Liberal Values Defending Liberty and Enlightened Thought

The New York Times has published yet another poll on health care reform. The polls  shows the same results as most earlier polls:

Americans overwhelmingly support substantial changes to the health care system and are strongly behind one of the most contentious proposals Congress is considering, a government-run insurance plan to compete with private insurers, according to the latest New York Times/CBS News poll.

The poll found that most Americans would be willing to pay higher taxes so everyone could have health insurance and that they said the government could do a better job of holding down health-care costs than the private sector.

Yet the survey also revealed considerable unease about the impact of heightened government involvement, on both the economy and the quality of the respondents’ own medical care. While 85 percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt, 77 percent said they were very or somewhat satisfied with the quality of their own care.

The first two paragraphs show why the Republican arguments against health care reform have not been very effective. Americans see a need for increased government involvement and are not swayed by Republican chants of “socialized medicine.” While some Democrats have backed away from the public plan, the poll showed that 72% support a government run plan like Medicare while only 20% are opposed. Americans are even willing to pay higher taxes to achieve health care reform.

Proponents of health care reform are most likely to quote the first two paragraphs and ignore the third. It must be remembered that while there are tens of millions who are uninsured and under-insured, there are also a tremendous number of people who are satisfied with their coverage. In some cases this is because they have been healthy and are unaware of the risk of losing coverage should they develop a serious illness and actually need the coverage. In other cases they really do have good coverage.

Regardless of the reason, a large majority are satisfied with the quality of their own care. While economically a single payer plan would make more sense, politically this is not feasible. If a plan is going to be accepted in this country, it is necessary that it be designed to help those who do need help and leave those who are satisfied with the option of continuing their current coverage. Legislation should ensure that those who are happy with their current coverage really have the coverage they believe they do, and that the coverage not be terminated once they become seriously sick.

There are also ambivalent feelings with regards to government involvement in medical decision making:

Three of four people questioned said unnecessary medical tests and treatments had become a serious problem, suggesting that they would support calls by health researchers for a payment system that would better reward appropriate care. But an even higher number, 87 percent, said the inability of people to have the needed tests and treatments was a serious problem.

Being concerned with both appropriate care and ensuring the ability to have needed tests and treatments makes sense. While calling for appropriate care in principle makes sense, it is very difficult to actually measure this. Treatment guidelines are often helpful and more should be done to ensure that they are followed when appropriate. However treatment guidelines cannot be strictly applied in every case. Individuals do vary in their response to treatment. Individual preference does often make it necessary to make changes. Treatment guidelines are typically written for a specific disease but individuals typically have more than one medical problem making the recommendations for one condition inappropriate for each individual patient. While health care reform should encourage appropriate care, it could also be dangerous if this is decided on a bureaucratic level.

Update: Maggie’s Farm questions the results because “73% of respondents who said they voted in 2008 only 34% voted for McCain and 66% for Obama. The actual vote was 46% (corrected) McCain.” This is most likely explained by the considerable decrease in people identifying as Republicans since the election. I suspect that any poll taken now would show that far more people will claim they voted for Obama than McCain as opposed to how they actually voted.

Regardless, this objection is only a concern if the exact numbers are an issue. The key results of the poll, such as support for health care reform, higher taxes to pay for it, and support for a public plan, have been present in multiple other polls. At worst this poll exaggerates the numbers on these issues, but more likely it is a case of less people saying they voted Republican than actually did.