who's afraid of public insurance?
full article at national journal
the writer discusses several recent surveys and polls showing high support for a public option - check out the consumer assessment of healthcare providers and systems survey he mentions.
cahps is an initiative of the department of health and human services that developed a standardized survey questionnaire used by virtually all health insurance plans -- public and private -- to assess patient satisfaction. most private insurers use the cahps questionnaire and disclose the data to the national committee for quality assurance in order to receive their accreditation. so thanks to cahps, we have a massive collection of data comparisons of how patients experience and rate medicare, medicaid and private insurance.
those comparisons show the depth of medicare's popularity. according to a national cahps survey conducted by the centers for medicare and medicaid services in 2007, 56 percent of enrollees in traditional fee-for-service medicare give their "health plan" a rating of 9 or 10 on a 0-10 scale. similarly, 60 percent of seniors enrolled in medicare managed care rated their plans a 9 or 10. but according to the cahps surveys compiled by hhs, only 40 percent of americans enrolled in private health insurance gave their plans a 9 or 10 rating.
more importantly, the higher scores for medicare are based on perceptions of better access to care. more than two thirds (70 percent) of traditional medicare enrollees say they "always" get access to needed care (appointments with specialists or other necessary tests and treatment), compared with 63 percent in medicare managed care plans and only 51 percent of those with private insurance.
he also suggests two reasons why people are so easily talked out of expanding the medicare experience:
first, younger americans not enrolled in medicare do not share the enthusiasm of seniors for the program. six years ago, the kaiser foundation asked a national sample of adults to rate the medicare program. medicare was hugely popular among those aged 65 or greater. eighty percent rated medicare favorably. similarly, more than half of seniors (62 percent) considered medicare "well run" compared to only 28 percent willing to say the same of "private health plans such as ppos and hmos that people get through their jobs."
those under 65, however, had very different views. only 45 percent rated medicare favorably. only 36 percent considered it well run, as compared to 47 percent who said the same about private health plans. while 73 percent of those over 65 said medicare allowed patients to choose any doctor, only 28 percent of those under 65 agreed.
second, the older americans who like medicare see little to gain from the public option since they like the coverage they have now. democratic pollster stanley greenberg finds "little support among seniors" for reform. a recent survey conducted by greenberg's democracy corps found a narrow plurality among all voters favoring "president obama's plan to change the health care system" (43 percent to 38 percent), but net opposition among seniors (34 percent to 50 percent).
so, the americans experienced with "government-run" health insurance like what they have and don't want to change it, and younger americans enthusiastic for change don't know what they're missing.