Friday, March 31, 2017

Americans overwhelmingly say they're satisfied with their health care coverage

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.

4 comments:

Feryl said...

WRT overall civil functioning, there's some discussion of the Mormon way/demos right now on Isteve.

Why are Mormons the most Republican demo in America? Well...

- They respect and trust strong "local" institutions (primarily the LDS church). There's an upbeat reciprocal culture, not unlike what used to be common in pre-1960's heavily native born white areas. Much of modern America is afflicted with cynicism towards institutions and civic activity of all kinds, with the end result being an ungrateful mercenary attitude that weakens all organizations save for mega corporations (that have run wild for 4 decades) and Uncle Sam (we all pay taxes/fees and a huge underclass/phony AA "middle class" demands gibs). Is it a coincidence that when people lose interest in participating in smaller/localized institutions, we see a huge boost in impersonal, multi-ethnic, monolithic mega structures? One misconception about the dark days before civil rights is that at all times supposedly an arrogant "majority" population imposed tyranny on smaller and less powerful people. In fact, each community had it's own structure to deal with it's own affairs. The effectiveness varied due to the different skills/interests of each community, but the point is that Federal and even State governments were less compelled to run things/intervene in people's affairs when local institutions were strong. If blacks or Jews were not welcome in an area, well, go have your own towns/boards/companies/churches. Don't ask Uncle Sam to make others pay for you and solve every problem you have.

- There's still a great deal of emphasis on family formation, again not unlike pre-1960's America.

- Mormon's are almost entirely British and Nordic of ancestry, save for some recent attempts to convert 3rd Worlders. They're remarkably, well, pure of heart and intentions. The MSM article cops to the whiteness of Mormons, but as usual, with the exception of Micheal Barone, there's no knowledge or interest in the differing customs of white ethnic groups. The Dems have long relied upon the strategy of exploiting the paranoia and cynicism of those most alienated from Protestant American norms (immigrants, non-German Catholics, Jews, urban dwellers, etc.). It's created a Frankenstein monster who seeks out the most alien people possible. Thus, the Muslim worship. Sadly, the GOP's sunbelt worship and free market (aka corporate) idolatry managed to alienate founding stock Americans in New England, the Upper Midwest, and even Appalachia to some extent. Trump did a much better job of cracking these nuts than the last several clowns who ran for the GOP.

It should be noted that the Dems growing worship of loser blacks, parasite invaders, and terrorists has weakened their grip on "ethnic" whites to some extent, as we saw with Trump winning Staten Island. Italians may never entirely assimilate to Protestant norms, but they've assimilated enough that the Dems have lost interest in them. Not bitchy, dependent, or restive enough to be worth Leftist agitation.

Last but not least, so many problems do not exist in the absence of diversity. It's funny hearing alarmist stuff about Japan, when the reality is that economic problems are but a tiny shadow of the chaos and terror inflicted by shoving dozens of ethnic groups into the same territory. The generally mild tensions that exist among slightly different white ethnic groups in historically white countries should be the extent of the conflict that we deal with. Man were we asking for it by inviting in different races.

Joshua Sinistar said...

"Healthcare". A misleading statement right off. Not Modern Medicine or Western Medicine. Also, its not about quality. Nothing the media says ever is. Pills made in China or India. Doctors from the Third World Diploma Mills. Vaccines full of mercury and toxins. I wouldn't buy that from a Dollar Store.
"Affordable". Another lie. Affordable? Who? Whom? Not White people. White people don't get anything or much less. Dark skinned failures and detritus get it for nothing. Yeah, that's the whole game right there.

Audacious Epigone said...

Feryl,

The GSS has a sample of 492 Mormons who are either married or divorced--it splits 90% married, 10% divorced. That's impressive. In general, Mormons are as close as we get to 1950s America. They're not ethnically conscious, they're just conventional, traditional, and most of all, functional.

Japan's alleged problems are drastically overrated. A modest decline in the real standard of living for the younger cohorts is survivable. Being demographically swamped by tax eaters who outbreed them would not be. Assuming there are personality and behavioral traits that favor childrearing, the demographic problem will eventually fix itself.

Joshua,

I trust the 'hardware' (setting a bone) a lot more than the 'software' (take this pill for X) when it comes to the medical field.

Random Dude on the Internet said...

Sometimes I get a bill that will say that the real charge was $2000 but thanks to my health insurance I owe $50. Most people probably think, "Wow! My health insurance provider just saved me 97% of the costs!" Gives the impression that the $400 or so per month for insurance really pays off. My mother, who had skin cancer surgery in recent years, makes similar comments even though they don't make much and their premiums went up by about 50% this year thanks to Obamacare.