Health Reform and Public Opinion
Few people have studied the effects of public opinion on health policy as extensively as Robert Blendon at the Harvard School of Public Health. In this post at Kaiser Health News, Blendon tells us that public support for health reform leaves little margin at the moment:
When Medicare was enacted in 1965, 62 percent of the public supported its passage. When the ill-fated Clinton health plan did not pass the House in 1994, support was between 39 percent and 43 percent. In recent polls, public ratings of the congressional and Obama health reform proposals are much closer to those for the Clinton plan than for Medicare. Support for enactment in recent polls ranges from 34 percent to 49 percent with the most recent suggesting growing public opposition since the summer. This is the case even though many of the policy elements of the current House legislation are popular with the public, such as requiring insurers to cover people with pre-existing conditions, and the presence of a public option offered as a competitor to private health plans.
Blendon suggests what questions to watch, and who is likely to be shaping the public's perception of health reform in the crucial weeks ahead:
...polls show countervailing concerns about the congressional plans. These involve the potential impact of the bills on Americans' health costs and affordability, their taxes, the extent of government interference in their health care decisions, and worries that health care for those receiving Medicare will deteriorate. Regardless of public enthusiasm for health reform as a principle, and support for many policy elements in the House bill itself, most Americans do not see their healthcare situation as getting better if this legislation is signed into law, and some see their situation as getting worse.
In the weeks ahead, Americans are unlikely to read the 2000-page House bill. Rather, they will form their judgment about the final legislation based on others' assessments. They will rely on those whom they trust as intermediaries to clarify its impact on them. Many of those who will be most influential will not be political figures working in Washington. Polls suggest they may be leaders of physicians' and nurses' groups, seniors' groups, and organizations advocating for patients with serious illnesses. Also they may rely on the views of major media figures and experts interviewed frequently.
The American public was promised throughout the presidential campaign that major reform if enacted would improve their current health care situation. At the moment they are not convinced that this will be the case. Changing their perceptions may be critical if a bill as extensive as the one enacted by the House is to be passed by both houses of Congress in the next few months.
UPDATE: Here is a more detailed analysis by Blendon from the most recent issue of the New England Journal of Medicine.
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1
Where is his poll data coming from KT? Genuinely curious.
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1.1
Blendon watches a wide range of polls. You can read about him here:
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http://www.hsph.harvard.edu/faculty/robert-blendon/
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I will email him and ask which ones he is looking at for this post and let you know.
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2
Agreed! Which polls? Whom got polled, how, etc.? e.g., Rasmussen is known to have a conservative slant; others vary.
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and KT, thx for family blog. I enjoyed reading that.-
2.1
Thanks. My aunt and uncle are pretty amazing, aren't they?
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I have emailed Blendon and asked him for additional information on what polls he has been looking at. I will post if/when I get it. -
2.2
Rasmussen is also known as the most accurate, at least in 2004 and 2008 elections.
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http://www.fordham.edu/images/academics/graduate_schools/gsas/elections_and_campaign_/poll%20accuracy%20in%20the%202008%20presidential%20election.pdf
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http://www.freerepublic.com/focus/f-news/1274530/posts
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Rasmussen also correctly predicted the outcome of the NJ governor election, which notably many other polling groups did not. -
2.3
Serpentfire, Rasmussen cooks his books. This is what has happened in 2004 and 2008. For the entire election cycle, the Republican candidate in the Rasmussen poll is way outperforming as opposed to the other polls, until the very last week. Then miraculously, Rasmussen's numbers start to dramatically change until the numbers are roughly the average of all the other polls.
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Rasmussen then claims to be an accurate pollster. Funny how that has worked both times. Rasmussen gets to be used as a talking point for like 6 months that McCain is doing super, then the last 5 days "suddenly" Obama has a lead in his poll. If it just happened in 2004, I could take a pass. He had Bush way higher against Kerry than it ended up. Again, until the last few days. It's a crock. Rasmussen is a hack. -
2.4
Thanks for the reply. After reading it, I looked up information to verify what you said, and you are indeed correct. My mistake.
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Sometimes I think I learn more from talking to average citizens in everyday life than from the media.
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Nearly 80 percent of American think a public option is essential to health care reform and is thus "mainstream,." yet the media still portrays it as "extreme" and "controversial," just like the GOP wants it to.
