Health Care Attitudes

Kaiser, ABC, and USA Today just released a pretty expansive poll documenting the country's opinions on health care. The nickel version is that your countrymen are mostly liberal, deeply confused, and more likely to loathe the status quo than clearly conceptualize potential alternatives. Respondents said it was the third most important issue in the country, behind Iraq and the economy, but before immigration, gas prices, or terrorism. That's probably because opinions towards the system are so overwhelmingly negative: 80 percent are dissatisfied with the cost of health care in the country, and 54 percent are dissatisfied with the quality. So the system starts out with few friends.

From there, things get more complicated. Nearly 90 percent are satisfied with the quality of care they received. Nearly 60 percent are satisfied with their costs. In other words, Americans believe everyone else's health care system costs too much and delivers too little. Their own system rocks. Meanwhile, a full 25 percent reported that they or someone in their household had problems paying for medical bill in the last 12 months, and 28 percent put off medical treatment due to cost. Of that 28 percent, 70 percent admitted that the delayed treatment was "serious." And remember, this is all in the last year.

Individual fears become more acute when asked about the future. 60 percent worry about affording insurance "over the next few years" and 56 percent fear losing their coverage if they lose their job. As for what's driving all these high costs, the reported culprits, in descending order, are excess profits of drug and insurance companies, medical malpractice lawsuits, fraud and waste, overpaid doctors, administrative costs, unnecessary treatments, unhealthy lifestyles, expensive new treatments, the aging population, and better medical care. That's depressing. In order to get an accurate view of what's driving health costs, you'd need to basically invert that list. To say the American people have it backwards is to be unusually precise.

How to fix it? Letting individuals shop around for the best prices they can get garners wide support, with 80 percent judging it some level of effective. Suggest far higher deductibles and low risk insulation, however, and watch that drop. 56 percent would prefer "a universal coverage program...like Medicare that is government run and financed by taxpayers" to the current system, but that number plummets if you ask about higher taxes, limited choice, or rationing. 70 percent support an employer mandate while a mere plurality support tax breaks for low-income workers (despite the fact that high income workers currently enjoy a massive tax break through employer deductions).

So, in sum: The health care system sucks, but nearly every American's health care is great. That would suggest the opportunities for reform are minor, unless directed at the loathed elements (like insurance or Pharma). Folks don't like the high costs and fear they'll soon be overtaken by bills, but they blame all manner of minor and moderate contributors for the problem, not their own health choices, overtreatment, or new technologies. Universal care is heavily desired, but only if it doesn't cost anything or demand any sacrifices. In other words, the appetite for reform outpaces the realism of would-be reformers. The tradeoffs of the current system seem poorly understood, and attitudes towards its desirability are contradictory. Not a whole lot of hope in here for anyone.