User talk:EastTN

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[edit] March 2008

Just a note to say thank you for your many excellent contributions to health care articles, and for being the voice of reason in discussions that can be somewhat contentious. Too many people on Wikipedia only use talk pages to criticize, warn, or complain about something, so I just wanted you to know that your good work is noticed and appreciated. --Sfmammamia (talk) 16:18, 6 March 2008 (UTC)

Thank you! (Really, thank you - I've taken you as something of a role model.)EastTN (talk) 16:36, 6 March 2008 (UTC)

[edit] Universal health care debate section

Please have a look at the poll section in Single-payer health care. While it's great that you are adding reliable sources to the cons in the universal health care article, it appears that more recent polls (2007) may show stronger support for tax increases and for single-payer than the 2005 research you pulled from. --Sfmammamia (talk) 23:33, 13 March 2008 (UTC)

You may be right. I wanted to bring in the 2005 Bodenheimer article because it was one, written by a liberal who has an unusually clear understanding of other points of view, and who talks pretty explicitly about the limitations of polling data on the issue. The polling data he quotes "76 percent agreeing that access to health care should be a right," "72 percent of U.S. adults, including 51 percent of Republicans, agreed that the government should provide universal health care even if it meant repealing most of the Bush administration’s tax cuts," and "Sixty-one percent of those who supported health care as a right viewed it as a moral as well as a political issue." I think those are reasonably comparable with the results in the poll section in Single-payer health care. He goes on to say:

"One caveat concerns the impact of taxes on public opinion. A 1994 survey found that fewer than half of respondents would pay more taxes to finance universal health insurance. A 1993 survey found that 64 percent were willing to pay more taxes for that purpose. Many respondents balked at paying even the tiny sum of $100 per year. Lawrence Jacobs and Robert Shapiro contend that when respondents were informed of the benefits the taxes would finance, support for tax increases of $40 per month reached 41 percent. If respondents were told that increased taxes reduce out-of-pocket health care payments, more than half were willing to pay an additional $1,000 a year."

That's what I was trying to characterize with the sentence "There is, however, much more limited support for tax increases to support health care reform." There may be a better way to say it, and we may need to bring in more sources. One critical point here is that most polling doesn't get at the magnitude of the taxes that would be required, and the way the question is structured and the magnitude suggested for the taxes (if any) can dramatically affect the results. Unless there's a crystal clear connection between higher taxes and a net, overall reduction in spending, people quickly change their minds when the taxes suggested get larger.

I wanted to bring in the 2001 Blendon & Benson article because it has a nice historical overview of polling data going back, in some cases, to the 1960s. Some of the things that caught my eye were:

In the twenty-two years the first question has been asked, more than 80 percent of Americans have reported that they are satisfied with their last visit to a physician (Exhibit 7). Also, confidence in ability to pay for a major illness has improved over the years. Despite the increase in the number of uninsured Americans nationally, the proportion reporting such confidence has risen from 50 percent in 1978 to 67 percent in 2000. This improvement in financial confidence may be related to more comprehensive insurance and increased benefit coverage for the insured population, or it may reflect the effects of increased family incomes and assets that could be drawn upon in case of large medical bills.

In 1964, the year before Medicare and Medicaid were enacted, only one-fourth of Americans expressed distrust in the federal government (Exhibit 8). When the Clinton health plan ultimately failed in Congress in 1994, distrust of the federal government had risen fifty-four percentage points. These same years have also seen a decline in public support for government regulation of the private sector. In 1964 only 43 percent of Americans agreed with the statement that the government has gone too far in regulating business and the free enterprise system. This figure rose to 60 percent in 2000. Americans are clearly less willing today to see expanded government regulation in general than they were during the 1960s. Similarly, in 1961 only 46 percent of Americans thought that their federal taxes were too high. This figure rose to 69 percent in 1969 and stood at 63 percent in 2000.

Americans hold many beliefs that are consistent with a general view of what is right or wrong about health care in the United States. However, it is striking to see how many conflicting views the public holds on health policy issues. On the one hand, Americans report substantial dissatisfaction with our mixed private/public health care system and with the private health insurance and managed care industries. A majority of Americans indicate general support for a national health plan financed by taxpayers, as well as increased national health spending. On the other hand, these surveys portray a public that is satisfied with their current medical arrangements, in many years does not see health care as a top priority for government action, does not trust the federal government to do what is right, sees their federal taxes as already too high, and does not favor a single-payer (government) type of national health plan.

Because Americans do hold many conflicting values and beliefs that affect their views on health care policy, it is important to be cautious in interpreting the public mood based on single, isolated public opinion questions. To be a useful guidepost for policymakers, opinion surveys require enough depth in their question wordings so that respondents can work their way through their conflicting values and beliefs to come to judgment on the issue.

I may have done a terrible job of summarizing all this (and may have tried to over-condense it), but I think there are some important insights here. It's easy to be baffled by the apparent disconnect between high poll numbers supporting some form of health care reform, and the lack of any political momentum towards the kind of national health system we see in other countries. I don't 'think' any of this is inconsistent with the other polling data we have in these articles, and if we can get it described right, it may help people understand what those poll results mean a bit better.

I really don't want to mis-characterize the polling data. Do you see a better way to handle this? I just think it's misleading to have polling data that suggests the vast majority of Americans want a national health system, and leave readers wondering why that doesn't have more impact on our political system. EastTN (talk) 13:59, 14 March 2008 (UTC)