I somehow ended up on a mailing list for the Republican National Committee (RNC) and so I get regular email updates from their chairman, Michael Steele. Usually, I don't read the emails, but this week they invited everyone to take a "Future of American Healthcare Survey." This poll is mostly an excuse to get you to click on a link where they can ask you to donate $$. (And to be fair, I've gotten plenty of the same type of surveys from the Democratic Party, and I find them kind of annoying as well.)
However, it bothers me (though I guess it doesn't surprise me) how each question is carefully phrased to deliver a talking point, and most questions don't actually give you the option of answering in a way that would oppose that talking point. I thought it might be a useful exercise to go through the poll and discuss each point. I hope that others will add their comments. Here are the first 3 questions (there were 12 total).
"Future of American Health Care Survey" by the RNC
Question #1: Do you believe that the state of America’s health care system is in crisis?
Yes
No
Undecided
There's some good, recent (June '09) Pew Research Polling data on this general issue here. My sense is that most people recognize there's a problem with the current system that affects them or someone they know. At the same time, people who can afford good coverage are probably afraid of what "change" might mean. Still, even among Republicans, I think everyone senses that healthcare is getting unsustainably expensive--for everybody--and something has to be done about that. I bet they'll get a lot of "Yes"'s on this question.
Question #2. What is your biggest concern regarding health care in America as it is today?
Cost
Quality
Availability
Other: ___
I expect this is an easy question for someone without insurance: they would choose "availability," while those with insurance will probably choose something else. I expect there will be a lot of people choosing "Cost" here. And I don't see anything wrong with that.
Question #3. Do you believe that your health care decisions should be made by you and your doctor, and not government bureaucrats in Washington, D.C.?
Yes
No
Undecided
Dear RNC: I would love for my health care decisions to be made by me and my doctor. And if I had unlimited cash to spend, then decisions would always be made by me & whatever doctor I wanted. But when a third party (of any kind) is paying our bill, they get a say, too. And that third party is either going to be a private insurance company or a public entity. (Or a very rich uncle.) So this question should really ask whether decisions should be made by a private or public entity. I think, at the very least, you would get different answers to your question.
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Here's a real-life example of decision-making: a person still many years away from retirement has cataracts. The best treatment is replacement of the bad lenses with corrective lenses. The person has insurance, but insurance will not pay for the best treatment, which runs $2600 per eye.
At the other extreme, I've seen examples where states mandated hair replacement coverage for women AND for men (under the theory that equal treatment must apply). Of course, most of the legislators voting were balding men. If there's no cost involved for what are elective procedures, there's no cost control.
At what point do we say NO, and how much do we let people decide to say no?
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