Health and the Body Politic

There is an interesting and, in my opinion, well done poll out from the Kaiser group on current perceptions about the Health Care Reform law.  The big headline has been that only 52% of respondents knew that the law was still "the law of the land", while 22% said that the law had already been repealed for good and the other 24% were unsure about the answer.

Its very tempting to write off that 48% as ignorant of the facts, but I think in fairness we must admit that there is a potential source of confusion: the current court challenges which have ruled against the law.  While its true that more cases have been decided in favor of the law than against it, the fact is that in at least 2 cases the law has been "struck down" by judges.  Even though these cases are not final and implementation of the law has not been stopped, I could see where some respondents could legitimately be confused about the status of the law, especially given the overwhelming news coverage of the successful challenges compared to the meager coverage of the unsuccessful challenges.  If I had to guess, I would say that few of these respondents are confused about the issue as a result of the legal challenges, but we must allow the for that possibility. 

There are some other interesting, though not necessarily new or surprising, findings in the study.  A majority want the law either upheld or expanded, and almost all the provisions of the law, with the exception of the individual mandate, are popular across all groups, even among those who want the law repealed.

What was new and interesting to me in this poll was a question about whether or not the respondent had been personally helped or hurt by the law.  In both cases the percentage saying the law had affected them was small.  A mere 14% of respondents said the law had effected them in a positive way, while 17% reported negative effects.  This seems about right, given that so few of the major provisions of the law have been implemented.  What was interesting, however, was the reasons people gave for saying the law had negatively effected them or their families.  There is both a statistical breakdown and open ended answers provided, and after looking at them my conclusion is that most who reported in the negative are either unaware of the provisions of the law or merely answered in the negative because they don't like the law in general, not because it has actually affected them.  Some examples from the negative column, with off the cuff analysis:

1a) “My health insurance doubled since the health care law, and I pay for my own because I run my own business.”
1b) “My personal health insurance went up, and I am sure it will continue. I am afraid it is going to break the country economically.”
1c) “My mother had to pay more money for medication.” 

This was by far the biggest complaint.  Among the 17% who reported personally feeling negative effects from the law, 48% complained of rising costs.  To me, this seems like a basic case of post hoc, ergo prompter hoc.  The law was passed, costs went up, therefore the law caused costs to go up.  Given that most of the law hasn't yet been implemented I have trouble believing that any costs increases in the last year are soley, or even mostly, a result of the law.  In fact, health care costs were already rising far faster than inflation before the law, and I see no reason to believe that this pattern didn't hold true for the last year.  Indeed, if we could jump in a time machine and stop the law from being passed, I wager that there would still have been large cost increases over the past year.


2)“Financially the middle class will not be able to afford the insurance.” 

I find this odd for 2 reasons.  First, the law provides fairly generous subsidies for middle income families who need to purchase open market insurance.  And second, this sounds like a theoretical response, not one which points out how they personally have been negatively effected.  Perhaps they personally have seen their costs rise, in which case refer to example 1.  But otherwise this response is out of place.

3)“It is going to cost the taxpayers more money. It was passed…and people didn’t get a chance to read it.” 

Again, unrelated to personal negative effects already felt from the law.  This is teabagger whining.

4) “Because of our income, we are being strangled with paying for everyone else. Middle America will not exist under these conditions."

More pissing and moaning from teabaggers.  I wonder if these people understand the concept of insurance, or the fact that everyone already pays for those who can't afford, don't qualify, or simply chose not to purchase insurance.  The emergency room ain't free, its a hidden cost we all pay for.  And again, this doesn't show how the law has personally affected you, since the tax provisions in the law have not yet been implemented.


5) “I don’t like someone telling me I have to do this.”

Again, wingnut whining which is unrelated to the question at hand.  Whatever your opinion on the Individual Mandate, it hasn't yet been activated.  Therefore, it can't have effected you yet.


6) “Whenever the government controls anything, people get affected negatively. Government should stay out of it and not have control over it.”

Rinse and repeat.  This doesn't show how you have been negatively affected.  This is just short sighted political ranting.

However, this is all relatively minor stuff.  Overall, the results of this poll give me... hope?  I guess we will see.  If nothing else, I applaud the researchers for delving into some interesting questions.