The Pundits Versus the People
My faith in democracy is being restored. Take a look at the chart below…..then look again…..and again.
Q: If the health care system is changed, do you think ….. will get better, worse, or remain the same?
These are some of the most remarkable polling results I've ever seen. If they don't knock your socks off, you just don't understand the situation.
Note first that these opinions are not directed at the Kennedy/Dodd bill or the Waxman bill or at a likely Baucus/Grassley bill. They are opinions about health reform as such, or about any reform bill that is likely to pass and be generically referred to as "Obama Care."
Note second that (a) these are the same people who gave Barack Obama a landslide election victory last November, that (b) Obama's signature domestic policy issue was health care and that (c) Obama claimed we needed reform for the express purpose of solving the problems of cost, quality and access.
Note third that the opinions reflected in the poll have not been vocalized anywhere on Capitol Hill or anywhere in the mainstream media. Sure, there have been Republican critics of Democratic proposals, and the mainstream media has questioned whether the bills will accomplish all that the sponsors are hoping for. But virtually no politician or news reporter or editorial writer or network talking head has gone so far as to say: not only are these plans not going to work, they are going to make every one of our health care problems worse than they would have been. [Okay, the Wall Street Journal editorial page comes close to being the exception.]
Note finally that the opinions held by the general public are almost certainly correct. As we have explained at this blog on many occasions for well over a year now, the fundamental structure of Obama Care is deeply flawed. So much so, that almost any version of it will likely make our health care problems worse — not better.
Here is a parting question for you to ponder: Why are the people so much more perceptive than the pundits who try to tell them what to think?
Good post. The people are definitely smarter than the pundits who tell them what to think. They are also smarter than the politicians who represent them.
Smarter, more perceptive and apparently better informed.
Answer to the parting question: The pundits could care less how any of this affects ordinary people.
John,
I am just not a strong advocate of ruling a nation through public polls. The health care today is unsustainable. Medicare is out of money in 8 years or so.
There are two meainingful ways to stay its execution. First, we can continue on our path and ration even more care than Medicare does today. Cut payments and reduce access – that is what you are supporting by these misleading posts about the current plan.
The second way to svae Medicare is by improving the quality of care (good quality costs less); reducing the overuse of irrational care which is not evidenced based medicine (more care is not better care); creating transparency for citing the best care so patients can make informed choices, and aligning payments which reward good care rather than any care. Add to that tort reform which creates safe harbors to void out the defensive medicine and you got reform.
Now, if you do not like a portion of the plan – like the public plan – then I agree with your right to object. But to mislead the people with ill begotten polls about the most complex piece of legislation in American history is – for someone of your intelligence – irresponsible.
Perhaps the Dems and the White House did not deliver a message adequately to withstand a barrage of misinformation. But the Dems have told the truth. Not the GOP.
We are heading for an absolute crisis of great importance and you have dodged the real question about reforming health care by focusing an attack on some of the vulnerable, perhaps less valuable, aspects of reform.
I want better care. I want more access. I want to rid the wasteful care for profiteering providers. I want knowledge for the patients so they know where to get the care they need. I want payments aligned with better care delivery. And I want the lawyers out of health care.
The current system does none of these things – so what is your alternative. More of the same bad health care?
Which health system is unsustainable? The public one, which includes Medicare, Medicaid, the VA, TriCare, and the federally qualified health centers, or the private one which provides care for the majority of Americans?
I would note that the private one is a) solvent and b) provides immediate, high quality care. The public one is a) insolvent and b) often provides care of questionable quality. The private system provides better access, too.
When reform consists of having a failing public sector take over sustainable private operations just to give unsustainable public operations a few more years of operation prior to the inevitable collapse, I submit that what currently passes for health care reform is something that we can do without.
People respond primarily from a base of emotion rather than reason; what they feel rather than what they know. Most have not availed themselves of the facts but rather the fiction of opposition to any healthcare reform. Those who would oppose be they “people or pundit” often do so from a political ideology rather than substantive information.
I take issue with the position; question the underlying validity of the polling; and am making every effort to understand the complexity of the situation.
Perhaps it is you who don’t understand.
