Democratic supporters of the public option, which include Joe Biden but also Amy Klobuchar and Kirsten Gillibrand, fear more than anything the wrath of the imaginary Voter Who Would Die For Their Private Insurer. A new poll from Morning Consult reveals that one particular aspect of this is flawed.
According to the poll, which asked which entities voters “trust” to “keep the costs of healthcare low,” respondents said they trust the federal government over private insurers to control healthcare costs, by 20 points. Just 18 percent of respondents had “a lot” or “some” trust in the pharmaceutical industry to reduce costs; that number is just 9 percent among seniors, which makes sense, since seniors need a lot more drugs but are not particularly well-protected from those costs by Medicare. Only 23 percent trusted private insurance to control costs.
It’s a bit of an odd question, since “controlling healthcare costs” isn’t the only or even the key question that voters should have about healthcare. The fact that voters trust the government over private insurance to lower costs doesn’t necessarily mean that voters prefer single-payer (though they do), or that they understand the complicated cost relationships in healthcare.
For example: 41 percent of respondents had a lot or some trust in providers and hospitals to lower costs, slightly less than the 43 percent who had trust in federal health agencies. But hospitals are a key reason why health prices are high: They charge just about whatever they like, and prices vary wildly between hospitals, in part because there is no federal agency making them charge a sensible price to private insurance—they charge what they can get away with. (Just one reason why making healthcare policy based on what polls well right now is dumb!)
The other key takeaway from the poll: Not any one institution, from the government to insurers to drug companies, got a majority of respondents saying they trust them to reduce costs. But why would they? Why would voters trust anyone to reduce healthcare costs, since that hasn’t happened, like, ever? Healthcare costs, and particularly the healthcare costs paid by patients, have risen and risen. The government hasn’t or won’t do anything to rein in costs, even though it has the authority to step in on drug prices. Health insurers and hospitals certainly haven’t.
Deductibles, in particular, have risen wildly, and paying those is especially difficult and dramatic for patients. A premium that gets taken out of your paycheck before you pay taxes is one thing; a bill for $1,500 when you go to the hospital because you haven’t paid anything towards your deductible yet, but you had the dumbass luck to injure yourself or because your appendix burst, is quite another.
A Los Angeles Times story from today highlights this: Many Americans with high deductibles believe they’d be better off on Medicaid. According to a poll the paper conducted with the Kaiser Family Foundation, while only 18 percent of workers with a low or no deductible report being frustrated with their health coverage, 40 percent of high-deductible workers are frustrated.
Voters are not healthcare policy experts. They can’t be expected to know exactly why their costs are spiraling out of control. But they’re sure as shit right about this: The federal government is the only thing—not private insurance—that could rein in their costs. The question is whether Democrats are brave enough to try.