Health Care: What Do the People Want?

To the New York Times’s credit, they asked them. And this is what they found (from the beginning of the article, entitled “New Poll Finds Growing Unease on Health Plan”):

President Obama’s ability to shape the debate on health care appears to be eroding as opponents aggressively portray his overhaul plan as a government takeover that could limit Americans’ ability to choose their doctors and course of treatment, according to the latest New York Times/CBS News poll.

Americans are concerned that revamping the health care system would reduce the quality of their care, increase their out-of-pocket health costs and tax bills, and limit their options in choosing doctors, treatments and tests, the poll found. The percentage who describe health care costs as a serious threat to the American economy — a central argument made by Mr. Obama — has dropped over the past month.

The article does cite several statistics from the poll, and does show several signs that are favorable to President Obama, including that the public overwhelmingly favors him over the Republicans when it comes to health care, and overwhelmingly thinks that he is trying to work with Republicans more than the converse. But the overall impression you get is that Americans are afraid of health care reform.

But are they?

Here are some of the raw numbers:

  • The government should guarantee health insurance for all Americans, by 55-38.
  • The government should “offer[] everyone a government administered health insurance plan,” by 66-27.
  • Insurers should have to cover anyone regardless of medical history, by 76-19.
  • It is true that 68% of people think that health care reform could limit their access to treatment; but 66% are concerned that without reform, they could lose coverage at some point.
  • Similarly, 76% think that health care reform could increase their taxes; but 75% think that without reform, the cost of their health care will go up.

It seems to me that on the most important issues, America is solidly behind the House versions of health care reform.

But although Americans favor health care reform, by 59-31 they think the current bill will not benefit them personally – presumably, as I’ve argued before, because they are under the probably-mistaken assumption that they currently have good coverage and will not lose it. Now, this does not necessarily mean they would not favor the bill. As Ezra Klein wrote a while back, the administration could have made the argument for reform in moral terms – society has a moral obligation to provide basic health care to all people, and if it costs the better-off among us a few bucks, then that’s the price we should pay. But instead, it went for technocratic arguments instead – we have to “bend the curve” of health care costs. (In 2007, people thought that universal coverage was more important than reducing health care costs by 65-31; after months of being told by both sides that it is costs that matter, universal coverage still wins by 53-43.)

So at this point, I think the key message has to be that health care reform is good for everyone (at least everyone under 65; those over 65 already enjoy the benefits of reform), because it protects you against the risk of losing your job and getting sick.

About James Kwak 133 Articles

James Kwak is a former McKinsey consultant, a co-founder of Guidewire Software, and currently a student at the Yale Law School. He is a co-founder of The Baseline Scenario.

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6 Comments on Health Care: What Do the People Want?

  1. Here is the big problem with government health care plan. What they don’t want us to know is that union force is behind the single payer. Single payert will make it easy to form unions. Imagine thousands of union employees on government payroll. Our tax dollars will be sucked dry and everyone knows how efficient are these union employees. Also part of the agenda is to put doctors as salaried employees. Now we have a union of doctors and federal government will end up managing and running a unionized force. They will vote in who ever they want, end less benefits and bloated salaries. Eventually country will be taken over by union thugs.
    Guess what? America’s health care is on strike!

  2. Universal heath care does not work with our current system. We should be working on educating more doctors and nurses and building more hospitals before we decide to provide coverage to everyone at a reasonable cost.

    After all insurance is not the problem the cost of medicine is. Any argument that leaves that out of the equation is not true reform.

  3. Part 1.

    Problems :

    1. No systematic, expansive Prevention & Wellness Program.

    According to the scoring of CBO on the prevention & wellness program, all fitness centers around the world should close down immediately and all media have to end
    reporting health tips about prevention. Rather, all of the excellent health systems seem to have one feature in common, a expansive, systematic preventative program
    requiring immense investments.
    I think a prevention system works as a ‘levee’ built against flood by the government, similarly, it also needs non-profit investments from the government ‘on a large scale’.
    This might offer us one clue of why all of the free states have public insurance policy in place.

    Surprisingly enough, the system today is designed around treating patients once they become sick. As far as I’m concerned, the congress affected by the special interests
    has turned down the budget request for prevention program in Medicare & Medicaid, which are the most expensive parts of the health program. Let’s imagine the astronomical
    costs and invaluable lives following the levee breach.

    2. A pay for each service / volume compensation, & No E-Medical Record.

    As much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the
    recipients, and this 700 billion dollars a year can cover a lot of uninsured people, in return, it could lessen the tragic, prohibitive ER cares.
    Medical errors ( No e-Medical Record ) & lawsuits, more profits motive, and indirect payments from employers etc would account for it.