Unfortunately, the opinions expressed by people are probably based on the expensive, elaborate “fear/smear” campaigns waged by health insurance companies. If nothing else, hopefully health insurance companies will be forced by reinstated legislation to be required to use 98% of policyholder’s premium dollars to actually PAY THEIR HEALTH CLAIMS versus themselves and their big investors on Wall Street. If not Single Payer, then forced accountablility and responsibility on the part of the health insurance industry.
Frank has some valid points but obviously has not read any of the proposed bills currently in congress. First, YES we need some reform: Medicare which has $100 million of fraud every 8 hours and controls the “price setting for 50% of our citizens as well as commercial insurance companies; insurance company reform and increased competition which has been negatively affected by “over-regulation” by states and federal regulators as well as demanding numerous “mandates” which are different in every state; and TORT reform. Just doing those things would greatly increase coverage, that mythical 47 million US citizens that politicians do not wish to talk about and break down into meaningful categories which can be dealt with in positive ways.
Enough for now, but obviously Frank is not from the United States if he believes that the quality and professionalism of our medical care is not the best in the world!
John, and then Frank. First John.
The regular pundits that we all see week after week mostly are journalists who switched from reporting the news to philosophizing about it. They generally know very little about anything. A few, such as Krauthammer, have training in a field other than journalism, but most have never studied anything rigorous. Why should we expect such people to be informed about anything? Why should we expect them to understand substantive issues better than those involved in and affected by those issues?
Now Frank. Frank, do you really believe the Dems have told the truth about health care? I don’t recall a single Dem pointing out that virtually every major problem with the delivery and pricing of American health care is the result of government intervention in the health care market at the federal, state, or local level. That is the truth, and I don’t see the Dems publicizing it. No wonder, really, because that fundamental truth also makes obvious the fundamental solution, which is less government intervention rather than more. Dems like government intervention, so don’t hold your breath waiting for them to admit that it is government intervention that has caused most of our health care problems. (For a similar phenomenon in an unrelated arena, see the recent chaos caused by government interference in the market for housing finance and the Dem proposal for even more government intervention coupled with adamant refusal to admit the cause of the problem.) My alternative is very simple: the free market. It works with food, shelter, clothing, life insurance, and practically everything else we consume, so why wouldn’t it work for health care?
Frank (above) is very generous in allowing you the right to object to specific provisions. But apparently you are not allowed to object to the whole enterprise. Especially not if your objections are supported by an “ill begotten poll” such as this one sponsored by the Washington Post and ABC News, all part of the right wing conspiracy, no doubt. I guess the only poll that is not “ill begotten” is one that agrees with Frank’s point of view.
He ends with the Big Zinger — “what is your alternative?” The fellow needs to pay more attention. John Goodman is one of leaders in advocating for health reform that is far more radical than anything proposed in Congress — empowering consumers, rather than bureaucrats, be they public or private.
>> “Why are the people so much more perceptive than the pundits who try to tell them what to think?”
read “the wisdom of crowds” (james surowiecki, aug. 2005). that the masses are collectively smarter than the individual experts is an extraordinarily important realization and the books shows how and why, beginning with the example that in the old “who wants to be a millionaire” t.v. show, of the three “helplines” a contestant could use, the studio audience had the right answer 91 per cent of the time.”
whether it’s about health care or t.v. show questions, the people know.
frank at 11:21 a.m. “wants … wants … wants …” and wants government to provide it all for him. and the answer to his question about what is his alternative is the answer to meeting the “wants” he itemizes: stand up and demand it from the providers.
frank, you want better care? have you talked to your doctor about it? have you changed doctors? why not? those guys are in it for good reasons, one of which is to make a buck. believe me, enough franks asking questions and they’ll catch on.
You may not know this Frank, but there are dozens of rigorous studies offering alternatives to the current defects in the US health care delivery system. Some of those have been done John Goodman, et al; some by Linda Gorman; some by Greg Scandlen, and many, many others.
The heart of he current reform effort in DC is not what will help people, but what will increase political centrism and control.