There's some poll data to look at...
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Go to prison for not having health insurance? Yeah, there's something guaranteed to be a winner in public opinion polls.
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Oh, and then there's the regressive medical device tax. (I thought Dems were supposed to be against regressive taxes.)-
4.1
" ..Go to prison for not having health insurance? "
Why not?
We, the people, determine what people go to prison for - and for how long. -
4.2
ok, cfukara, if that's so unobjectionable, let's see Dems tout it . . . .
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KT, what's your view on the political palatability of the prison provision? -
4.3
…spob, where in the house bill is the prison stuff (chapter / verse or page # please)? I remember cash penalties / “taxes”, but where's the jail? It's tough trying to read 199,000 pages to find it. We may be in agreement over penalties. I hate them too. Everyone needs to play to avoid Dirigo II, but hopefully there are other ways to do this.
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4.4
Here's what Media Matters has to say about it:
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http://mediamatters.org/research/200911070007 -
4.5
From the MM link:
.Matt Drudge and WorldNetDaily.com both falsely asserted that, in Drudge's words, the House health care reform bill states that people must "buy a $15,000 policy or go to jail." In fact, as stated by the Joint Committee on Taxation letter on which Drudge's and WND's claims are based, the bill does not impose criminal penalties on people merely for failing to purchase health insurance; rather, people who do not buy health insurance and also willfully refuse to pay the tax imposed on them for such actions can face civil or criminal penalties.
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Which, as far as I can tell, is the exact opposite of the point spob is trying to prove here. -
4.6
"refuse to pay the tax imposed on them for such actions can face civil or criminal penalties".
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Ahhh, from your own source Cliffy. What part of "can face civill or CRIMINAL penalties do you not understand?
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Do you believe the IRS has the power to put you in jail if you fail to pay your taxes?
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If you do not pay, then you GO TO JAIL
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Period.. -
4.7
But it's not a straight line, as spob was implying.
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Not buying health insurance =|= jail time.
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Not paying the fee is the crime, as opposed to not buying health insurance.
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I don't see you getting worked up about tax evasion leading to jail time, or not buying auto insurance leading to jail time, or not paying your parking ticket leading to jail time. -
4.8
"I don't see you getting worked up about tax evasion leading to jail time, or not buying auto insurance leading to jail time, or not paying your parking ticket leading to jail time."
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Have you ever thought that right now, I am not FORCED into buying health care insurance. Are you forced into buying it Cliffy?
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There are no penalities for not having auto insurance. The State will simply not allow me to continue to register my car to drive if I choose (keyword my choice), not to buy insurance for my car. I can CHOOSE to ride the bus or a horse even.
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Tax evasion is and always has had a provision to go to jail, go directly to jail if I do not pay up. Case in point, the couple I believe up in New Hampshire, New England none-the-less who the ATF, FBI and IRS stormed their home for not paying their taxes. To my knowledge they are in jail.
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Your analogy to "parking tickets" is a stupid response.
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Again, for the pea-brains on the liberal side of the aisle.
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Do not pay out of pocket for your health care insurance, be fined and penalized. Do not pay after you are fined and penalized, face the possibility of being put into jail as some have said who are extremely knowledgeable about the judicial system. Go to JAIL for up to 5 YEARS
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Indeed, "change we can all believe in".
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Shouldn't you first assure us that he is not paid to push a certain line? Does he hold shares in the pharmaceutical or insurance companies?
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I guess I am skeptical of polling by anon sources after Nate Silver just demolished Strategic Vision yesterday. They were cooking the books. Frank Luntz also polls a great deal, and he of course is very evil.
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6.1
This is a Frank Lunz poll or, at least, the results of them (sounds like a boilerplate for what the "conservatives" disinformation campaign needed to achieve by the master propagandist himself):
...polls show countervailing concerns about the congressional plans. These involve the potential impact of the bills on Americans' health costs and affordability, their taxes, the extent of government interference in their health care decisions, and worries that health care for those receiving Medicare will deteriorate.
The only way to drive a stake in the heart of the false beliefs to which many Americans have succumbed is to pass decent legislation that makes even more obvious liars out of the right - though why that should even be necessary at this point is absolutely unfathomable to me.
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I do not remember which poll it was but in the same poll the Public Option was very popular, but on over all health reform they were reserving judgement on what is finally in the bill.
