Thursday, October 1, 2009

Pelosi's Public Option Propaganda

Speaker Pelosi took time from her busy schedule to upload a chart on her Flicker account showing massive public support for the public option.  She or one of her little flying monkeys sent an email to Mother Jones nominating this chart for "Chart of the Day."   Mother Jones blogger Kevin Drum was happy to oblige the Speaker's request writing:
Bottom line: the public really likes the idea of having a choice between either a private or a public health insurance plan.
Of course people would support a choice, problem is no one really believes Pelosi's plan will result in more choice and they clearly believe it will expand the deficit.

For the sake of argument though, let's take a look at the Speaker's chart, shall we?

click on chart to enlarge
From Madame Speaker's Newsroom:
MYTH: The American people don’t support including a public health insurance option in health insurance reform.

FACT:  Poll after poll has shown an overwhelming majority of Americans – including more than 7 in 10 doctors – believe a public health insurance option SHOULD be a component of health insurance reform.
First, the poll citing 7 in 10 doctors support a public option was a Robert Wood Johnson Foundation  survey that had some limitations.  Overall, though the poll shows only 9.2% of doctors support a public only insurance program, 62.9% supported a mixed public and private insurance program and 27.3% supported a private only insurance program.  We currently have a mixed public and private insurance program so basically the respondents supported the program we already have.  In the survey report the authors write:
The majority of physicians (62%) prefer private plans to Medicare in terms of adequacy of payments while only 9.2% preferred Medicare.
It's rather remarkable that exactly the same percentage of doctors who find the Medicare payments adequate is identical to the percentage of doctors who support a public only insurance option.   Unless the doctors who responded to this survey were suggesting they would be willing to accept inadequate payment for their services so  that the public option Pelosi proposes becomes law, it is quite misleading to say 7 in 10  support the public option.

Furthermore, the RWJF doctor poll sent out their early wave of surveys before any legislation was written.  An IBD poll showed two-thirds of doctors opposed the proposed government expanding plan.  More strikingly, of those polled a full 45% said they would consider quitting if the proposed plan were enacted.  I am guessing the 9.2% who found Medicare payments adequate might have a little something to do with that.

The remaining polls that survey public opinion suffer from a variety of sampling issues that cast severe doubt on the subsequent results.  For example, Ed Morrissey does a great analysis of the sampling problems in the NYT/CBS poll.  This is just one issue he lays out:
Let’s get to the sampling first.  The party split in the sample has Republicans at 22%, Democrats at 37%, and independents at 33%.  That would make sense — if Barack Obama had won the presidential election by 20 points last November.
The bottom line, however, as with all surveys how a question is asked can lead to significant differences in responses from  the sample population.  The Kaiser study Pelosi includes in her chart makes that point quite clearly:

Kaiser asked, "Would you favor or oppose creating a government-administered public health insurance option similar to Medicare to compete with private health insurance plans."  Of the 59% who favored a public insurance program to compete with private plans,  support declines significantly in the subsequent follow up questions.  As Kaiser notes:
Americans’ views on the topic remain malleable, as demonstrated by the results of argument testing embedded in the survey. When supporters are read arguments commonly heard in the debate, such as that the plan might give the government an unfair advantage over private companies, or that it might be the first step toward “single-payer, government-run health care,” overall support falls roughly 20 to 25 percentage points. Alternatively, arguments about how a public plan could increase choice or lower costs boost support to roughly seven in ten.
After a few months of hearing these arguments, public support for Democrats health care reform continues to decline. Rasmussen surveys only likely voters, the most recent poll shows a clear majority opposing the reform.  Ultimately it is the likely voter who will heavily influence the Blue Dogs who will likely pay the price for Pelosi's unpopular reform if it is passed.  Let's be clear, if Pelosi and the Blue Dogs were convinced of the support in the polls they cite, this would have been passed by now.  They clearly have the control of both the House and Senate and no reason to avoid passing a reform they believe to be wildly popular.  The post at Mother Jones makes the same point:
At a wonk level, a bill without a public option can be perfectly good.  But wonks aren't a large voting bloc, and among people who do vote, the public option is very popular.  So, um, why not pass it?
Go ahead Madame Speaker, pass it if you are sure this chart of the day truly reflects public support for your "public option."  Come 2010 Republicans will gladly accept your broom in surrender.
H/T: Memeorandum

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