    Supposedly, ‘a pay for each service / volume’ compensation seems to leave the medical institutes unequipped with the essential IT system. To understand its importance, If
    we imagine the cost difference between the previous and current system in financial institutes, the magnitude of cost-savings and the mess in health care system can
    be easily explained.

    3. Premium Inflation.

    This last spring, due to the demand decrease, the peak fuel price came down below $40 per barrel, though, the
    ‘Similar’ insurance premiums keep on rising, accordingly the inaction could bankrupt family, business, and
    government ‘BEYOND this recession’ , as all across the spectrum agree.

    Basically, as demand diminish, the price tends to reflect it, nonetheless, the insurers that formed a cartel through
    consolidation have replenished the loss by exercising inhumane malpractices involving denying, capping, rapid
    premium increase and the like. And this runaway premium ended up in the collapse of middle
    class ranging ‘ from finance to mental health’ , alongside the peak fuel price and fast-growing mortgage rate, as all of
    us know. Thereby they could be cited as an objective for anti-trust or anti-corruption. If the public plan sets the same rate of the insurers, it will be another headache.

    Ironically, the Deficit-sensitive groups have a distinctive common ground, they all have a Deficit-driven background out of
    question. Therefore, I’d say they have nothing to say about deficit unless they are free from the sponsors.
    And the spoiled menu, ‘Takeover and Rationing Cliche’ is still marching for bankruptcy, as opposed to its motto.

    4. ‘Work or Break’ health system with no brake or safety system.

    Just like marriage, economy also undergoes up and down, however, economic downturn is not reflected in the employment-based system.
    The rising mental stress or illness & ‘keep eating habit’ , which are the epicenter of a number of different diseases,might be traced
    to this insecure system and exorbitant premiums.

    Part 2.

    The Public Plan:

    1. Thankfully, the health care reform bill currently before Congress makes several key investments including more primary care doctors in preventive care, and those pieces
    of the public plan must be maintained .

    2. The pay for ‘Outcome’ pack is most likely to expedite the introduction of Health Care IT SYSTEM, and it will help doctors focus on their patients.

    3. The ‘innovative’ idea of a ‘pay for value / outcome’ pack will allow for Quality and affordability
    . If you are a physician, and your pay is dependant upon your patient’s outcome, you will most likely strive to
    prescribe the best medicine earlier in the process, let alone skipping the wasteful, unnecessary risk-carrying
    Young folks and advocates need to explain the notion of a pay for outcome agreement to the elderly misled by the

    4. The synergy effect of the combined Health Care IT & a pay for ‘outcome’ system may allow the clinicians to
    ‘correctly’ diagnose and effectively treat a patient earlier in the process so that it can measurably decrease the
    crushing lawsuits and deter the excuse for unnecessary cares to make fortunes.

    5. The creative idea of ‘a pay for outcome’ will more likely prompt team approach and decision, as at Myo clinic.
    Under the ‘pay for outcome’ pack, for good reason, best practices as ‘recommendations’ would simply help them
    make a better decision, and the government won’t still have to meddle in the final, actual decision-making
    process as a non-expert.

    6. This New ‘Payment Reform’ could accelerate the progress in medical science, in return, it will save more cash.
    And this idea will be able to bring ‘competition’ to the private market, as a result, it can contribute to mitigating premium inflation.

    7. Supporters of the agreement say it could save the Medicare System more than $100 billion a year and ‘improve’
    care, that means more than $1trillian over next decade, and virtually needs no other resources including tax on the
    wealthiest. Supposedly even the ‘conservative’ number of such savings might be able to meet the objective of revenue-neutral.
    (Please visit for detailed infos).

    8. Through clinic’s network, users of its health-care services can keep up with their health information and information for family members, and receive health guidance and recommendations from clinic that is optimized for each person.
    The system also allows patients to upload information from home-health devices such as blood glucose monitors and digital scales. Patients can authorize whether they want to share their health information with doctors or other caregivers, and those caregivers can provide health-care and general wellness recommendations based on the information patients provide.

    9. In case the health care reform provides the general public with peace of mind, the rising mental stress, obesity caused by the insecure system and
    exorbitant premiums may bend the curve surprisingly.

    10. Clearly, the positive impacts involving massive job creation, promising stem cell research, several times more economic effects of ‘from bed to work’ lie ahead, these will
    lead to economic recovery.