Some correspondents above have mentioned some of the sound ideas for reducing costs in our health care system: reforming Medicare and Medicaid payments systems will save billions and reduce the cost shift to private payers; reforming and limiting tort will save billions if by nothing other than lowering the costs of defensive medicine and motivating physicians to be more thoughtful; reduction or removal of the crushing weight of state and federal mandates will save billions each year, not the least of which is EMTALA which forces hospitals to spend billions on minimally compensated care. This list goes on and on. The gist of this is that our current overpayment environment is largely the province of political machinations, and political machinations will need to undo a good bit of what has been wrought over the past 30-40 years.
What is my alternative, you ask? I have concluded that no other workable alternative exists except to return the decisions on how to provide health care to the people/consumers, and allow the tested methods of the market to provide practical, cheap options for care. Certainly, we will need continued assistance for some categories of people, but by making real reforms, as alluded above, which will free up hundreds of billions of dollars, we can achieve reform that will last and create stability.
Let all Americans stand up, and protect this Country.People, should learn all the facts.I do agree this country is ours. Lets don’t give in to what we don’t believe in.Protect,out Vets, and olders. I’m satisfied with my Federal insurance. no complaints. But if Health reforms comes. I want have the care I have now. Let them go check out Welfare,and Ca optoma
to see how much fraud they could save. Then people might find a better solution. God bless this country,and our leaders to see and feel what is truly need Americans.Our Men & Women are fighting for our safty.Leave well enough alone. Ellie
We need to change the discussion on solutions to third parties like Medicare and insurers.
There is a big difference in tracking the inefficiencies between specialists/hospitals getting payments from third parties and primary care physicians practices who take care of 80-85% of the needs of the patients.
The fundamental structure and business model of primary care is changing rapidly to direct practices.
We QuACk doctors are focused only on providing our patients with Access to Quality care at a reasonable, transparent Cost. The patient (free market) determines quality and value when they have a direct financial relationship with their patient. We do our best to keep their costs down b/c we work for them.
Advocating that 98% of premium dollars be used to pay claims for those who are privately insured displays a fundamental lack of understanding about how insurance works.
Some of the premium dollars that do not pay claims goes to customer service, customer health education, improvements in networks, innovative experiments in ways to reduce costs, new products, and fraud detection which keeps costs down for everyone.
Best estimates of current private system insurer overhead are less than 20%–which is, if Dr. Zycher is correct, less than Medicare overhead.
Again, it is the systems run by government that are failing, not the private insurers.
Just about every four years, public health advocates gear up to make health care a pivotal, election-year issue. Advocates tailor polls to elicit the desired response from those being surveyed. The surveys emphasize the benefits of universal coverage without mentioning the costs. When surveyed, citizens all claim they favor universal coverage — some even say they are willing to pay higher taxes. However, when voters realize they may lose the coverage they currently have and the costs will be huge, voters reveal their true preference – to keep the current system. Then, public health advocates all lament “what happened to health reform?”
Unfortunately, progressives and liberal advocates of a government-takeover of our health care system still don’t understand that Americans want everyone to have coverage, but are not willing to endure the hardships that Canadians, Australians and British put up with in their socialized health care systems.
Wow!
How about my 10 commandments for health reform:
1. Patients should be free at all times to choose their own doctor, insurance plan, hospital, and treatment plan/strategy.
2. Health care decisions should be made by the patient and physician working together in collaboration and without government intervention.
3. Patient privacy must be paramount and maintained at all times.
4. The doctor/patient relationship is confidential and personal. It should not be regulated by outside agencies.
5. Patients should be free to contract with doctors, hospitals, and all other licensed providers provided those fee schedules are transparent and readily available. Insurers and government payers should publish their payment schedules.
6. Insurance is an actuarial risk and should protect patients from the financial catastrophe that might befall a person at the hand of an unplanned illness or injury. HSA provisions should be expanded to cover any other routine medical care directly purchased by the patient.
7. Payment of benefits is between the payer (either private or public) and the insured. Payment for services is between the patient and the doctor, hospital or other provider of care. The two should not be mixed.
8. The patient should determine quality of healthcare. Standards of care are the discretion of specialty organizations and should be published and available to all patients. Physicians within that specialty network should do peer review exclusively and confidentially.
9. Any tax benefit provided for the purchase of health care or health insurance should accrue to the individual patient/insured.
10. There shall be no unfunded mandates. There shall be no individual mandates.
Frank, we know the reform debate is NOT about cost, quality, or access. It is about power as described in my article below.
