Survey Says What?

The problem with health-care polling

Peter Suderman | September 4, 2009

William Hazlitt once said that "nothing is more unjust or capricious than public opinion." When it comes to health-care, our nation's pundits and activists seem determined to prove Hazlitt right. Some days it seems like everyone has a poll on their side. Participants in the health-care debate have variously claimed that the public supports a public plan and that it doesn't; that comprehensive health-reform is overwhelmingly popular and that it isn't; that people have a dim view of insurance companies and are happy with their own insurance plans; that a majority of Americans favor a single-payer health-care system and that they also support deregulating insurance markets. 

Are pundits and pollsters to blame? Or is the public just crazy? The best answer is that it's a little of both. 

Part of the problem is that the public is fickle, and opinions change over time. Cherry picking from different months or years—as I did in the previous paragraph—makes finding useful opinions easy. But a larger concern is that many prominent polls are conducted and interpreted in ways that are sure to skew the results. 

The most garish examples are what are known as push-polls. These polls, typically conducted by interested parties, artificially inflate public support or disapproval with loaded questions. At their most blatant, these blundering attempts at manipulation come off as laughable. And in the health-care debate, Republicans have been the worst offenders. One RNC survey, for example, asked whether respondents were concerned about the possibility that the government might deny health-care to Republicans because of their political affiliation. Another GOP poll ominously questioned, "Do you think Democrats in Congress should pick your doctor?" (Even more embarrassing: The largest percentage of respondents said "yes.")

Other polls are not so explicitly designed to bias the results, but still push respondents toward a particular answer. One NBC/Wall Street Journal poll, for example, asked whether interviewees favored or opposed health-care reform, and described it with borderline flack-like language:

The plan requires that health insurance companies cover people with pre-existing medical conditions. It also requires all but the smallest employers to provide health coverage for their employees, or pay a percentage of their payroll to help fund coverage for the uninsured. Families and individuals with lower- and middle-incomes would receive tax credits to help them afford insurance coverage. Some of the funding for this plan would come from raising taxes on wealthier Americans.

It's not quite a push-poll, but the description comes right out of the reformers' playbook: Play up the potential benefits and say that only the rich will have to pay. The pollsters might as well have asked whether the respondents had warm feelings towards puppy dogs and ice cream.

Another problem is deciding which questions to reference—and what they actually mean. When public plan-advocate Robert Reich referred to a poll showing that "76 percent of respondents said it was important that Americans have a choice between a public and private health-insurance plan," he wasn't making things up. But that answer came when respondents were asked how "important" it was to "give people a choice of both a public plan administered by the federal government and a private plan for their health insurance." The key words are "important" and "choice." There's a big difference between asking people if they think having a choice is important and asking them if they actually prefer a plan. And as it turns out, when asked straightforwardly about support for a government plan, 47 percent said they opposed it. 

The key, then, is to ask better questions, and that means getting specific. Kristen Soltis, a pollster with the Republican-affiliated Winston group, says that "what you're actually looking for is a question that at least gives a little bit of context." The most revealing polls, she says, are those that questions "whether people agree or disagree with what a policy intends to do." So rather than ask whether people support health-care reform generally, or whether they like Obama's plan, effective poll questions seek to assess support for specific proposals—and tend to explain what the proposals are designed to do. 

Indeed, questions that have asked about "Obama's plan" are particularly egregious violators of the tenets of good polling: As of yet, no such thing as an "Obama plan" exists. So when CNN asked respondents whether or not they "favor or oppose Obama's plan to reform health care" and the NBC/Wall Street Journal polling team asked whether "Barack Obama's health care plan" is a good idea, they were asking respondents to voice an opinion on an imaginary concept. 

Comments

The Angry Optimist|9.4.09 @ 3:07PM|#

Slightly OT: In case you were wondering.

BakedPenguin|9.4.09 @ 3:10PM|#

Another GOP poll ominously questioned, "Do you think Democrats in Congress should pick your doctor?" (Even more embarrassing: The largest percentage of respondents said "yes."

That's creepy on many different levels.

Total Tool|9.4.09 @ 3:13PM|#

""The most garish examples are what are known as push-polls. These polls, typically conducted by interested parties, artificially inflate public support or disapproval with loaded questions. At their most blatant, these blundering attempts at manipulation come off as laughable. And in the health-care debate, Republicans have been the worst offenders."

Ever watch the Ed Show, Toolboy? Last week he did a push-poll that showed 95% of respondents want government run healthcare.