    Part 3.

    Conclusion ;

    1. The last thing to expect is rallying for premium inflation

    2. Over time, supposedly, the public plan will concentrate more on basic, primary cares, and the private insurers will provide their clients with differentiated services.

    3. With the Prevention & Wellness Program as a stable levee in place, the promising pay for value/ outcome reimbursement reform based on IT system could clear the way for revenue-neutral. Some say the installation of IT network will take time, but once this new outcome-based payment system is implemented, the hospitals reluctant to adopt it will most likely rush to introduce it.

    4. The final hurdle looks like a scoring issue surrounding the savings on Prevention & Wellness Program, but I’d like to say
    health clubs and media reports on prevention tips must be maintained.

    Thank You !

  4. Healthcare reform is needed in the US because the US Medical, Pharmaceutical, and Insurance Systems ARE TOO CORRUPT! THESE GIANTS HAVE BEEN DRINKING AMERICAN BLOOD…for way tooooooo long. THE TIME HAS COME FOR THEM TO PAY FOR WHAT THEY HAVE DONE TO HUMANS FOR PAST 40-SOME YEARS!
    It is the fact. Take it or leave it. Who does not know the system in-and-out should not jump and blame it on a healthy healthcare reform.
    This reform will only help the REGULAR CITIZENS. Yeah, sure, it’s not going to be beneficial for the insurance companies if they have to lower their cost and stop cutting insurance benefits for the real medically sick people…and bluntly, the purpose of this reform is not for the doctors and nurses who were used to mistreat and misdiagnose and play on human bodies and minds and get rewarded by ‘quantity’ of treatments not by QUALITY…as They should have performed their jobs;….you folks …don’t know what the CORRUPTION IN THE PHARMACEUTICAL AND MEDICAL INDUSTRY is, and for how long it has been in place! I, a real Christian…am praying and even keep fasting for this Healthcare reform to take place, to take shape and for it to help the REAL HUMANS AND NOT THE CORRUPTED INDUSTRIES WHO MESSED up the American population to a great extent.
    Gutsy-blunt-crazy-honest: Zalmoxis!
    Wake up people….or the sharks will continue to swallow your lives…as they have done it so well fo soooooo many decades…and for what: for the sake of their PROFIT-MARGINS!

  5. The runaway premium similar to the peak fuel price last year and left so many folks in despair insists on staying the course with the attitude ‘unchanged’, clearly this trend could bankrupt individual, business, and government. Now the government subsequently is tasked with these two main assignments, first, to address premium inflation, second, to expand coverage to all in urgent need.
    In order to cover all and not to add to the deficit, the public option can not set the same rates of private market, rather, it needs to have the function to keep it in check in terms of inflation, too. Unfortunately, this ‘unavoidable’ direction is aggressively being accused by the runaway premium, citing government ‘take-over’ .
    Under the circumstances the energy bill to determine human future and the other major issues is presently piled up, who wants to waste time making enemies ?, which also does not benefit the forthcoming election.
    On the other hand, to make things worse, critics say the savings from the proposed public option is not enough to meet the revenue goal. Furthermore, on another hand, some say ‘hands off’ . Where do these No tax, No saving and the like intend to force this reform to go ? The conclusion by ‘just-say-no’ is no doubt. Ironically, the Deficit-sensitive groups have a distinctive common ground, they all have a Deficit-driven background out of question.

    Of all choices, the best thing would be savings through efficiency. Considering the wasteful structure, the highest premium in the world, and the most expensive part of medicare, with the prevention / wellness program in place, an American style innovation, an ‘outcome’-based payment founded upon IT system may be enough to save more than 50 billions per year (500 / decade), both ‘improving quality’ and removing the unnecessary procedures (as pay is dependent on patient’s outcome). Young folks and advocates need to explain the notion of a pay for outcome agreement to the elderly misled by the disinformation.

    Unlike private market, this public option includes large-scale investments, these large investments still does not get the fair score, instead seem to become a source of acute conflict, even so, this common sense-based program needs to develop further as early detection goes beyond monetary value.

    In short, with the heartbreaking tears in mind (Nearly 11 Million Cancer Patients Without Health Insurance), private market also needs change and should join together to complete this reform , as promised, if not, the runaway premium only has itself to blame. Job-based coverage (indirect payment), mandate code, and ample capital might be favorable to the private market. And It can be said that fair competition starts with fair market value.
    Over time, supposedly, the public plan will concentrate more on basic, primary cares, and the private insurers will provide their clients with differentiated services.

    Thank You !

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