Gallup reports today that Americans' rating of US health care quality is at its lowest point since they started keeping records. That's true, but as usual it doesn't tell the real story:
Among Democrats, satisfaction with the quality of health care has been dead flat for 20 years. Among Republicans, satisfaction dropped a bit when Obamacare passed but rebounded quickly. Then it took a permanent dive in 2021. So the real story is not that sentiment about quality has steadily reached an all-time low. The real story is very specific:
Media fueled anti-vax conspiracy theories and anger over medical advice during the COVID pandemic caused Republican satisfaction with the quality of American health care to plummet 26 points in three years.
Whenever you hear someone talk about how trust in our institutions has collapsed, keep in mind that in most cases this is solely Republican trust. And it's almost entirely driven by Fox News and the rest of the right-wing media ecosystem. They are bent on undermining the country, and it's working.
As for the general state of the health care system, it hasn't budged in 30 years:
We mostly think the health care system has some serious problems but isn't in crisis. Gallup says that partisan views on this measure are "nearly identical."
Lifelong Democrat and leftie here: Health care has never been good but the big providers and insurance have had a field day with Covid. Services are down, costs are up, and the workers "in the field" are being squeezed more than ever. Coincidentally, executive compensation is stratospheric and rising. Even pro-vax, pro-science people can connect those simple dots.
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Well, D's on that chart were more negative on healthcare (about 50-50) which just about reveals that it's not a system doing well if it's upsetting half of them.
Also rural hospitals shutting down because they aren't "profitable". My god we've got to get profits out of the equation here.
Health care itself, I'm sad to say from personal experience, is excellent. It's getting to it and dealing with insurance that's awful.
I have what I think is decent employer paid health benefits with UHC as insurance. I had an injury last year which required ER and some PT. Before that I had no medical issues at all. It went ok with UHC. Most people are like me. We don’t have big expenses. They make money on me.
No, they don't, because you're not paying anything.
Not sure what you mean but of course I hit my deductible and had additional costs in 2023 and 2024. And my employer pays to the insurance company and I do as well. It’s manageable for upper middle class folks like me.
That's just not how that math works.
Check your pay stub. If you have employer-provided insurance, yes, you pay a chunk and your employer pays a chunk and that's how the insurance company makes money, provided you aren't some freak of actuarial nature that ends up with a condition that costs hundreds of thousands of dollars a year to treat or something.
Insurance is arbitrage -- collecting payments from healthy people (or employer plans) who won't cost a lot so you can cover the few who do. In between you try to control costs by negotiating physician and hospital reimbursements.
‘Arbitrage’ implies that the costs of alternatives are known in advance; not the case with insurance, which is properly described as risk pooling.
any increase in health care costs not passed through to workers via higher premiums or out-of-pocket expenses is coming out of workers’ wages or other compensation
The Hell he isn't paying. His employer paying health insurance is part of his pay package. One of the largest problems we've had with health insurance is that the costs have been hidden by the employer paying them. Costs go up, the employer pays them and the employee doesn't get a raise because it went to pay for higher health care costs.
The employer pays healthcare costs for their employees. That's part of their labor costs. Employees forego additional pay for healthcare.
And all this incentivizes the employer to seek cheaper medical insurance every year. Cheaper, as in poorer service, fewer doctors and facilities "in network", higher copays and deductibles. The proverbial race to the bottom, or maybe the spiral into the old crapper.
A smart employer would be lobbying for universal, GOVERNMENT-funded medical care. CARE, as opposed to "insurance." But, contrary to conventional wisdom, people who run businesses are not the epitome of intelligence or forward-thinking. If the evil gummint provided socialized medicine, their taxes would go up, and that's all that matters. It's irrelevant that a vast swath of paperwork and negotiation would go away, or that paying premiums for each individual employee and their families would leave the company's ledger.
The potential "higher taxes" trumps (heh! see what I did?) everything. It's like religious faith.
That's what I have always thought. Why aren't employers lobbying for Medicare-for-All? I would think they'd much rather be paying a tax (almost assuredly less than what they're paying now), instead of the insurance costs they're paying, particularly those large employers who are self-insured. And they'd have cost-certainty, which they certainly don't now.
Except that Salamander is describing a National-Health-like system, in which providers are government employees, not Medicare-for-All, which is tax-funded insurance. In actual practice, most OECD universal health-care systems are universal-insurance/private-provider; the UK is atypical. Costs appear similar for either approach.
"Whenever you hear someone talk about how trust in our institutions has collapsed, keep in mind that in most cases this is solely Republican trust. And it's almost entirely driven by Fox News and the rest of the right-wing media ecosystem. They are bent on undermining the country, and it's working."
