American Missive

ATLANTA— The health care debate in this country is an extremely complicated one.  In my reading of the myriad polls that have been released on this debate over the past few months, it seems to me that neither the left nor the right has a clear mandate for their various proposals.  There is surprising support for the introduction of a public option in some polls, which favors the left.  Also, Americans overwhelmingly do not want their health care benefits taxed, which works against one of the big proposals from the right.  However, there is clear evidence that the vast majority of Americans like their current insurance coverage (much of which is private), which favors the right. Further, the majority would not choose to participate in a public plan if such a plan were offered, which works against the left.

With that being said, I think there is enough evidence in the current polling to suggest that if the bill being considered by the House of Representatives were passed, it would likely be very unpopular.

Here are my reasons.

The plan would significantly expand health care costs for the government by establishing a public option, expanding coverage under current government programs, increasing subsidies to private insurers to cover higher-risk individuals, and reversing scheduled decreases in MediCare reimbursements.   The Congressional Budget Office (CBO) warned this week that the bill would do nothing to address health care cost inflation, but would rather exacerbate the problem.  The CBO said the course this bill charts would be unsustainable.

The plan would also formally establish a series of government bureaucracies, the purpose of which would be to play a direct role in telling hospitals and medical care providers how to treat patients in given circumstances, with the goal of reducing the overall costs for care.  Whether or not this would actually reduce costs is unkown.  But it is clear this would restrict doctor / patient freedom in addressing health concerns.

The plan would levy a tax of up to 8% of payroll expenses on companies that do not provide health insurance to their employees. Many companies may determine it is easier to pay this tax than provide insurance, thus steering a large swath of workers towards the public plan, whether those workers would otherwise choose the plan or not.  Additionally, such a tax on smaller businesses could cripple their ability to hire and retain workers, potentially causing higher unemployment rates for the country.

In light of these facts, the polls suggest rather overwhelmingly (in my view) that Americans will not like this program, if passed in its current form.  Check out the data in these polls that I have read in the last several weeks.

• When directly asked about the plan in the House, 49% opposed it in one poll.
  (http://www.rasmussenreports.com/public_content/business/healthcare/july_2009/78_say_health_care_reform_likely_to_mean_higher_taxes_for_the_middle_class)

• 52% were against the plan in another poll.
  (http://www.zogby.com/Soundbites/ReadClips.cfm?ID=18967)

• Now that the debate is heating up and more details are known, 50% now say they oppose a government run public option.
  (http://www.rasmussenreports.com/public_content/politics/toplines/pt_survey_toplines/july_2009/toplines_health_care_july_14_15_2009)

• Even though there are still many that like the idea of a government run health option, when given a choice, 53% would choose private against 28% who would choose public.
  (http://www.bloomberg.com/apps/news?pid=washingtonstory&sid=awNeGQfmE378)

• While controlling costs is everyone’s primary concern, 54% believe overall costs will increase under the House plan.
  (http://politicalticker.blogs.cnn.com/2009/07/01/cnn-poll-americans-worry-obama-heath-care-plan-will-increase-costs/).

• Another poll shows a whopping 73% lack confidence in government to decrease costs.
  (http://www.ibdeditorials.com/IBDArticles.aspx?id=332724880943398).

• On the idea of government involvement in specific health care decisions through the establishment of a series of government bureaucracies, we find that an overwhelming 90% oppose government-imposed limits on getting whatever tests or treatments they or their doctors think are necessary.
  (http://www.usatoday.com/news/washington/2009-07-13-poll-health-care_N.htm)

• In summary, only 20% believe they will be better off under the House plan.
  (http://politicalticker.blogs.cnn.com/2009/07/01/cnn-poll-americans-worry-obama-heath-care-plan-will-increase-costs/)

• Overall, 49% believe the plan would decrease the quality of care against 12% who believe care will improve.
  (http://www.ibdeditorials.com/IBDArticles.aspx?id=332724880943398)

• Or, another poll shows 40% believe the plan would decrease the quality of care versus 21% who believe it will improve.
  (http://news.yahoo.com/s/mcclatchy/20090716/pl_mcclatchy/3272692).

In light of all of this, it is interesting to note that the vast majority of people are satisified with their current coverage.  See the various polls I have found below:

• 84% satisified with current coverage.
  (http://www.zogby.com/Soundbites/ReadClips.cfm?ID=18967)

• 80% are satisified with quality of health care they currently receive.
  (http://www.cnn.com/2009/POLITICS/03/19/health.care.poll/index.html)

• 85% are satisfied with their current coverage.
  (http://www.bloomberg.com/apps/news?pid=washingtonstory&sid=awNeGQfmE378)

Conclusion

The short of all of this is that while the general idea of health care reform is hugely popular, the specifics being offered by the left-wing of the Democratic Party in the House are not flying very well.  From my reading of the details of the polling data, there is a real chance people will not only dislike the current bill in the House of Representatives, they may well hate it.

I say this because if this bill is passed in its current form, people will very quickly begin seeing changes in the way their health coverage is structured and in the flexibility they have in choosing care.  When such large majorities are content with their current care and do not want government interfering, my guess is there will be significant, popular backlash to all of this.

Within a few short years, this bill, if passed, could tank Barack Obama’s presidency. The opposition party would have an easy time running against this bill, particularly given that very few of them will likely support it in the first place.

It is clear that Americans want health reform that expands coverage and reduces costs.  But it is also clear that they don’t want the bill that Barack Obama wants.