As always, Nate Silver does an excellent job of processing the news, but his recent analysis of government health insurance polling neglects a crucial part of the question: willingness to pay. Why take pains to accurately portray a public policy if we don’t also frame it in terms of costs?
When asking about costs, it’s also enlightening to quantify them. Consider this awkward citation made by former Senator Tom Daschle in Critical:
A New York Times/CBS News poll conducted in February 2007 found that the majority of Americans wanted the federal government to guarantee health insurance to every citizen. Sixty percent of the respondents, including 62 percent of independents and 46 percent of Republicans, said they’d be willing to pay more in taxes to ensure that every American is covered.
Sounds compelling, and then you read the next sentence:
Half said they’d be willing to pay as much as $500 a year.
Huh? So, roughly speaking, the average person thinks it’s a good idea but does not want to pay more than a pittance, comparable to a couple additional months of FICA withholding, to make it happen? (And this for universal insurance.) Daschle of course realizes this tension but doesn’t readily address it. To me this is the mundane, selfish fundamental issue that underpins the vigor of the resistance to expanding coverage. Enough people are satisfied with their current coverage/situation and know that change will come with a cost. It is not principally an inadequacy in Obama’s “messaging” skills that can be usefully diagnosed over a laptop and a Starbucks Venti. It’s caveman politics.
Daschle does provide the useful warning that a bill’s complexity is directly proportional to the difficulty of passage. While moving towards single-payer could reduce prices, the presence of a public option in a bill creates a nightmarish legislative logjam.
Despite the emotional resonance of the coverage problem, the financing problem is more fundamental, otherwise coverage can’t be sustained. Begin to address the financing problem now, and try to expand coverage in another bill. Of course this is easier said than done as interests don’t want to risk being left out in the cold. If only there were another way for concentrated interests to meet each other half-way….
