A Genuine Difference of Opinion on Healthcare

The Gallup organization has produced a poll of American opinion on healthcare insurance, the results of which are above:

PRINCETON, NJ — In a recent Gallup survey, 89% of Republicans, 64% of independents, and 61% of Americans overall say Americans themselves — rather than the government — have the primary responsibility for ensuring that they have health insurance. Six in 10 Democrats say the government should be primarily responsible.

My interpretation of this, rather than asserting that such and such is right and so and so is wrong, is that there is a genuine and profound difference of opinion among Americans on this subject. A solid majority of Americans (and an even higher proportion of Republicans) don’t believe that the government is primarily responsible. Note that on this question independents are fairly representative of Americans, generally.

Many Democrats, particularly progressive Democrats will ask “Don’t elections mean anything?” Indeed they do. The winner of the election gets the job and has the ability to set the agenda. However, the government is the government for all of the people, not merely the victors and I believe that good governance requires that attention be paid to the views of most Americans.

I have seen this same result in polls of the public option. When asked whether they believe that the public option should be available alongside private insurance a sizeable number of Americans say “Yes”. However, when asked if they want to abolish private insurance in favor of publicly provided insurance, they say “No”. Americans want a choice.

That presents what I think are the legitimate questions about the public option. If the public option operates under the same rules as private insurance does, among which are that payouts are strictly limited to premiums taken in, can it survive? If it doesn’t operate under the same rules, can private insurance survive?

Meanwhile, I think that Congressional Democrats would do well to consider whether, even if they’ve got the votes to impose something on Americans that Americans don’t want, should they? A tyranny of a narrow majority is bad enough. A tyranny of a minority that through a combination of gerrymandered districts, safe seats, and an unpopular Republican president happens to have a majority in the legislature is much worse.

I am not arguing here for a mechanical bipartisanship. Honestly, I don’t think that bipartisanship has anything to do with it. I am arguing for good governance and sometimes good governance means foregoing your preference in favor of the will of the people.

5 comments… add one
  • I find the phrasing “government responsibility” fascinating, because generally I’ve found that polls that imply government CONTROL are unpopular, but polls that imply government is making sure that people are COVERED by insurance show that that is popular.

    I’d also point out that even if most people BELIEVE that its their own responsibility to be insured, the fact of the matter is that, for a variety of reasons, many Americans simply CANNOT get coverage for a variety of reasons, and it is NOT their fault that this is the case.

  • for a variety of reasons, many Americans simply CANNOT get coverage for a variety of reasons, and it is NOT their fault that this is the case.

    Really? That’s an interesting assertion.

    When my husband and I were first married, we did not have health insurance. We did not have it because we were well below the poverty line for a family of three.

    One of the recurring discussions we had at the time was, “Should my husband quit college and get a better paying job so that we’d be covered and have a better lifestyle?”

    Over and over, we decided that the smart (albeit higher risk) course was for him to stay in school and earn his degree. So, were we “unable” to get health insurance?

    NO. We chose a course of action that made health insurance unaffordable. Voluntarily.

    The fact was that if he’d quit school, even though he had no skills, he could get a job loading trucks for $10 an hour (in 1979 that was quite a good living). I could have chosen to put my baby in day care and get a job, and in fact I moved in with my mother for his senior year, we sublet our apartment to decrease our expenses, and I worked graveyard shift.

    People say “can’t” a lot when in truth they mean “won’t”, or “my choices are unpalatable”. I moved to another state, never saw my husband, and worked at a crappy job I was overqualified for to pay the bills. Many folks can’t find employment in their chosen line of work but could easily get a job doing something less attractive to them. They often CHOOSE not to.

    If you’re truly poor, you qualify for Medicaid.

    If you’re not poor, you can afford SOME form of health insurance. To get it, you may need to change a few things but life is full of tradeoffs. Personally I’m sick and tired of people telling me they “need” for me to pay for a choice they have decided on their own isn’t worth giving anything up for.

    Otherwise, great post Dave. You’re spot on – we just don’t agree about whose responsibility a lot of this stuff is. And you managed to say that without being unfair to either side.

  • I’d also point out that even if most people BELIEVE that its their own responsibility to be insured, the fact of the matter is that, for a variety of reasons, many Americans simply CANNOT get coverage for a variety of reasons, and it is NOT their fault that this is the case.

    Yes, because for most of them insurance no longer is an option. Just as you cannot go out and buy auto insurance once you’ve had the accident you cannot get insurance once you become ill.

    You are confusing insurance with health care and subsidies. Work on the definitions there Alex.

  • Drew Link

    Cassandra –

    I, too, once didn’t have a pot to piss in. I made similar calculations and tradeoffs. That’s called freedom.

    Millions do the same.

    God speed that your calculations work out. Mine did.

    Soon, we may not be free to choose.

  • Observer Link

    Cassandra and Drew,

    I know several people, personally, who are unable to get any type of health insurance at all because they have chronic conditions. It’s not a question of having the money–they’ve been denied coverage, period. They make too much money for Medicaid. They have no option. Some of them have to pay hundreds of dollars each month for medicine or, simply put, they will die. They are lucky right now because they have jobs, but many of them struggle to make ends meet because they have diseases they contracted through no fault of their own.

    I’m glad that so far you’ve all been able to get coverage. But if the day ever comes that one of you gets cancer or some other disease, and your insuance companies exploit a loophole that allows them to use “recission” to refuse to cover you even though you’ve paid your premiums, or if you lose your jobs and then are involved in an accident you’re not responsbile for and end up owing hundreds of thousands to the hospital, suffice to say that it will be very difficult for me to feel sorry for you.

    “F– you, I’ve got mine” is not a sentiment any decent human being should have in civil society.

Leave a Comment