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HCAN Survey unintentionally boosts the case for single-payer reform

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  • Jerry Policoff
    There is an article in Huffington Post today: Poll: 73% of Voters Think
    Message 1 of 1 , Mar 11, 2009

      There is an article in Huffington Post today:  Poll: 73% of Voters Think Health Care Reform Must Include Choice of a Public Health Insurance Plan (http://www.huffingtonpost.com/robert-creamer/poll-73-of-voters-think-h_b_173398.html?view=print)


      The piece draws attention to a recent poll commissioned by  HCAN (Healthcare for America Now) that suggests strong grassroots support for the Obama supported Healthcare reform plan.   It is indeed an interesting survey, though not a particularly honest one, and if one reads between the lines the survey strongly suggests that the one option respondents were not asked to consider, the single-payer option, would have roundly defeated the others if it had been included in the survey.


      The survey questioned  "likely voters" utilizing a random digit telephone sample which means all non-telephone and cell-phone only households were excluded from the survey (cell phone numbers are not included in random-digit phone samples).  These two demographics now account for nearly 20% of all U.S. households, and there is a growing body of research suggesting that any health survey that excludes these constituencies is bad research since these households tend to be larger, poorer, and more likely to be uninsured than the population as a whole.  They also tend to be at higher risk health wise than the general population.  One also wonders why people unlikely to vote were excluded from the survey.  What does having an intention to vote have to do with personal health issues?  The probable answer is that non-voters would also tend to be disadvantaged minorities more in need of comprehensive, universal health care reform than the population as a whole.  In other words, the survey seems designed to over-represent that segment of the population that currently enjoys health coverage.  It is also worth noting up front that polls suggest that while the majority of Americans are strongly in favor of radical healthcare reform, most with insurance are personally satisfied with their own coverage.  This does not mean they have good coverage.  It simply means that they have not been in a situation where their coverage was tested by large medical expenses that their insurance company later balked at paying.  Remember, “SiCKO” was about people who thought they had generous health insurance benefits until they got sick and discovered otherwise.


      The survey asked respondents whether they preferred health care reform with "everyone getting health insurance through private health insurance plans;" or "everyone getting insurance through a public health insurance plan" or “everyone having a choice of private health insurance or a public health insurance plan?"

      15% favored private only: 9% public only: 73% a choice of public or private.  


      Next respondents were given a description of the reform plan proposed by AHIP (American Health Insurance Providers, the PR/Lobbying  arm of the health insurance industry) and the Obama plan.


      AHIP would require all private health insurers to offer at least a set amount of health coverage to all who wanted to be covered (regardless of pre-existing conditions) through a high-deductible plan whose cost would be determined by the insurance companies. The Government would then subsidize the cost of insurance for low income and some middle-income families. Everyone would be required to buy health insurance.


      The Obama plan would require all insurers to offer at least one standard comprehensive health plan with guaranteed benefits with the cost determined by a family's income.  Denial of coverage for pre-existing conditions would be prohibited, and restrictions would be imposed on how much people with pre-existing conditions could be charged.  Everyone would be able to keep the insurance they have, or have a choice of private insurance or a public insurance plan. (Note: nothing in this plan guarantees comprehensive, universal coverage or affordability)


      A Single-Payer system, privately administered but publicly financed was not included as a third possible option despite strong national support for such a system.


      Not surprisingly, given only the Obama Plan option or the AHIP Plan option 67% chose the former and 24% the latter.


      The next question is tricky.  It asked respondents if they favored or opposed providing access to affordable quality healthcare for all Americans even if it means raising taxes (tricky because in reality neither the Obama Plan nor the AHIP Plan provides this, though single-payer, the only popular option excluded from the survey,  does).  60% favored comprehensive universal health care (which only a single-payer plan could deliver) even if it resulted in higher taxes. 31% were opposed.


      The next question is interesting, and the response to it fascinating: "Do you favor or oppose providing access to affordable quality healthcare for all Americans even if it means a major role for the federal government?”  71% favored a major government role versus 21% opposed.  Once again this suggests that a third option in which the government financed a privately delivered healthcare system (single-payer) would have been warmly approved of in this poll if the respondents had been offered that option.


      By a 62% to 28% margin respondents rejected the notion that a public health insurance plan would be a big government bureaucracy that would increase costs to taxpayers. 


      The respondents to the survey hold a dim view of private insurance companies. 60% agreed with this statement:


      Private health insurers will always find ways to put profits before people.  That’s why we need an independent non-profit public health insurance plan that is not driven by making higher profits, in order to control costs and guarantee access to quality affordable health care. 



      Respondents were  read 7 different names that could be used to describe "the public insurance plan option" and asked to rank each one on a scale of 0 to 5 based on how favorable they felt toward each name.

      The choices were:


      "A Public health insurance plan like Medicare"

      "A public health insurance plan"

      "A public health insurance option"

      "A public health insurance option like Medicare"

      "A non-profit public health insurance plan"

      "A publicly sponsored health insurance plan"

      "A public Plan"


      The winner with 74% approving; 53% strongly approving was "A public health insurance plan like Medicare" This is significant because the Obama plan is nothing like Medicare, but a single-Payer Plan is often referred to as "Medicare for All."


      It is unfortunate that HCAN chose to formulate its questionnaire in a manner clearly intended to marginalize the single-payer option, and utilized a sample that excluded those most likely to strongly favor and most desperately need the single-payer option, but despite their best efforts it seems pretty clear that single-payer is the option that would have scored most favorably if it had been specifically included in the questionnaire.. 


      Check out the survey here:


      and here (PowerPoint presentation):

      Download the Lake Research Presentation (ppt): http://healthcareforamericanow.org/page/-/documents%20for%20download/HCAN%20-%20Lake%20Public%20HI%20Plan%20Option%20Presentation%2020090204.ppt



      Jerry Policoff





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