I do think it is the time for the news media to forget about the conflict between ideology's and report the facts to the American people. News Media participation will be judged as well congress.
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Here's a question--absent the Stupak Amendment, would the House bill permit the subsidization/coverage of abortions of viable fetuses?
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and there's this:
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http://www.cbpp.org/cms/index.cfm?fa=view&id=2921 -
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…OT but KT, do you know Gerald Seib at the WSJ? He crossposted his new cap. journal piece at Jay's last Dems Go It Alone post since he quoted her …but he got HER gender wrong (c. #25). I tried to comment there directly but couldn't (did email some editors but doubt they'll read them). In case Jay's away on a story or at happy hour, can anyone at your office contact him to spare Jay further grief? (even if you have a full plate, sorry)
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…back on topic, I'd agree with the mystery poll author about media and association influences. I'll head off Dee, pluk, et al at the pass and give you kudos for bringing us the latest stuff without spin or shilling. If someone here, ahem, calls your pieces negative in tone, well, it's still a tough fight now, esp. in the Corporate Senate. Real people who've faced pre-existings, denials, and bankruptcies know the system is royally f'd, but many more probably haven't faced them. Fight Anthem T-shirt teabagging with more personal stories and bite-sized pieces of HC reform facts. BTW, these + your recent trip remind me, KT, to hope that your brother is now fully treated / cured.-
10.1
thank you for asking about my brother. thanks to the very expensive chemotherapy drugs that he now has access to by virtue of the, ahem, (county) government health program that he is in, his kidney function has increased and dialysis does not appear to be in his near future. however, his doctor says we won't know for sure until he has been with this program for a year. and it does require him staying on some very powerful and expensive drugs.
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10.2
KT, that's great news.
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Hopefully, the county will try to get the insurance co. to cough up some of the cash, as it is likely subrogated to your brother's claims against that insurance co. Governments can be quite aggressive in getting cash. -
10.3
KT, best wishes to him. I hope the program leads to a 100% recovery when the year is up.
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10.4
KT:
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So glad to hear that, all the best. -
10.5
KT - so glad to hear your brother is stable for the moment. I continue to be grateful that he and you were willing to speak publicly about his predicament, as his circumstances put the lie to so many arguments against this bill.
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Another issue, poll-wise, is whether the healthcare push will be seen as a good idea if the unemployment figures don't rebound.
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I have written this same comment (as elucidated above in the Blendon piece) in so many ways here and elsewhere. I however think that efforts should be made to encourage the average reader, TV watcher or listener to use his MIND in coming to a reasoned conclusion.
There are opinions up to the wazoo in this matter, and while some maybe right, nothing is better than viewing a condensed version of the bill YOURSELF alongside the opinions and comments of others who are learned about its contents.
Hey, Sarah Palin has an opinion and a strong following for these opinions despite the fact that they border on plain hysteria. Rush has one too, as do many people on both sides of this Healthcare matter.
It is clear that determining what people will believe is no easy matter. As far as I am concerned no one can accurately predict who will be taken most seriously by the public. Even the anti-Obama "warlock" Beck, might garner a huge following because of his sensational interpretations and wild conjecture.I happen to read this blog because I know the difference between seasoned journalists and those journalists who write because they just do. Many do not have the ability to discern between real journalism and quackery which is replete even in so called reputable magazines and news sites and so read other sites and blogs in which the material is skewed and viciously partisan.
My hope is that in addition to opinions, most people will take time to understand the bill themselves and form a reasoned and objective opinion about it.
Nice Piece Ms. Tumulty!
Sincerely,
LMhttp://theblindspotsofgod.wordpress.com/2009/11/06/i-fully-support-gun-ownership/
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Here is my problem with the analysis. I do not believe that, in 1965, there was a massive amount of misinformation about what Medicare legislation was about. People knew that it was a government program to guarantee health care for the elderly and they either supported that or didn't.
Today, millions of dollars are being spent on propaganda designed to mislead the public as to what the current legislation entails. Today, someone can easily believe that our current system is in crisis (e.g. that costs are rising unsustainably, that those with prexisting conditions should still receive treatment, and that people should not be exposed to rescission as soon as they need their insurance) and still not support the current legislation.
