Friday, March 02, 2007

Healthcare, Polls, and Bad News

In “top Yahoo news stories” this past week, a Reuters' wire article announced a poll just found that health care is the "top domestic concern" of a majority of Americans (Iraq being the top overall concern). This article is an example of serious problems with public opinion produced through polls, and its representation in the news.

First of all, the trouble with this Yahoo/Reuters article is the same a lot of news suffers from: lack of context. We need to know the history of this issue to understand whether this is a new concern, which many readers will likely infer. If the issue's been around for a long time, then how would that be news? ‘Course it wouldn't be; it’d be "olds." And if we dig a little in the mainstream press and public opinion research, we find in fact that health care and Americans' interest in universal health care has been a big concern for a long time. A Harris poll in 2005 surveyed Americans on a range of health issues. It found that 75% of Americans "strongly favored" universal health care in the U.S. Interesting finding. However, the poll doesn't tell readers how Americans think it should be funded. Would Americans be willing to pay a bit higher income tax for this coverage? Questionable, given the popularity of tax breaks. Americans are notorious for having their cake and eating it too. A poll last year, for example, found that nearly 60% of Americans think the U.S.
tax system is unfair.

Going back further, what do you know? In October 2003, an ABC News/Washington Post poll “found that Americans prefer universal health care to the current health system by a margin of two to one. Even more revealing is the fact that Americans favor guaranteeing health insurance for all, ‘even if it means raising taxes.’” Indeed, some sources claim that Kaiser Foundation polls from 1992 to the present have shown majorities of Americans favoring universal health care for Americans or “health care guaranteed for all Americans,” but it’s not always clear what respondents understand by these terms.

Questions that ask what is a "top concern" among a variety of issues handpicked by pollsters can also be misleading. No one asks, "Do you want your government to address your top concern only or several of your concerns?" So, first of all, the questions in public opinion studies can be skewed and misrepresent public opinion in its deeper sense, a public agenda, which would, in turn, supposedly influence a legislative agenda--how representatives are supposed to serve their constituents or be thrown out.

Yet the way questions are asked and the way issues are presented in the news without giving a history of an issue and opinion about it, legislators are free to press on with pet issues that they may have put on the polling agenda in the first place (such as immigration, for instance). Nor do such questions about "opinion" often measure how well citizens understand opposing arguments on such issues. This is the problem with democracy by opinion polls. As the late Christopher Lasch pointed out, American democracy does not just need information; it also direly needs public debate and citizens capable of critically evaluating it.

Indeed, opinions that have not passed through the filter of public debate and information-gathering was not the vision of the father of modern public opinion polling, George Gallup. In his Public Opinion in Democracy(1939), Gallup argued “the people, having heard the debate on both sides of every issue, can express their will” in public opinion polls. The result would be the nation as “one great room.”

What we have today is more like a million different rooms, which hardly arrive at opinion through debate. Indeed, as I've shown, it's not always clear how opinion is formed and how strong it is on a personal political agenda. Is there another way? Stay tuned for Part II of the problems with public opinion.
(also published by Blogcritics Magazine)
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Steve said...

Very right, Jayson. Polls are misused all the time in this country.

If I may say something about universal health care, I remember that issue being discussed at my very first Iowa caucus way back in 1980. As I recall, the issue has always been out there, and the American public has generally supported it. Hillary got sidetracked when she took on the issue in the 1990's, primarily because she defined the matter as "universal health INSURANCE." The public didn't like that. Polls, of course, never quite picked up on that nuance at the time. Too bad - we'd all be better off with universal care.

Stronger Than Dirt Pete Moss said...

The previous commenter beat me to it in pointing out that there is a lot of fudge factor in the definition of "universal health care." I haven't heard any candidates express support for a "single payer" system -- including Obama, although I apologize if I'm wrong -- and the emphasis seems to be more on a Mitt Romney style mandated insurance system. I believe Romney compared health insurance to auto liability insurance -- as in, it's everybody's responsibility to get it for themselves. Any help they get from the government will be toward buying (some probably sub-substandard form of) insurance from the same wretched, greed-ridden carriers. I don't think a bunch of tax incentive carrots and legal sticks are going to please the electorate on this issue, but the politicians don't seem to be picking up the ball yet on true universal care.

Something related that doesn't get a lot of press -- but that I think is a big deal to a lot of USAians -- is the often dispiriting reality of being tied to a job so that you can get ever-dwindling health care coverage. I'm not necessarily saying I'm one of them, but I think a lot of people would be inclined to leave their current unpleasant gigs if they weren't going to be cast into a maelstrom of uninsurability, due to expensive premiums, denial of coverage for "pre-existing conditions," etc.

Anyway, I don't know about the polls, but my impression from talking to a lot of people is that health care is probably the overall top concern they have, Iraq notwithstanding. Iraq is like a huge evil noise that's impossible to ignore, but health care ... well, maybe I should speak for myself -- it is my number one concern.

Sorry for the disjointedness of this comment -- I just got back from a business trip and I'm a little punchy. Anyway, I was in Washington, D.C., this week, coincidentally in a hotel that is located next door to the Veterans Administration building, at a time when the poor health care of returning vets (and active duty personnel, at Walter Reed and elsewhere) is finally getting some of the press attention it deserves. Which is a whole 'nother topic entirely, but it does sort of tie together those two prime concerns, Iraq and health care.

Steve said...

Pete: If I knew I had health care, I would definitely leave my job, sell everything I own, and travel the country in a volkswagen combi van with about 8 ounces of pot, smoking all along the way until I ran out of dough. Could take a good long time, and it would be one hell of a fun ride. Maybe there's some way to get Canadian citizenship and do that there? Someone who might like to go along for the ride would be welcomed.

Anonymous said...

Perhaps the biggest reason this issue is on the political radar is that businesses and individuals are finding it harder and harder to pay for increasing health insurance premiums. When even the CEO of Ford Motor company is saying something needs to be done about rising health care costs, you can expect this issue will get public attention. Remember what's good for General Motors is what's good for the US. So, can we assume the converse is true? What's bad for GM is bad for the US....

At any rate, the share of health costs have been converging on a 50/50 share between the government (federal, state, and local) and businesses and individuals. And, sadly, Americans pay more but get less value for their health care dollars than any other nation in the world.

Something will be done about health care costs, but not just because of poll results, but because US businesses don't want to or can't afford to bear more of the burden, and neither can individuals.

Steve said...

That's absolutely right. In a fascist society, nothing happens until it's good for business, and we are undoubtedly fascist.