The Road to “Hellth” Reform
Health Reform or Hellth Reform? Health reform in Washington has never been about health or healthcare. It is about power. Controlling $2.5 trillion dollars gives politicians control over election results. The bill passed out of the Senate HELP Committee is loaded with new controlling councils, agencies, boards, departments and other entities all with the power to spread tax dollars around to cronies through “planning and establishment” grants. The word “grant” shows up 421 times in the bill.
We already have the largest national health care system in the world. The government controls 50 cents of every healthcare dollar spent in the United States. Federal programs of Medicare, Medicaid, CHIP, VA health, and Tri-Care are responsible for half of the healthcare in the country. Yet, these government controlled programs exemplify out of control spending, waste, fraud, abuse, and the lack of modern technology that the president so confidently states that the federal bureaucracy will change once all healthcare is under their control.
The reason Congressional health reform proposals make little sense to the general public is that they inherently know that the federal government cannot solve the problems that are created by current government ineptitude. Many citizens are confused by the proposals because they believe that the political class is trying to improve health and healthcare for all. They are not.
If improving health and controlling healthcare costs was the goal, why would the president and Congress ignore the non-partisan study by the American Academy of Actuaries which identified an approach where “total savings generated could be as much as 12 percent to 20 percent” and future “trend rates (are) lower than traditional plans by approximately 3 percent to 5 percent.” Importantly, the Academy report also concludes that in these plans “recommended care for chronic conditions (are) at the same or higher level than traditional plan participants” and the “studies reported a higher incidence of physicians following evidence-based care protocols.”
The basis for these remarkable results is the use of consumer-directed health plans. Healthcare consumerism has been developing in the employer and personal insurance market for nearly a decade. The report is an unbiased view that shows amazing results. New generation plans are being developed and implemented by employers and purchased by individuals that show even higher levels of savings. Healthcare consumerism encourages personal responsibility with rewards and incentives for healthy choices and adherence to physician treatments. They are good for both the healthy and those suffering from chronic conditions. But consumerism is rejected by the proposed bills. The president speaks many of the words and uses the language of consumerism, but the Senate bill would make illegal rewards and incentives for those who take the initiative to control their blood pressure, lower cholesterol, stop smoking, or improve other health related standards.
Changing federal and state laws to support the growth of healthcare consumerism by promoting personal responsibility can lower the uninsured by 15 million without any government expenditures. If Obama and Congress have better ideas proven to control costs and improve quality of care they should start by changing the 50 percent of healthcare already under government control. Mr. President, show the country, employers, and voters how to successfully implement health reform before the 180 million with private health insurance who are moving towards healthcare consumerism suffer from your political Hellth Reform. We all know that the road to hell is paved with good intentions and that the devil is in the details.
I’m very glad that these opinions are current, but I’m afraid I don’t share your newly found faith in democracy. As your third paragraph demonstrates, this is almost certainly a result of the old odds game–even a stopped clock is right twice a day. What will you say if the pundits convince the “public” that they are wrong, and the next poll is opposite? Maybe you need a twelve hour intensive reading of Mencken and Twain.
And you think democracy means scaring old people about “death squads” and lying about the government inspecting your personal bank accounts until the polling results you exult are achieved. Very sad, John.
Scaring people would be telling them that millions more are going to lose their health insurance and rates on current plans will be double in a few short years if we don’t act now. Then parading a few people (who are suffering some illness) into a candlelight vigil (these are planned across the country)and tell us we must pass Obama’s health reform now.
The truth is the percentage of the “uninsured” has been about the same for years. Most work for small business owners that do not offer insurance or choose not to take an employer’s plan. We don’t hear our president talking about the value of HSAs as part of the solution in covering them yet we know that 30% of those who have enrolled in an individual or group consumer driven plan, were formerly uninsured.
Despite what we see in the AARP spots, people are not blocking ambulances, nor are they trying to stop health reform. Just THIS health reform concept. John, Greg, Linda, Ron, Devon, and others on this blog have been advocating health reform for many years. Where was Obama when President Bush was trying to pass his health reform which included equalizing the tax treatment of health insurance premiums?
