Tuesday, October 27, 2009

Honesty and Inevitability

The healthcare reform debate has been marked by a very high level of interest by the American people. The most recent Survey USA poll suggests that 73% of those polled are following the issue with "a lot of attention." For any issue that is a remarkable statement. Another indicator is that of those who favor the President's plan (or some variety of the public option) 79% of those strongly favor the option. Of those who oppose the public option 86% strongly oppose it. In spite of the levels of interest the political class seems intent on trying to manipulate opinion rather than trying to discern what is moving the American people.

A really interesting article in the New England Journal of Medicine found that "public support for change is shaped by the interaction of three factors: people's perception of problems that affect the country, their assessment of their own current life situation and their worries about the future." Those highly critical of the current system favor the system should face major change. There seems to be pretty widespread support for an expanded federal role in health care - including a mandate for coverage.

Rasmussen suggests that 57% say a health care plan will increase costs while 53% say it will reduce quality. Remember that of the people with health insurance the vast majority are satisfied with their plan. A large majority argue that they would oppose a plan for government health care if it would mean that employers would drop their current programs.

Gallup's most recent poll found that an increasing margin of voters (now 49%) think a federal plan will result in worse health care. 70% think quality of care would diminish and 75% think costs would climb. 50% think a final bill should include a public option while 46% think it should not. That is hardly the mandate that Senator Reid claimed in offering his opt out public option.

But then we find that the Christian Science Monitor claims that "the public generally supports the public option." From my review of the polling I think the CSM is blowing smoke. According to the experts that have looked at the polling more closely than I "You can move the public opinion needle significantly with changes in wording or emphasis." (Karlyn Bowman, a polling expert at the American Enterprise Institute)

I have a pretty strong belief in the intelligence of the American voter. But I believe politicians still want to try to manipulate opinion to fit their narrow beliefs. Were the politicians intent on understanding the will of the people they might be able to craft a pretty good bill. If they continue headlong in their pursuit of their own agendas one of two results will happen. First, we could end up with no change. As an alternative we could end up a lot worse than we are today. Neither is a very good option but when you begin with an ego problem like Reid and others seem to have, the possibility for a positive result seems limited.

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