By Matthew Sheffield
The Hill, February 7, 2019
A new poll finds that about only one in 10 registered voters want the equivalent of Medicare for all if it means abolishing private health insurance plans.
In a Hill-HarrisX survey released Thursday, 13 percent of respondents said they would prefer a health care system that covers all citizens and doesn’t allow for private plans, an approach that is sometimes referred to as “single-payer.”
The most popular option, at 32 percent, consisted of a universal, government-operated system that also would allow people to buy private, supplemental insurance.
Twenty-six percent of respondents said they wanted a government insurance plan offered to all citizens, but one that doesn’t compel people with private plans to use it, a system sometimes called a “public option.”
A small minority of 15 percent of voters said they wanted the government to completely remove itself from paying for health care, while another 14 percent said they want to keep the existing health care system intact.
The Hill-HarrisX survey was conducted among a statistically representative sample of 1,001 registered voters from Feb. 1-2. It has a sampling margin of error of 3.1 percentage points.
The Hill-HarrisX Daily Poll
Which of the following comes closest to your view?
15% – The government should remove itself from paying for all health care
14% – The current healthcare system should be kept as is
26% – Any citizen should be able to sign up for Medicare/Medicaid regardless of age or income while those with private plans could keep their existing insurance
13% – Medicare/Medicaid should be expanded to cover all citizens regardless of age or income and private health plans should be abolished
32% – Medicare/Medicaid should be expanded to cover all citizens regardless of age or income but people should be able to purchase private supplemental plans
By Don McCanne, M.D.
This survey is important because it is being cited by others as proof that voters want to be able to keep their private insurance plans, and thus they believe that politicians are stretching too far when they support a single payer version of Medicare for all that would eliminate all private insurance.
Actually these results are not that straightforward. Those surveyed were given five choices, and that means that each choice would average 20 percent support. For any option to approach 100 percent support, almost everyone would have had to reject the other four choices. That would be highly unlikely in any poll in which the advantages and disadvantages of each option are not that clear.
Three of the choices included a base of Medicare/Medicaid. That alone can be confusing since many people are aware that Medicaid is a welfare program for low-income individuals and there would be some reluctance to choose a welfare program to apply to everyone as either an option for enrollment or as a mandated plan.
The Medicare/Medicaid option that allows people to sign up voluntarily or keep their existing private plan corresponds to the public option proposal being bantered about, although many might not make that association, nor even know what the ramifications of the public option would be. One-fourth selected this choice.
One of the other two Medicare/Medicaid options is a mandated program that includes everyone and would allow individuals to purchase additional private supplemental plans. That is not unlike our current program of allowing Medicare beneficiaries to purchase a supplemental Medigap plan. By implication, this seems to assume that the proposed Medicare/Medicaid program leaves people exposed to financial risk unless additional coverage is obtained. Thus it is perplexing that this was the most popular choice – with one-third selecting it. Why would people select a plan that would require the purchase of additional coverage to ensure adequate financial security?
The other Medicare/Medicaid mandated plan seems scary to some because it would abolish private health plans with which most of us are very familiar. This fear made this the least popular choice – at 13 percent – and thus led to the title of the article in The Hill. Only 13 percent want Medicare for All if it means the end of private insurance. The irony is that this is the choice that is closest to Single Payer Medicare for All in which everyone is guaranteed health care for life which is affordable – the least expensive model of comprehensive reform – and allows free choice of health care professionals and institutions. The need for private health insurance, with all of its inefficiencies, extra costs, and administrative excesses, is eliminated.
The other two unpopular choices were keeping the system as it is and removing the government from paying for health care. Apparently the public does understand that the system needs to be changed and that the government should be involved in the financing. Seventy-one percent chose one of three Medicare/Medicaid options – presumably a proxy for government involvement.
Although the politicians campaigned on Medicare for all, they are very busy backpedaling now by denying that they would abolish private insurance. Surely they understand that keeping private insurance as an option destroys most of the benefits of the single payer model – universality, equity, administrative efficiency, comprehensiveness, accessibility, and affordability. By keeping private insurers in place, collectively we pay more and get less. That’s not what we want, or at least it shouldn’t be.
Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.