A few weeks ago, I invited blog readers to take part in a two-question poll about the Supreme Court decision concerning the health care reform law. I’m sharing the results here, along with a caveat: Our sample is not large enough for statistically significant conclusions.
A total of 159 people participated. Thank you!
Of that number, 125, or about 79 percent, were people who work in health care. Eleven people, or 6.9 percent, strongly approved of the Supreme Court’s decision and felt that the reform law accomplishes its goal.
Almost half (73 respondents, or 45.9 percent) approved the court’s decision and felt that the health care reform law was not perfect, but was better than what we’ve had. That’s a total of 84 people, or 52.8 percent of everyone who responded, who are supportive of the decision.
Forty-nine people, or 30.8 percent, strongly disagreed with the decision and are placing their hopes on the law being overturned after the elections, and 23 people, or 14.5 percent, were disappointed but ready to move on to try to make things work under the circumstances. That’s 72 people, or 45.3 percent of everyone who responded, who disagreed with the decision.
Three people, or 1.9 percent, were neutral about the ruling.
So in our little poll, there are slightly more who support the Supreme Court’s decision than those who oppose it. At the same time, there are more strong emotions against the decision – 30.8 percent strongly disagreed vs. only 6.9 percent who strongly approved of the decision.
Also interesting to me: At a time of bitter partisanship and elected leaders who seem to take positions merely for the sake of opposing the other party, rather than what would be in the best interests of the people they represent, almost half of the respondents took a middle-of-the-road viewpoint, realizing the health care law was not perfect, but that there were good elements that were better than what we had before.
Here’s where people came out by background. Twenty-five respondents identified themselves as patients. Of these, 56 percent approved of the decision, and 12 percent strongly approved. Twelve percent were disappointed but moving on, and 20 percent strongly disapproved, the lowest percentage among the groups that strongly objected to the decision and, along with students, one of the two highest-percentage groups to vote that they approved of the decision even though the law is not perfect.
Employees of a health care employer and employees of a non-health care employer had almost an identical distribution of responses, with 46 percent and 42 percent respectively approving the decision; 6 percent and 8 percent respectively strongly approving; 17 percent in each group disappointed, but moving on; and 31 percent and 33 percent respectively strongly disapproving of the decision.
The employees of non-health care employers and physicians were tied at 33 percent for strong disapproval of the decision. Forty-four percent of physicians approved of the decision and 22 percent strongly approved.
Many comments were submitted; following are some of them.
First, a comment that “health insurance coverage does not equal health care access.”
This is a point I have made often. Assuming the state decides to expand Medicaid, and given the physician shortage in Idaho, we have to find new models to care for the more than 80,000 newly covered Medicaid beneficiaries in the state. And that’s a conservative estimate; some predictions would put the expansion at almost double that number.
One poll participant observed that though something has to be done to address insurance reform, the law does not control costs, and there is concern about how much the law will aggravate health care costs. Another saw it as a point of departure. “You have to start somewhere. Worse is no action,” this participant said. Another commented, “We need to put politics aside and create a better system. The (Affordable Care Act) is far from perfect, yet it is an important start.”
Perhaps not surprisingly, there were several comments calling for a single payer system. One of our participants was from England and wrote, “(I) know health care needs to be fixed, but don’t think this is the way forward. … National health care does not work!” This may be a good topic for a future blog post.
Here is a very sobering comment:
“Part of my job is to work with women who have been diagnosed with breast cancer and have no health insurance. I see firsthand how St. Luke’s provides care for them regardless of their ability to pay.
For women without assets of any kind, this is a tremendous help. But for women that have assets, but didn’t protect them with insurance (for whatever reason), this is devastating as they will have to use most of those assets to pay for treatment costs.
St. Luke’s cannot cover the costs of care for everyone so those that have assets need to use them to cover their own care. The disconnect here is that people don’t think they will become ill and even if they do, they have no concept of what health care costs with a diagnosis like breast cancer.
By requiring people to have health insurance, the law is actually protecting them from disaster. It is true that many are very healthy and don’t feel that they would need insurance, and yet I see 33-year-old women who are very healthy who develop a very aggressive cancer and need a large amount of treatment. These are just the folks that don’t think they need insurance.
My observation as a nurse for more than 30 years is that the unexpected happens all the time.”
My objective, with the poll and with my blog, is not to tell you what the right or wrong answer is. I couldn’t even if I wanted to.
I do know that we aren’t going to get to good answers until we can have discussions based on facts and information, without polarized and inflexible bias. My objective is to help us all stay better informed, so that we can all think through these very complicated issues.
I have to conclude with a shameless, self-serving plug for my blog by recounting this comment:
“It was great when I was talking with my family at dinner the day of the ruling, that I could already share Dr. Pate’s thoughts. What a fantastic use of our leader’s precious time!”
Thank you again for taking part in the poll. I'll want your thoughts on another hot-button topic soon; more to come!
David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.