Wednesday, July 22, 2009

RNC Survey (Part 2)

[See my previous post for an explanation of where these survey questions came from.... -JG]

Question #4: Do you believe it is right for the federal government to use age and life expectancy as criteria for determining access to health care?
Yes
No
Undecided
Um, we do that now, by limiting Medicare access to only people over 65. And since access and affordability go hand-in-hand, those people have access. The rest of us are on our own. Is that right?

Question #5: Estimates show that the Democrats’ plan could cost more than $1.7 trillion dollars. Do you believe that America can afford this added debt when the deficit has already reached record levels?
Yes
No
Undecided

First of all, the CBO report just came out that the latest bill is $1 trillion, not $1.7. Second of all, just because something costs $X that doesn't mean that it automatically creates $X of "added debt." (Well, I guess unless you belong to a group who believes that the government should never raise revenue and should borrow money for everything. Hmm, that does sound kind of familiar. I think their group's name starts with an "R.") In fact, the bill is designed with revenue streams to pay for itself. Third of all, I wonder who we have to thank for the deficit having "already reached record levels." I think their group's name also starts with an "R."

Question #6: If you have private insurance, please rate your level of satisfaction with your coverage.
Excellent
Good
Satisfactory
Unsatisfactory
N/A
This is one of those genuinely complex issues. "If you have private insurance," then yes, you may be relatively happy with it. But as I pointed out in an earlier post on this blog, people with Medicare are happy with that, too (maybe happier than you). And if you're one of the people that has to answer "N/A" to this question, well, you're in trouble.

Tuesday, July 21, 2009

Some reading on health care reform options

Here's a selection of commentary from Robert Reich, Dean Baker, and others from the NYT:

http://roomfordebate.blogs.nytimes.com/2009/07/20/should-the-rich-pay-for-the-uninsured/


And if you haven't seen it, here's Walter Brasch on Prescribing Cake for the Health Care Crisis:

http://www.opednews.com/articles/Prescribing-Cake-to-Cure-t-by-Brasch-090720-273.html

My reading is that the final bill will "pay" for reform in one of two ways: either by taxing excessive health care benefits or by some kind of surtax on superearners (over $500,000 per year or so). The latter option seems to be preferred right now, but it's going to be a long process. Dean Baker's anaylsis--that the projected health care reform deficit amounts to .15% of GDP while the military operations in Iraq/Afghanistan is 1%--puts the issue in proper perspective. But, of course, we still haven't gotten at the problems with long-term Medicare and Medicaid (which are much more difficult than the long-term problems with Social Security). But let's tackle one mountain at a time, shall we?

Wednesday, July 15, 2009

RNC Survey (Part 1)

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.

Wednesday, July 1, 2009

Surprise! Medicare Ranks High in Consumer Satisfaction

CSCC is considering partnering with a local university to co-sponsor a poll of the PA-10 District about healthcare reform and a "public option" for health insurance. The results, regardless of what they show, would be published for all to see and shared with our local lawmakers.

This article from the National Journal Online is definitely worth reading, and may be important in informing the type of poll we want to do. It shows two important things:
  • When asked if they support "having the government create a new health insurance plan to compete with private health insurance plans," 62% of Americans supported that. Describing the plan as "government administered" and "similar to Medicare" resulted in even more positive reactions: 67% and 72% support in two other polls.
  • Even more encouraging is the data from the Dept. of Health & Human Service's CAHPS survey which gauges consumer satisfaction with their current health insurance. 51-60% of people who have government insurance (Medicare or Medicaid) give their health plan a 9 or 10 rating (out of 10), whereas only 40% of people with private insurance do. What's driving this difference is that Medicare patients perceive they have better access to care, with 70% saying they "always" get access to needed care (vs. only 51% of those with private insurance).

I think the people arguing that "Americans are afraid of government-run health insurance" don't want us to look at this type of information. So take a look. And if you favor a public option, make sure your representatives know it.