Polls and Representative Democracy

In reading through the comments on newspaper sites in the district, I see a lot of remarks to the effect that Eric Massa isn't listening to his constituents at town hall meetings, that he's holding positions contrary to his constituents, and that he represents a small minority in the district.

The obvious counterargument to these commenters is that this a representative democracy, and that the last accurate poll taken in the district was in November, 2008, when Massa was elected. But let's forget that for a moment and find out what polls can tell us.

The latest Wall Street Journal/NBC News Poll says that 36% of Americans think Barack Obama's health plan is a good idea. However, once respondents are read a one-paragraph description of Obama's plan, 53% of them approve of it. Here's the paragraph:

The plan requires that health insurance companies cover people with pre-existing medical conditions. It also requires all but the smallest employers to provide health coverage for their employees, or pay a percentage of their payroll to help fund coverage for the uninsured. Families and individuals with lower- and middle-incomes would receive tax credits to help them afford insurance coverage. Some of the funding for this plan would come from raising taxes on wealthier Americans.

We've heard a lot of talk about socialism and death panels, and the reason is clear: once people hear the modest reforms that are actually contained in the healthcare bill, they think it's sensible. I don't know if 53% is the number in the 29th, but the notion that a vast majority of 29th residents oppose Obama's healthcare reform is simply ludicrous.


Is it unreasonable to use the slippery slope theory and be afraid that the new health plan will lead to some of the things feared some time in the future?

It depends on the feared thing, I think.

Euthanasia -- don't think so. End of life counseling is a win all around, because it can save money and lead to a more peaceful death. People without end-of-life directives automatically get full services, which can be painful and are certainly more expensive.

"Socialism" -- if this means government-sponsored healthcare, well we have some of that already (Medicare). Apparently there's at least one other country (Switzerland) that has mandated insurance for all and hasn't socialized the system.

Scarcity, waiting in lines, rationing, etc -- Go to an emergency room on a Sunday and you'll wait in line, guaranteed. Also, doctors spend a lot of time on phones with insurance companies, and there is no uniformity in testing, which means a lot of time is wasted and resources utilized unnecessarily in the current system. I think we'll just have different annoyances.

What else is feared?

How about not knowing the full cost of implementing such a plan and the impact on the federal deficit?

The CBO has studied the impact and the cost estimates vary depending on scenario. But it looks like ending Medicare Advantage and some increase in taxes on the top 1% will handle most of the cost.

One of the reasons Massa stated for voting against the bill is that it isn't deficit-neutral. So it's a legitimate concern.

On the other hand, unhealthy Americans are a concern, too, because sick people can't pay taxes. That seems to be lost in the conversation about deficits.

Obama just said, less than a minute ago, that it would cost thirty to forty billion per year. While we may not know the cost anymore than we will know the cost of gas or the war over the next ten years, we can be pretty sure that compared to the cost of continuing as we are today healthcare will cost considerably less, no matter who is paying for it. What's more results should improve. No need to remind anyone that we could have done this with the money wasted on the war in Iraq.

Everybody knows that the public plan would drive health insurers out of the market for basic care. That's why people who have insurance are are against it. They are afraid that their plan will be replaced with some sort of Medicare, which they know providers hate, and that once that is accomplished their insurance will degrade as the government attempts to cut costs.

We liberals are shocked to hear seemingly rational people call the President a liar. It's because those people see that he is clearly recommending the demise of the private insurers that stand between them and theirs and death and/or poverty. He claims that he is only recommending healthy competition, and that they can keep their current plan. Why should they trust this man?

As a retiree, I have good private insurance and Medicare, but my children and grandchildren don't, or won't if they move, change jobs, leave school, or start their own business. Universal health care should be our goal, and as Edwards and Clinton said in '07, '08, the public option, along with other cost savings could make that possible.

The problem is that to do it with complete honesty the President and would need to state the obvious -- that private insurers add no value to the system and should go the way of buggy whips.

I can imagine some incarnations of the public option where some insurance companies can live to compete with the Government. There will be room for a slightly better basket of coverage for a slightly higher price. Today, there's all kinds of "gap" coverage out there for seniors, and there's no reason a "gap coverage plus basic plan" couldn't exist.

With a robust public option, many of the current private insurers will go out of business, because their business model has too much overhead, and a new set will take their place.

But we're not going to get a robust public option, so there's no fear for the insurance companies.