Saturday, June 27, 2009

What needs reform even more than health care?

Not only the mainstream media, but a lot of smart policy wonks have failed to address a paradox at the heart of the health care reform debate. For example, former Clinton Administration labor secretary Robert Reich blogs (hat-tip Krugman):
A new president -- even one as talented and well-motivated as Obama -- can't get a thing done in Washington unless the public is actively behind him. As FDR said in the reelection campaign of 1936 when a lady insisted that if she were to vote for him he must commit to a long list of objectives, "Maam, I want to do those things, but you must make me."
Reich makes a valid point, but puts the cart before the horse. The underlying problem is not lack of support for the health care bill. Rather, it's lack of knowledge.

Do Americans know what the proposals on the table actually are? How many Americans know that the purpose of H.R. 676 is "to provide for comprehensive health insurance coverage for all United States residents?" How many Americans can point to any of the intended benefits of H.R. 676? Few, I suspect, given that so much of what passes for health-care reporting amounts to interviewing uninformed people and then passing along their misconceptions without comment.

The US news media
bombards Americans with dollar figures, but provides no way for readers to put big numbers in context. "Senators claim $1 trillion bill in reach" reads one headline. Judging by this headline and so many others like it, you would think entire purpose of the health bill was to add a trillion dollars to the deficit! It's as if the United States has become a bubble-world inhabited by a people who can tell you the price of just about everything, the value of nothing.

But is there any data that backs-up such anecdotes?

Yes. But first, I will show you why the lack of public support for the Obama plan is a paradox.

When polled about what they really want in health care reform, the public seems to be clearly behind the main thrust of the Obama health reform bill. That is, Americans say they support the main principle that the Obama plan happens to embody. A recent CBS/NYT poll indicated that 72% of Americans support a "public insurance option." A NBC/WSJ poll (Pdf) indicated 76% of Americans considered it "somewhat important" or "very important" to give people a choice of a government-administered public plan.

But how many Americans know that HR-676 is a means by which the country could realize this ideal -- one they yearn for? Surprisingly few. Two recent polls have included questions that indicate just how little knowledge Americans have about the specifics of the health care reform legislation.

The first was the NBC/WSJ poll mentioned above. In the poll only one third of respondents said they thought the Obama health care plan was a "good idea." About as many thought it was "a bad idea." Concerning this poll, Sam Stein of the Huffington Post blogged,
In short: the administration has yet to complete the sale. An additional 30 percent of the public had no opinion of Obama's proposal for reform. But when read a description of the general outline . . . . the number of respondents in support rose to 55 percent.
The second poll, a Washington Post/ABC News survey of 18-21 June also revealed that Americans have low regard for Obama's health reform plan. When asked, "if the system is changed" will things get "better, worse, or remain the same," only 16% said things will get better; but 31% said things would get worse, and half said things would stay the same. Some other findings:
  • Over half of Americans report being "very concerned" that the Obama plan would have a negative impact on quality, personal cost, efficiency, and treatment options. In the dark about the plan, Americans are scared of... the dark.
  • Only 27% of Americans "strongly approve" of the way Obama is handling health care and another 26% "somewhat approve." Imagine that! The president wins the support of only a bare majority for taking decisive action on an issue that up to 76% of the population supports.
No wonder Americans are not marching in the streets in support of the Obama health care plan. They don't understand the proposal before Congress. They are clueless as to the gist of it. They are lacking in knowledge. One is reminded of polls taken in 2006 showing that many Americans still believed weapons of mass destruction had been found in Iraq.

The mainstream media has scarcely reported on this key paradox of the health care reform debate. One citizen who perceived what was happening months ago and tried to spread the word was Eliza Jane Dodd. Not having heard anything about the bill before, Dodd describes Americans she contacted as being "blown away" by HR 676, asking her "How can we get it!"

Who is responsible for this state of affairs? I contend that if the mainstream media covered this issue adequately, Obama's plan would likely have all the public support it needs. It looks as if news media reform might need to come before health care reform.


  1. AnonymousJune 28, 2009

    Excellent point. I have been following the debate closely for months with people like Maggie Mahar at her blog Health Beat and a stable of informed pros at The Health Care Blog.
    A couple months ago the Kaiser people put up a very informative interactive site that lists all seven of the actual proposals on the table with a way to compare each on a series of issues. (I was glad to find that both "portability" and "no pre-existing conditions" were in every plan on the table.)
    I actually downloaded 17 PDF pages, then cut and taped them all together in a dining-table sized spreadsheet. And it's amazing how little of the actual information is being discussed by the media. It's not like it's some big secret, for crying out loud.

    In addition to better output from the White House, a little old fashioned investigative journalism is just waiting for a prize if someone would take the time to do it.

    [John Ballard here, aka Hootsbuddy. I can no longer sign in with the Google account because it got hijacked, so I'm between blogs at the moment.]

  2. Clearly, the overriding issue here is campaign finance reform. If that one issue could be successfully addresses it would make it much harder for the super-wealthy special interest groups like corporate health insurance companies to corrupt “our” elected representative with massive campaign contributions.

    The congress is a representative body that is theoretically supposed to reflect the views of their constituents. If that were true today and the corruption factor was brought under control, then we would have our single-payer option and instead of quibbling over $1 Trillion over the next ten years, we would be on the road to saving a whooping $4 Trillion instead in that same period of time under expanded and improved Medicare for all as called for in House Resolution (H.R.) 676.

    If you believe that affordable universal health care in America is worth fighting for, then join The Citizens Alliance for National Health Insurance, today and your voice will be heard.

    Thank you,
    Larry Pius, Dir.

  3. John (Anonymous),

    Thanks. Great point. I agree, the problem is that the news media is not passing along any actual information to people. Mainly just opinions and so on.

    And I concur also about the need for more investigative journalism and that the White House is not off the hook on this debacle.


    What's likable about the current bill, HR676 is that by allowing for the public option, it will allow a government plan to go head to head with the sleaze-balls in the insurance industry, proving to Americans just how lousy their private insurance plans are relative to the alternative.

    So the present bill ought to be an important stepping stone toward getting to where you want to see it go.


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