individuals more choice and freedom in their health care would be Nazi-like government health care. You need to learn that not everything you disagree with, even if undesirable such as Islamic fundamentalism, has anything to do with Nazi Germany. This is especially ironic since your views come the closest to fascism of anyone I know. Being libertarian on some victimless crimes and opposing health care reform does not make you a libertarian when you oppose basic civil liberties and support a massive expansion of the state in the guise of a “war on terror.”

    Among all your nonsense you actually do make a statement which is very true, and which is often forgotten in the health care debate: “This is not about practicallity. This is about ideology.”

    The opposition to health care reform does come down to ideology. If you really look at any other factors of the health care debate, including cost, access to care (or rationing), autonomy for physicians, greater choice for consumers, or quality of care, then the conservative arguments do not hold up and the evidence is in favor of government action to reform the system. It is only when you adhere to blind ideology that you can oppose it.

    “What right does the government have to be in the health care business in the first place?”

    Government is involved in health care because it is a function which the free market is unable to handle without a significant amount of organization from the government. We have Medicare because without Medicare people would not be able to afford health care once they were no longer receiving it from their employers. Employers can barely afford to provide supplemental coverage to their retirees–they could not afford to foot the entire bill for retiree health care coverage beyond age 65.

    Even libertarians, beyond anarcho-capitalists, acknowledge a role for government in some areas. It is possible to envision totally free market solutions for everything the government does, but in reality these are not practical. Anarcho-capitalists do envision private companies handling police and military functions. In reality, these are at a scope beyond where the market can handle them on their own. Even if we can have a massive Halliburton handling these functions, we would be reluctant to have such power in private companies without the type of oversight we can have in government functions.

    Under the free market the employer-based system is collapsing and it has become extremely difficult if not impossible for people to obtain coverage on the individual market unless they are young and healthy. The insurance industry has developed a business model based upon taking premium money and then finding ways to avoid paying out claims to save money with disastrous results. Health care costs has became a major cause of bankruptcy in this country, even among those who are employed, and among many who thought they had insurance coverage. We really have no choice but to utilize government to reform the system.

    As someone who leans libertarian philosophically I might not like it, but the universe doesn’t give a damn about what we want. Real world considerations force us to utilize government to fix the problem, making it necessary to ignore ideology out of practicality.

  22. 22
    Fritz says:

    Eclectic — in the end, you and your doctor will not be making those health decisions with a free hand unless you are paying for your own medical care.  And that is irrespective of the system we are talking about.

    I don’t think history has shown that artificial costs in a government bureaucracy can be effectively controlled in the long run.  And the parallel costs in a business can only be controlled through the creative destruction of a really free market.  Which health care is definitely not.

    I don’t think anything like an efficient solution (where solution includes universal access) is possible, since everyone has a very strong desire to live forever while third-partying the costs of treatment and research.  I think we will get a system which will provide universal access and decent care and will sacrifice a lot of expensive research (which only American consumers were paying for anyways).  And risky hobbies will be under intense pressure.

  23. 23
    Ron Chusid says:

    Fritz,

    There will always be some external restraints upon health care decisions when people are not paying out of their own pocket. The reality is that it is not feasible to have a system in which people pay out of their own pocket, so we must look at how such restraints are kept the most benign.

    At present I must deal with such restraints from both private insurers and government plans. Comparing the average private  employer-paid plan with Medicare, the result is that Medicare is far less restrictive on the choices made by patients and far less intrusive upon physician practices.

    With all its problems, and lack of cost effectiveness, there are strong arguments for eliminating the private insurance system entirely, and many make compelling arguments for this. An alternative to scrapping the dysfunctional system is to reform it–which is what the Obama administration and most Congressional Democrats are advocating.

    Such a hybrid private/government system is what exists in most of the world–despite the right wing scare tactics of only mentioning Great Britain and Canada. Such systems tend to provide higher quality care than is provided here at a lower cost, and typically with greater freedom than is seen with those covered by private insurance in this country.

    Of course the devil is in the details with health care reform. It is even possible that I will oppose a current proposal based upon the specifics, once one is proposed, as I opposed HillaryCare which managed to not only preserve but to worsen the worst aspects of HMO’s and managed care.

  24. 24
    Eclectic Radical says:

    It’s worth noting that not only ‘American consumers’ are paying for expensive research. Several pharmaceutical companies are based in Scandinavian countries much reviled for their ‘socialized medicine’ and quite a bit of that research is funded by the governments of those countries and consumers around the world. The claim that only Americans are paying for such things is simply false. Appealing to the American ego, but like so many appealing truisms about our nation, just plain incorrect.

  25. 25
    Eclectic Radical says:

    Ron, on that note, there is Teddy Kennedy’s plan. It adds a public component to the ‘Romneycare’ style ideas being thrown around in DC right now, but fails to correct one of the most serious drawbacks of the current system: Kennedy wants to give employers the choice of either paying for their employees’ health care as they are now, or paying a specific tax to subsidize the national plan.

    Everyone here or who reads my blog knows that I am not the biggest fan of the American corporation, and usually I love Teddy Kennedy. But reforming health care without addressing one of the biggest reasons it needs reforming is… a mistake at best.

  26. 26
    Ron Chusid says:

    Mike,

    “What I mean is, if you think trash on the beachs is a problem, encourage a group of people to go clean up a beach with you.”

    What the hell are you, some sort of left wing community organizer? 🙂

  27. 27
    Mike says:

    🙂

  28. 28
    Fritz says:

    Eclectic — do you happen to know how much of the profit of those Scandinavian pharma companies comes from American sales?  If it’s a lot, then they will be in the same boat as the other pharma companies when Americans go on the same COGS system as everyone else.

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