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Public Is More Savvy than Harris Polltakers

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Are the nation’s polltakers part of a surreptitious plot to convince us that what’s good for us is bad and what’s bad is good? A new Harris poll is the third in the space of a week claiming that the public (or some subset of it) is badly misinformed about the Patient Protection and Affordable Care Act. This follows on the heels of similar polls commissioned by Kaiser and the National Council on Aging (which I have criticized at my blog).

Yet the people responding to these polls appear to have a much better understanding than those asking the questions. Consider this tidbit from Harris:

Eighty-two percent think the bill will result in rationing of health care or that it might (it won’t).

Really? Well, what would a reasonable person expect to happen if (a) 32 million newly insured people try to double their consumption of health care, (b) 70 million or so additional people are moved into much more generous insurance than they have today, (c) most of the remaining 200 million people are promised preventive services without the deductibles and copays they face today and (d) almost nothing is done to increase the supply of providers?

Do you think health services are going to magically emerge from thin air? Or is it more reasonable to anticipate significant rationing?

Granted, Secretary Sebelius (apparently panicked by the looming problem) is trying to pull money out of various buckets to add to physician supply. But she will still have to deal with the same Congress that zeroed out all new money for medical education in the reform bill passed last March. At the government’s Web site (designed to sell ObamaCare to a skeptical public) you can find the claim that 16,000 new doctors are being created. But this appears to mainly count students who are already in medical school and will be needed to replace retiring doctors.

Here are a few more questions on which the public perception appears to trump the Harris pollsters:

Will the Health Reform Act Cause:

Public’s

Answer:

Harris Polltakers’

Answer:

An
increase in the federal deficit?

Yes

No

Higher
income taxes for the middle class?

Yes

No

A cut in
Medicare benefits?

Yes

No

I believe I can honestly say that I don’t know a single soul who knows anything about health economics who thinks ObamaCare isn’t going to increase the deficit. (If there is someone, correct me in the comment section.) Granted, the CBO was forced to assume that future Congresses and future presidents will be willing to do what the current Congress and current president are unwilling to do: to approve huge cuts in Medicare spending. But even the CBO has tacitly acknowledged they don’t believe it will happen.

No higher taxes on the middle class? Is this some sort of lawyerly trick? Who does Harris think is going to pay the $500 billion plus new levies on drugs, health insurance, medical devices, tanning salons, etc. Maybe they are trying to weasel with the word “income” taxes — figuring that all those other taxes are “excise” taxes. Even so, excise taxes get passed on to consumers and they’re paid out of income. Moreover, the fine for not insuring (expected to bring in $4 billion per year) is an income tax and the government is now arguing in federal court that the individual mandate is itself an income tax.

No reduction in Medicare benefits? Again, is this another lawyerly weasel word (as the Annenberg (fact-check) Center suggested the other day)? How is it possible to reduce Medicare spending by more than half a trillion dollars and have no reduction in benefits? It isn’t. And no knowledgeable person thinks it is.

John C. Goodman, PhD, is president and CEO of the National Center for Policy Analysis. He is also the Kellye Wright Fellow in health care. The mission of the Wright Fellowship is to promote a more patient-centered, consumer-driven health care system. Dr. Goodman’s Health Policy Blog is considered among the top conservative health care blogs on the internet where pro-free enterprise, private sector solutions to health care problems are discussed by top health policy experts from all sides of the political spectrum.

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Vikram CExhaustedMDRobert KaminskyNateciphertext Recent comment authors
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Vikram C
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Vikram C

On surface nothing wrong with what people think. However this is very thoughtful topic. Unfortunately, appearance of thoughtfulness is a political liability unless it can be reduced to a single line. Economically speaking, there are two ways that growth will return. One through more private saving and secondly through alteration in consumption pattern. The bill with its medicare cuts and more coverage for younger one is correct alteration from economic perspective. There are other alterations as well such as free preventives. Now moving onto the intuitive point of more for all implies rationing and deficit. Let me take that separately.… Read more »

ExhaustedMD
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ExhaustedMD

So I will say the painfully blatant comment that will be either shouted down, rationalized, minimized, or just plain ignored: More and more of the patients in medicaid are not invested in responsible health care choices, but just looking for quick fix solutions to long term problems, and being indigent in the first place to be in this insurance program does not enable them to efficiently problem solve to improve their physical and social well beings and make true progress. And I can say this without hesitation and with complete validation having been treating them for most of my career.… Read more »

Nate
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Nate

” Note that there will still be the option to not accept new patients, or Medicaid, or Medicare,” Will there? When Medicare first passed it was codified in the law that doctors would be paid fairly. It took all of 5? years until that become an inconvenience and Congress changed the law and forced doctor to accept their fee schedule, now that they whipped out all other insurance for everyone over 65 it was a lot harder for doctors to walk away. When public failures insure 20% of the market it is easier to opt out and still have a… Read more »

