The New York Times
April 30, 2003
Health Care Limps Up Political Ladder
By Robin Toner
The health care crisis is returning to American politics – gradually, but inexorably, with a force that will most likely grow as rising costs and deepening cuts squeeze more and more voters.
Pollsters say the issue ranks high with Democratic primary voters, which means that every presidential candidate must address it.
Meanwhile, rising health costs, coupled with declining revenues, are forcing states to consider major cutbacks in Medicaid – the program that already covers millions of people who would otherwise be uninsured. State officials have not, so far, received the help they are pleading for from Washington.
There is an incongruity here, as Bob Blendon, a Harvard University expert on public opinion and health, put it: Candidates are proposing bold visions to expand coverage in the future, “and we don’t have enough money to pay for the present.”
Comment: Dr. Blendon’s comment is unfortunate. His polls (with KFF, NPR, WP and others) have been used to inform our political leaders that Americans do not want a government-run, taxpayer-funded system. His insistence on continuing with the pejorative phrasing of his question on social insurance has contributed to the belief that reform must be incremental and not comprehensive.
Now Dr. Blendon has adopted the rhetoric of those who are opposed to reform in stating that “we don’t have enough money to pay for the present.” Numerous studies have demonstrated that we are already spending more than enough to fund comprehensive health care for everyone, but we need to reform the system to make that a reality. 98% of Americans believe that the issue of affordability of health care must be addressed.
Dr. Blendon could improve his credibility by conducting polls that ask about views on universality, comprehensiveness and affordability of social insurance. Rather than asking exclusively about government and taxes, the poll should begin with a statement such as “Medicare and Social Security are programs of social insurance that are designed to include everyone and to be funded equitably.” Then asking questions about support for adopting social insurance for health care for everyone should provide more objective responses.
It is helpful to understand the impact of the prevailing political rhetoric, but it would be even more helpful if we understood precisely what Americans really do want in the way of affordable access to health care.