I would recommend reading “How American Health Care Killed My Father” (The Atlantic Monthly) written by a Democrat who clearly identifies the problem with our current system and has come to the realization that consumer driven health care is the answer. If you are interested, you may read my letter to the editor here. http://www.hsabenefitsconsulting.com/blog
Medicare should be abolished not “saved”.
Describing the “public option” as a mechanism for improving competition is marketing, pure and simple. Government has:
Unlimited resources, pays no taxes, is often exempt from the rules it imposes on market players, has no incentive to improve its output, responds to the will of politicians, not customers and is ultimately backed by the police power of the state
There are very few things the government has taken over that were improved. If we look down the road to the results of the bailouts, I think it will be the most chaotic and expensive act of government ever seen.
As someone who has struggled with the cost of high insurance premiums only to see claim after claim denied or mitigated by my insurance company, I have firsthand experience with our health care crisis. More than 46 million Americans are uninsured. Even for those lucky enough to have insurance, rising costs and deteriorating coverage cause nearly a third (31 percent) to go without needed care because they can’t afford it. Indeed, of the one million Americans bankrupted by medical bills annually, more than three-quarters had insurance when they got sick.
In 2001, my wife Laura was diagnosed with a malignant brain tumor. Due to the life-threatening nature of her illness, (and because she worked at a physicians’ office and was familiar with the procedures and paperwork involved), she was able to qualify for Medicare.
Laura received excellent treatment and care under Medicare, and is fully recovered today. If we had been forced to rely solely on my private health insurance through my employer, many of her claims would have been denied and we would now be facing bankruptcy. Worse still, she may not have even survived, because much of the care she received through Medicare would most likely have been off limits to her. So in actuality, the much-maligned “government option” you are fighting to eradicate from the public discourse helped save her life.
Many stories do not have the happy ending ours did. In view of my own personal experience, I stand in opposition to organizations such as yours who make it their business to obstruct meaningful healthcare reform for those who need it most.
When shopping for life insurance (and we will all need it under ObamaCare), I can call any provider nationwide and get competitive quotes. The same for car insurance. White House is claiming that the so-called “public option” will increase competition and lower prices. How about Health Insurance reform that would insurance companies to sell health insurance across state lines? I believe that alone would help lower insurance rates. As to improving the delivery of better health services, I propose to immediately move all government employees (military excepted) to private plans that the employees themselves pay into; just like any “real” employee.
The “Stimulus” gave seniors a one time bonus of $250. That’s approx. $5 a week for a year. Compare that to the $13 a week added to the average paycheck. Now throw in the projected cuts in Medicare, the threat ( either imagined or at least partially true), of rationing healthcare for the elderly: Guess what? Seniors think they’re now considered second class citizens. Gosh! WHERE did they get that idea from? The government. When a social worker tells a 67 year old diabetic that he can’t get his SNAP food credit increased ( even though dietic food costs 35% more on average), you know something is terribly wrong:
My husband and I just got turned down for a SNAP Food credit increase ( He’s diabetic and we live on SSI). Which would you prefer: An extra $100 for dietic food, or $180,000 a month for Hospital costs if or when John has a Diabetic blackout or slips into a Coma? You already pay for his SSI and VA, so you decide. If Obama wants to prevent complications associated with diabeties, obesity, heart disease and other ailments, wouldn’t it make sense to issue specified food vouchers/ Dietic foods/Care boxes to VA clinics,Food pantries and other institutions that address the needs of Low income Americans? Why is it that Government Commodities ( often delivered to Non Profit Organizations) are extremely high in Sodium and Carbs?
Worst of all, not ONE version of the Healthcare proposals include tax deductions or incentives to encourage responsible, healthy lifestyles: Therefore, Costs will skyrocket.
I am sick of what the President is doing to our country and I really don’t care if you tell him. He is destroying the rights that God gave us and trying to make our country to suit himself and his zars. If the people would come together and force him from office along with his zars and those who want change we could get our nation back. As things are going we will be in slavery within the next two years. Look at how he is running from country to country with his family at our expense. Where did he get the money for his education in the first place? He refuses to answer spicific questions but I truly believe we need to have the man removed. Not impeached, because he would have to resign but remove him with our petitions and votes of the people The young ones who think he is so handsome does not know that good looks are not what runs a country. Thank you for your time.