Robert Kaminsky
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Healthcare is not a zero-sum game. Increases in one area of healthcare spending (ie, expanded coverage) do not have to be offset by decreases in other areas of healthcare spending. There are other areas of the federal budget that can be reduced to limit overall growth in the federal budget. Reductions in the defense budget and agricultural subsidies easily come to mind. Rationing healthcare is nothing nnew. Payers ration healthcare everyday through the medical and formulary policies the implement. Rationing healthcare through arbitrary cuts in reimbursement leads to unintended consequences. A better approach is to provide incentives for higher quality… Read more »

ciphertext
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ciphertext

Oh, the employer has the only duty to decide what coverages you and your family Needs.So, I don’t know about you, but even though my employer pays a much much smaller share and the fact that his bottom line is all that matters. — Gary Lampman I’m not sure I understand what you are wanting to say. The employer has no “duty” to supply healthcare to anyone. There are a great many persons who are employed via contract vehicle that do not receive healthcare coverage from the employer. I’m not speaking of Unionized labor, I’m speaking more of the Form… Read more »

Gary Lampman
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Gary Lampman

Oh, the employer has the only duty to decide what coverages you and your family Needs.So, I don’t know about you, but even though my employer pays a much much smaller share and the fact that his bottom line is all that matters. Is evidence enough that employers are not good advocates for employees. Also,the fact that Health Insurance is employer based and lacking accountability to its members. Also stengthens the argument that contracts between insurance and providers leave members as prey for the Market. Oh,I know it will come with a price but at least I will know the… Read more »

jd
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jd

Nate, I don’t mean to say that no one will quit and blame reform. Of course, what people say may not correspond to the statistics so I won’t put much stock in individual pronouncements. Note that there will still be the option to not accept new patients, or Medicaid, or Medicare, so any doc who is unhappy with getting new folks or Medicaid or Medicare can just opt out. Yes, volume may go down, but why would any doc quit outright when they could see their old patients more or less as before and stop seeing any patients in programs… Read more »

Nate
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Nate

“But the supply of health care practitioners will not decline due to HCR.” jd are you really going to claim not a single doctor will retire becuase of HCR? There went your argument, now you can try to reword it and claim not many will retire thus the decline will be small but then you just ceded John’s point. “usually through the form of an allowed amount of the good to be consumed, though it can also take the form of price controls meant to curb supply or demand.” There are currently millions of uninsured that pay full prince for… Read more »

ciphertext
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ciphertext

I believe I can honestly say that I don’t know a single soul who knows anything about health economics who thinks ObamaCare isn’t going to increase the deficit. — John C. Goodman According to a letter from the CBO to Senator Jeff Sessions: SourceThe passage of PPACA does both reduce the publicly held debt and increase the publicly held debt. Apparently, the provisions of PPACA that apply to the financial inflows and outflows of the H1 trust fund would act to reduce the federal deficit by (net) $132 billion over the 2010-2019 time period. However, provisions of PPACA as they… Read more »

propensity
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propensity
Ryan S.
Guest

There’s a lot going on here, that seems hard to answer one part, some observations though: 1. The history of congress cutting medicare has been documented, and shown that congress sticks with the cuts it promises. There is obviously the exception of the SGR, but that was not meant to save money anyways, and was flawed. If implemented it would drastically reduce income of doctors, versus the near zero reductions implemented by the PPACA. Here’s a summary of the CRS report that documents the history pretty thoroughly, http://www.cbpp.org/cms/index.cfm?fa=view&id=3022. 2. The issue of limited supply of doctors is a good one,… Read more »

Margalit Gur-Arie
Guest

Well, assuming the “haves” are currently over-treated in order to rack up more revenue, maybe with the addition of newly insured, there will be enough demand for proper treatment so there will be no need to over treat, and the same capacity can serve a larger number of users without harmful rationing.

Gary Lampman
Guest
Gary Lampman

Sick Care for the wealthy at the expense of Seniors and Middle Class.Why should a bunch of self serving Deadbeats decide what is best for the 30 million people. who’s opportunities out of reach! Furthermore a far greater burden on society has been festering for decades and the yahoo’s choose to keep digging our nation deeper into debt and denying Coverage to a population who can neither afford or are uninsurable. Oh how easy it is for some!

jd
Guest
jd

Inchoate said what I was going to say. To elaborate, adding millions won’t increase rationing, but it may change the form of rationing a bit. There are two ways to think about rationing: 1) as a deliberate government control on utilization of some good, usually through the form of an allowed amount of the good to be consumed, though it can also take the form of price controls meant to curb supply or demand. This is what most people think of, and nothing in the bill, certainly not the mere fact that more people will be insured (the only reasons… Read more »

inchoate but earnest
Guest
inchoate but earnest

since healthcare is already rationed, PPACA may change how it is rationed but not introduce rationing.
John G is a clever, enterprising ideologue with many an idea, and a manner less abrasive than Gingrich. Certainly has much more brainpower than most of what passes for conservative leadership in our benighted land. Unfortunately he is not above slumming in semantical ghettoes when it suits his purposes.