There are lies, damn lies, and Suderman columns"

STFU, Suderman.

Caption Contest|9.4.09 @ 3:24PM|#

And the number one answer to the question - what is Suderman's IQ?

56!

Joe M|9.4.09 @ 3:49PM|#

...Republicans have been the worst offenders

Where's John?

EJM|9.4.09 @ 3:50PM|#

Slightly OT: In case you were wondering.

The late Mr. Combs, however, could take him easily. (Sigh.)

Mike Laursen|9.4.09 @ 4:11PM|#

Must vent! A flood of liberal friends all posting the same message on facebook today: "No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day"

I hate this kind of passive liberal political argument. I mean, who is going to disagree with the above statement? The whole part about instituting a huge Federal program that nobody knows how to fund is merely implied.

Sean W. Malone|9.4.09 @ 4:13PM|#

I'd just like to say: Fuck you Frank!

Citizen Nothing|9.4.09 @ 4:14PM|#

No one should trip and fall on the ice and slide inexorably toward the open water that's gaping like the maw of hell itself and then, just when the slide is stopped by digging fingernails painfully into the ice, a polar bear appears and devours ...you. If you agree, please post this as your status for the rest of the day.

Sean W. Malone|9.4.09 @ 4:15PM|#

That facebook bullshit started yesterday, and I was annoyed by it then. OF course no one thinks that it's ok for people to die or go broke because they need some medical care - but magical thinking doesn't solve any problems! You can't just miraculously pull 300,000,000 people's worth of health care out of your ass just because you write a law mandating that everyone can get it.

|9.4.09 @ 4:29PM|#

I have been a physician for a long time. I can tell you that I have never seen anyone die for lack of funding. The hospitals and doctors always find a way to get the job done. As to going broke, sure, you get sick can not work and you don't have money. As to the hospitals and doctors bills, forget it, most people don't pay them anyway so its not a problem.

Remember, if you sense a problem with health care, it was created by the government. They have been very active since the 80's in trying to fix a preceived problem that really does not exist. They have increased the cost, caused over regulation, purged the system with under trained and ethically challenged foreign docs and so forth.

The Sudertool|9.4.09 @ 4:30PM|#

Online Journal E-Mail Center





September 4, 2009 -- 4:13 p.m.
See all of today's editorials and op-eds, video interviews and commentary on Opinion Journal.

FORMAT TODAY'S COLUMN FOR PRINTING


9/11 and 9/9
Will President Obama even mention Afghanistan when he addresses Congress next week?
By JAMES TARANTO

America is at war, and next week the president will address a joint session of Congress.

The president's speech comes at a time of both military and political adversity. August was the deadliest month for U.S. troops in the nearly eight-year Afghan conflict. Military leaders are expected to ask for more troops to combat a resurgent enemy, but the president's political advisers are divided over whether to grant the request. The president has been losing support for the war both within his own party and among the public. A prominent Democratic senator has flatly called for withdrawal, while one poll shows that 57% of Americans now oppose the war effort.

Podcast
James Taranto on the war and the president's address.

The timing of the president's speech is also symbolically important. Next week marks the eighth anniversary of the attack that provoked the war--a terrorist assault that killed some 3,000 people, mostly civilians, on American soil. There could hardly be a better time for the president to rally the public, to remind Americans why this is, as he has said, "a war of necessity . . . not only a war worth fighting," but one that "is fundamental to the defense of our people."

Will the president even mention Afghanistan in next week's address to Congress? The question alone exposes the topsy-turvy priorities of Barack Obama's Washington.

According to news reports, the primary purpose of the president's address to Congress is to make a sales pitch for his proposal that would vastly expand government involvement in the health-care industry--a proposal that has already sparked a nationwide popular revolt.

Because Obama insisted on launching a war that should have never been waged, and then doubling down on a failed strategy, the war in Afghanistan has been ignored. If Afghanistan burns while the president is fiddling with health insurance, he could be remembered for one of the greatest abdications of responsibility in the history of the American presidency.

The Terrible Tooth About ObamaCare
Sad news from Thousand Oaks, Calif.: Contrary to early reports, including the one we noted yesterday, William Rice, the ObamaCare opponent whose finger was bitten off at a MoveOn.org rally, did not have the appendage reattached. Rice tells Fox News Channel's Neil Cavuto that there was no point in sewing it back on. Because the MoveOn.org supporter's mouth was teeming with bacteria, doctors told him, "the chances of [the finger's] surviving reattachment were almost nil."

