This research study, prepared in part by Democratic pollster and Montana native Celinda Lake, says Americans very much want to change our health care system - but don't want a one-size-fits-all “government” program, such as national health insurance for all.
Its conclusions also have influenced the health care reform plans proposed by Sen. Max Baucus, D-Mont., who often uses language straight from its script, such as saying we need a “uniquely American solution” to reforming health care.
But supporters of national health insurance are denouncing the study as “junk science,” saying it goes against years of accepted polling data showing strong support among Americans for a national plan that covers everyone equally.
“We've had good polls going back to the late 1980s saying that two-thirds of Americans, across all walks of life, across all income categories, will support a ‘Medicare for all' system,” says Kip Sullivan, a health policy analyst in Minneapolis.
The conclusions of the Lake study “are not a relevant argument until you demonstrate that all of this other research is wrong,” Sullivan says.
The study is a product of the Herndon Alliance, a coalition formed in 2005 by groups that have been pushing for years to reform the U.S. health care system. It includes scores of unions, health organizations, consumer groups and universities.
Sherry Prowda, director of communications for the Herndon Alliance, says its founders were discouraged by the lack of progress on reforms and wanted to “change the debate and be more productive.”
They decided to embark on a “communications project” that would plumb the “values and beliefs” of Americans on health care, she says - and then craft reform proposals that spoke to those values.
A consulting firm hired by the alliance divided the public into eight values-related groups, giving them names such as the Health Justice Base (those apparently most supportive of reforms), the Proper Patriots, the Marginalized Middle-Agers, the Mobile Materialists or the “drifters.”
The Mobile Materialists, for example, are deemed to be 13 percent of the population and are said to be people who try to impress others with their possessions and looks.
The study concluded that the Health Justice Base is only about 15 percent of the population, and that health reforms must be crafted to appeal to enough of the other groups to form a majority support for reform.
Lake then did focus groups in California, Colorado, Ohio and Georgia and conducted national surveys to come to the conclusion that something called “guaranteed affordable choice,” or GAC, is the best sell for reform.
“Guaranteed affordable choice,” as defined by the study, looks very much like Baucus' proposal revealed Nov. 12: a mix of public and private insurance options, paid for by employers and individuals on a “sliding scale,” with people choosing the plan they want.
Lake's polling showed that 64 percent preferred GAC, while only 22 percent preferred a “single-payer” reform proposal. She also said that GAC held up well after those surveyed heard the likely attacks by opponents of reform.
Lake also advised against using terms like “universal coverage” or “Medicare for all,” saying it's better to use “quality, affordable health care” or “a choice of public and private plans.”
Prowda says using the preferred terms helps keep people open to reforms: “If people shut the door on you, you're never going to get them to move along. At least get them to leave the door open. Our concept is not to play to the lowest common denominator; it's to educate them and move them along.”
Sullivan, however, who examined the study on behalf of Physicians for a National Health Plan, says it assumes that Americans' values are programmed “like a computer chip in their brain,” and that they can't be persuaded by the facts.
He also says the questions about GAC and single-payer are clearly biased in favor of the former, so the result isn't valid.
The description of GAC just isn't accurate, Sullivan says, because it doesn't reveal that the proposal needs taxes to support it, has no real cost controls and doesn't really expand consumers' choices of medical care.
“The same people who are saying that single-payer is not politically feasible are the same people who were saying that in 1993,” when a push for a proposal similar to GAC failed, he says. “You're contributing to a self-fulfilling prophecy, and you need to own up to that.”
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