And with this, we start to at least come close to a satisfying explanation for the real mystery of the recent election--which is not how the Democrats could have lost (we have more reasonable explanations for an incumbent party's narrow loss than we know what to do with) but, rather, how someone like Donald Trump, and a party so clearly in thrall to someone like Donald Trump, could have won, after having demonstrated to the whole world who & what he was, in his first term.
Would be interesting to see these by insurance classification: Medicare, employer sponsored private insurance, self paid private insurance, Medicaid, uninsured.....
Healthcare in the US is a brutal experience, but it isn't the same for each group....
I have always had excellent insurance and personally have no problems with the industry aside from their profit motive. I also understand why many have problems with insurance and hate the industry. However there is a huge problem with the quality of the care provided and it seems to have degraded substantially since COVID. It is difficult to find a provider that cares AND has the ability to be an even adequate diagnostician. They don't listen, care is rarely individualized, profit is too often paramount. Making money off someone's misery is reprehensible no matter who is doing it.
My advice, FWIF, is avoid male doctors if you can. They don't do much, if any active listening, particularly the older ones. Try to get a female physician instead. They practice a lot more active listening, particularly the older ones.
It's beyond me how Gallup, and Kevin parrroting that, can call the views nonpartisan. Democrat views bounce around with, of course, a dip for Covid when, we have learned, the entire world became more cynical about institutions quite generally (surely a cause of Harris's loss hard to blame on her).
But Republicans? Naturally they fall in line with Trump and Fox. The system held steady for a while, although the time scale here is none too deep. That extended even into Obama's first time, when if you're not careful you might think Bush tanked the economy. But the outrage at the black man's second term grew, only to turn right around for Trump's presidency, which could do no wrong, and again for Biden's, when we all know the country was a hell-hole on every measure.
I was responding really only to the first chart and Kevin's conclusion, but seems to me he's really loaded the dice with his second poll result. You don't think asking people to speak of a crisis might ask them a little too much? What would it take, the quality of health-care delivery in West Africa? Is a steady 70 percent speaking of a crisis or "major problems" not enough?
Apparently not to those deciding that Obamacare was way too radical, especially when it expanded Medicaid (for those people) and planned a government option. While single payer is way, way out of the question.
But seriously, does Kevin have to be such a contrarian (and such a centrist) that the outpouring on social media this week wasn't just appalling on the one hand and a serious symptom on the other (both of which I believe), but nonexistent or a joke?
There's broad consensus across political lines that our health care system, from the pharmaceutical industry to our overpriced, patchwork insurance system is broken in terms of access and affordability. Democrats' response is to say "screw these bastards" and use market regulation and insurance reform to make access more equitable and affordable. Republicans' response is to say "screw these bastards" and advocate just taking invermectin and raw milk for that tumor. I don't know how you're going to get anywhere when one side is looking for policy solutions and the otherside is sitting there in a tinfoil hat trying to snake a UV light up their nose.
What exactly is the Democratic Party's plan on healthcare?
People remember Obamacare, and they remember that prices climbed ever higher since.
Factually incorrect. The rapid rise in health care costs of the 'aughts has moderated significantly in the years since Obamacare was implemented. You might argue that there's not a cause and effect, but you can't say prices have increased faster. That's false.
Looking at FRED, I don't see a slowing of healthcare pricing in any category beginning circa 2012.
In 2023, employment-based plans covered 55% of the population
in contrast, ACA Marketplace covers around 7.5% of the population
so...
This is a lot like the Q about the state of the economy vs one's own finances. When asked about how ppl feel about their health insurance, at the top end people on Medicare rate their experience highest, ~ 91% positive, and at the low end, marketplace users rate it, unsurprisingly, ~72% positive.
I'm a little confused.
Kevin routinely bombards us with statistics about life expectancy in the US and how it's problematic in various forms (going down, below the value in Europe, whatever), likewise for horror stories about medical care bankruptcies and suchlike.
Seems like a LOW opinion of US healthcare.
And yet the moment it's Republicans who are saying this, he switches to insisting that it's a fantastic system, and that anyone who criticizes it must be deluded.
Uh, have you visited BlueSky recently? Half of them there have just declared Jihad on the US Health System!
One could easily make up a story that this is about Republicans as high information voters realizing just how problematic the situation is (so much extra money spent to get worse outcomes) while it is Democrats who are clueless about the true state of the system.
Antivax sentiment was primarily coded as left in the US. It's substantially more prevalent in Europe than the US eg
https://www.politico.eu/article/poll-48-percent-of-europeans-believe-false-claims-on-vaccines/
What has changed in the US (slowly then rapidly) was people noticing problems with the health establishment, and in particular its politicization. This began with nutrition. Keynes, McGovern, the constant flip flopping on nutrition advice that eventually became a joke it was so well-known.