They may believe -- falsely -- that it is Maoist takeover of health care by the government. They may believe -- largely accurately -- that the current proposals will not be sufficient to hold down costs. And they may also believe -- entirely fairly -- that mandating that people purchase private insurance is a rather odd, and extremely dubious method of providing universal health insurance.
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OT, but I don't care. After all the BS in the threads about PTSD, I have to link this:
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http://www.jrsalzman.com/post/2009/11/07/PTSD.aspx
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This SOB Hasan was a f'ing traitor. I hope he rots in hell. And his family ain't exactly loyal either--calling him a "good American" and spreading BS about him being harassed in the military. -
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KT:
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We really need to know what data Robert Blendon is reading, because this seems silly:
Many of those who will be most influential will not be political figures working in Washington.
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Polls suggest they may be leaders of physicians' and nurses' groups, seniors' groups, and organizations advocating for patients with serious illnesses.What polls is he talking about, KT?
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The obvious, immediate question for Robert Blendon would be:"How did your polling account for the various levels of funding that would allow for some to influence perceptions more than others?
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Did that polling factor in the amount of advertising dollars available to each entity seeking to influence public perception, in terms of predicting who/what would be most influential?"If Robert Blendon isn't taking into account the money needed to compete in today's sophisticated messaging campaigns, then how valuable can his work be?
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Is he, KT? Or is he assuming "all funds being equal"...?-
15.1
Wow, just finished reading that.
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It's beyond inadequate, except as the most shallow, copy-producing analysis.
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Note to commenters:
Just got this email from Bob Blendon:
Hi,Karen we will be back to you tomorrow with the references.Much of the piece is drawn from a larger paper published in NEJM last week.We will be back.Best.
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Here's the NEJM link:
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http://healthcarereform.nejm.org/?p=2253-
16.1
Thanks so much for following up, KT, and for the link.
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KT:
In regards to JNS' question below:
.So why push through a bill now, the week after twin gubernatorial losses in New Jersey and Virigina and a day after the country hit 10% unemployment?
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Why should gubernatorial races have the slightest bit of impact on the HRC bill? Shouldn't the unemployment rate be an argument for HRC (since more and more people are unable to afford health insurance)?
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Are these valid concerns or is JNS just making crap up? -
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Are these valid concerns or is JNS just making crap up?
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Neither.
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What we see is a subset of the press corps so caught up in the optics of a debate that they totally neglect the real-world consequences of the debate itself. One of the downsides of democracy is that the most important decisions are ultimately entrusted to the people paying the least attention.-
18.1
Goddammit, I was trying to trick KT into being a media critic. Now she'll never take the bait.
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And for the record I think JNS was concern-trolling pretty fiercely right there.
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[...] more here: Health Reform and Public Opinion – Swampland – TIME.com Health, Uncategorized [...]
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[...] Continue reading here: Health Reform and Public Opinion – Swampland – TIME.com [...]
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The problem with this comparison is that Medicare was a sensible, understandable, rational, single-payer plan. It's appeal was straightforward. This monstrosity on the other hand is a hideous contraption consisting of bureaucracies whose only purpose is to keep the insurance companies in the mix.
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What happens a year from now when Medicare is the same as it was before and the Republican promises of Communist tanks driving down our streets haven't materialized?
I don't give a rip what is thought about the bill the day it passes, except for the usual watching of how dishonest the traditional media is in describing what happened. -
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The Republicans continue to blather on about "ignoring the wishes of the American people" no matter what the poll numbers say. They have been doing this for so long they've learned to milk the untruth for all they can get.
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[...] professor a homework assignment, but that's what Swampland commenters did yesterday, after I posted this Kaiser Health News column by Robert Blendon, the Harvard School of Public Health professor who is one of the leading experts [...]
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This link is from Oct and I don't know what's been changed but it's easy to search document using key words
http://docs.house.gov/rules/health/111_ahcaa.pdf
- ktumulty @LATimesrainey Could you get them to check for my earrings? I lost a pair of silver ones and have been hunting all over the house for them. - 12 hours ago
- ktumulty @TeresaKopec @fishbowlDC thanks! am declaring my age to be the avg of mine and fellow bday girl jen psaki. - 16 hours ago
- ktumulty New Blog Entry, "Health Bill: What Would It Cost Me?" - http://tinyurl.com/y8uxg5w - 1 day ago
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