Given the amount of attention it receives, costs it imposes, and passion it engenders, I'm surprised by this Reuters-Ipsos polling result. In a sample of 5,199 Americans, (admittedly vague) responses to the question "How satisfied are you with your health coverage?" breakdown thus:
Only 1-in-8 express some degree of dissatisfaction.
The demographic differences are modest. Men are more satisfied than women, black are more satisfied than members of other races, the young and the old are more satisfied than the middle-aged, the wealthy are more satisfied than the poor, and Democrats are more satisfied than Republicans and independents, but just about whatever way it's sliced up, 85% responding either "very satisfied" or "somewhat satisfied" is the satisfaction floor.
Repealing Obamacare was one of Trump's oft-repeated campaign pledges, but it wasn't unique to him--most of the Republican field advocated the same thing. I'd have expected that to show up here, but perceptions among Trump voters are only marginally distinguishable from those of Clinton voters:
Compared to questions about trust in various institutions or approval ratings of political figures, this suggests an astounding level of public contentment.
Is the frustration over costs? Access? Is it mostly ideological in nature?
It's something I'd like to better understand. Prior to having kids, I never saw the inside of a doctor's office, visiting just twice in probably 15 years, both times for fractured ribs. My firsthand experience is limited. Nowhere do I have better access to based, candid, and insightful opinions than here so I'll throw out my general perceptions, none of which are firmly held:
- The contemporary zeitgeist contains two overriding objectives with regards to health care in the US--that it be affordable for everyone and that everyone have access to the best health care available. Realizing both of these simultaneously is impossible, of course. Moving towards one inevitably pushes us away from the other.
- Requiring insurance be provided to everyone who applies for it without allowing rates to adjust according to risk profiles guarantees that the system will not be viable without coercion to force those who would otherwise elect not to purchase insurance to purchase it.
With Obamacare, this manifests itself most spectacularly by restricting premium rates to narrow ranges based on general demographics like age so that insurance providers have to provide insurance to those with pre-existing conditions even though it is obvious that these people are going to cost providers much more than they pay in premiums.
If providers of home owner insurance had to provide the guy dumping gasoline all over his roof as his wife set up a fireworks display on the driveway with coverage for the same price they charged everyone else even if he waited until after his house caught on fire to purchase the insurance, no one else would purchase home owner insurance until their houses got on fire, either. Given these priors, the only solution is to force everyone to buy home owner insurance whether they want it or not
- The mechanism for determining perceived value in consumer goods and services, namely price, is so obfuscated when it comes to health care that it might as well not exist. Neither those providing health care nor those receiving it have a clue how much it costs to provide or how much those receiving it are being charged.
I've had plans where, in addition to a co-pay, I would be billed 10% or 20% of the total and my insurance would cover the remaining 90% or 80%. Since I wouldn't know the total beforehand, this pricing structure would've had no influence on my purchasing behavior.
My current employer charges a flat rate depending on what type of medical provider I use ($200 for an ER visit, $25 for a pediatrician, etc). That's an improvement. I now know what my cost will be and am able to act having at least taken it into consideration.
- Single-payer is a bad deal for younger whites with their stuff together. Government health care expenditures result in the large scale transfer of resources from the young to the old and from those with family-supporting incomes to those without them. It's a double-whammy.
Additionally, the socialization of costs means that access becomes the rationing factor--after all, something has to be and in single-payer access is the only option since cost isn't one. That, or the decision of an oversight board of some kind. Horror stories of excruciatingly long wait times are legion from countries with single-payer systems. Lots of similar experiences come out of the VA. One thing young whites trying to build a family do not have a surfeit of is time.
- The more insurance covers, the more often it will be used unnecessarily. If automobile insurance covered tire rotations, car washes, and paint detailing, people would take their cars in on a whim. What would keep everyone from washing his car every single day? As noted above, time. Car wash lines would be long all the time, everywhere.