Then it grew into a widespead (if not universal) understanding of the corruption of the AMA and its subbranches (eg the cap on number of residencies, or the current exposure of massive corruption in anesthesiologist billing).
Then the flip flopping around masks and other covid precautions. The point is not that "we did not know", it's that when you don't know, you say as much, you don't pretend that you do know.
Then the insistence that, sure preventing crowds was important, but protesting (for the RIGHT THINGS, not just any protest) was more important.
Then the going along with trans hysteria (culminating in the infamous "the report may be true but shouldn't be published because that would make us look bad") incident.
Now were these the fault of the "medical system"? Some were, definitely. Others are the fault of politicized medicine. But that's what happens when you politicize a field, you open yourself up to a whole new set of attacks and reasons to hate you...
If the medical establishment is eager to tell you that, sure, your kid should have puberty blockers and gender transition (even though the fact that the incidence of this has doubled over the past five years from an already crazy high base compared to historically) why exactly are you going to trust their claims about other things they want to inject into the kid?
There's a LOT going on here in these graphs. Simplifying it to score party points is giving yourself a deliberate lobotomy.
Your narrative doesn't accurately reflect the levels, rates of change or timing of the changes shown in the chart.
Nice try, well...not really.
"And it's almost entirely driven by Fox News and the rest of the right-wing media ecosystem. They are bent on undermining the country, and it's working."
Funny, think about why they are doing this. They do it to help the rightwing/MAGA brand. By making it look like the country has massive corruption due to barely hidden terrible behavior by Democrats, this makes right-wingers look like the saviors of the nation. Fox News and similar media use mega distortions and lies as a form of dishonest populism to gain political influence. Overall, this means that rightwing/MAGA is selling out their country to gain power. It's pathetic. These super-patriots aren’t so super and aren’t even good patriots.
Also, Fox News makes gobs of money by biasing news and commentary, while claiming to be fair, balanced, and objective.
It’s more focused than that, and it’s been going on much longer than MAGA. It’s not about undermining ‘the country’, it’s aimed at undermining any countervailing authority to business interests. Weakening private-sector trade unions was an early victory; government regulation has been a target since Reagan; it has moved on to denouncing scientific and medical authority, and the academy in general. The objective is unchallenged dominance of business interests, so, yes, about power, but power for a specific group. Republican politicians are just the pawns.
Got it in one. If you go with Spengler, we're about due for a period of Caesarism. They tend to last a long time, at least, as humans reckon time.
Having worked at a major corporation for over 40 years, I can't say I ever saw executives seeking to influence government with some broader political agenda. Anything asked of politicians was for narrow issues having to do with the company’s immediate business interests, such as being able to hire more foreigners on H-1B visas.
Most company that get involved more broadly in politics promote lefty causes. Hundreds of corporations proclaimed their support for BlackLivesMatter. Dozens publicly opposed the Supreme Court’s Dobbs decision, which overturned Roe v. Wade. Coca Cola and Delta prominently criticized Georgia’s restrictive voting laws. Disney took a stand against Florida’s “Don’t Say Gay” law.
Personally, I don’t think corporations have any business getting involved in social issues or divisive politics. They are imposing the views of a few at the top of the company on their employees and shareholders. Corporations should mostly stay out of politics.
Some billionaire business owners can of course be different, as they can spend millions to promote their personal political values. But I think most major corporations are rather non-political in regards to promoting some broad agenda, such as pushing anti-union legislation.
BTW, I don’t see Trump’s political power coming from corporations. It’s his huge base of white working-class voters who tend to dislike and not trust people in power, including those running corporations.
It is true that corporate executives have generally been supportive of human-rights issues; those are in ways in the best interest of corporations.
I didn’t actually say that corporations in general are behind the campaign to sow mistrust of government and expertise. In fact, it seems to be a personal obsession of some retired executives (e.g. Bernie Marcus of Home Depot), descendants of founders (the Koch’s, Uihleins, Timothy Mellon, et. al.), and tech bros who hit it big in the dot-com boom (Elon Musk, Marc Andreesen, Peter Thiel). Executives of certain industries have had particular areas in which they sought to discredit regulators and authorities: tobacco executives against health authorities; fossil-fuel executives against EPA and NOAA scientists.
ETA: https://www.yahoo.com/news/musk-spent-least-quarter-billion-040534626.html
Kind of swamps those $25 contributors
Gee, whatever happened to Richard Nixons Health Care plan - or maybe Mass Care (formerly known as Romney Care - which is still wildly popular)
I like the Japanese HC system. It sounds very well thought out.