Rice did not lose his sense of humor in the attack, as evidenced by this exchange:

Cavuto: So what's weird about this, Bill, is a guy who was advocating for the president's health-care reform bit your freakin' finger off, and now you're down a finger. What are you going to do?
Rice: Yes, sir. I guess I'll have to take different piano lessons or something.
One might say Rice is lucky to have lost only a finger, when ObamaCare may end up costing all of us an arm and a leg.

But there is a serious point to be made here too. Democratic leaders in Congress--though not Obama himself--have resorted to increasingly extreme rhetoric aimed at demonizing dissenters. According to Senate Majority Leader Harry Reid, they are "evil-mongers." House Speaker Nancy Pelosi has described them as "carrying swastikas." She and Steny Hoyer, the House's No. 2 Democrat, have called them "un-American." Most recently, Rep. Charles Rangel, chairman of the powerful House Ways and Means Committee, has claimed ObamaCare critics are motivated by racism--a comment even New York's WCBS-TV describes as "incendiary."

All of these comments are fully protected by the First Amendment, but being legal doesn't make them right. When political leaders stigmatize dissenters as racist, un-American, swastika-carrying evil-mongers, can we be surprised if some deranged individuals turn to violence? Before opening their mouths again, Pelosi, Reid & Co. should step back, count to 10, and reflect on the plight of Bill Rice, who for the rest of his life will have to stop at 9.

Up With Business, Down With Big Business
John Carney of The Business Insider has an acute observation on the political failure of ObamaCare:

The Obama administration "expended great effort to line up the support of health-care insurers, pharmaceutical makers and care providers, believing that by keeping them around the table, they could win over Republicans and stop the kind of industry-led attacks that helped sink the Clinton plan," writes the Journal team.
It was supposed to be a simple formula. Win over the health care industry shepherd, and the Republican will follow like sheep. But it didn't work.
What seems to have gone wrong can be described as a failure of the imagination: Obama's administration just never believed Republicans would stand up for their limited government principles if that meant opposing business interests. They were apparently assuming that Republicans and conservatives could be won over by winning over "business interests," as if free market and anti-government positions were just rhetorical cover for policy making at the behest of business.
A useful distinction can be drawn here between business (commercial activity) and big business (large corporations or industries acting collectively to seek economic advantages from the political system). Those of us who adhere to free-market principles are pro-business, in that we think commerce is a good thing, but owe no allegiance to corporations or industries as such. If the president and his men are still confused, they could do worse than to read "Down With Big Business," a 1979 editorial written by the late Robert Bartley, editor of The Wall Street Journal.

Metaphor Alert
"There is a common ground. It's half a loaf, possibly, from the administration's viewpoint. But what it does is take us way down the field."--Sen. Bob Corker (R., Tenn.) on ObamaCare, quoted in the Washington Post, Sept. 4

Gesundheit!
"Rep. Anna Eshoo Jeered Over Health Care at Palo Alto Town Hall"--headline, San Jose Mercury News, Sept. 3

Two Wire Services in One!

• "THE FACTS: Republicans are correct that only a small percentage of the $48 billion in transportation money has been spent. But red tape is a red herring. In fact, stimulus projects have to be ready to begin quickly. Projects that have yet to clear permitting, environmental review or other bureaucratic hurdles won't get funded because they won't meet the law's deadlines."--"fact check," Associated Press, July 10

• "Biden, Obama's chief stimulus cheerleader, proudly pointed to more than 2,200 highway projects Thursday funded by the program, but didn't mention the growing frustration among contractors that infrastructure money is only trickling out and thus far hasn't delivered the needed boost in jobs."--"fact check," Associated Press, Sept. 3


You'd Think These Would Be the Last Guys They'd Want to Stimulate
"Sex Offenders Living Under Miami-Dade Bridge May Get Help From Federal Stimulus Cash"--headline, Palm Beach Post, Sept. 3

Reliable Sources
"Besieged by leaks of several closely held secrets, the CIA has asked the Justice Department to examine what it regards as the criminal disclosure of a secret program to kill foreign terrorist leaders abroad," the Washington Times reports:

Two U.S. intelligence officials, who spoke on the condition that they not be named because of the sensitivity of the case, said the leak investigation involved a program that CIA Director Leon E. Panetta told Congress about in June and that surfaced in news reports just a month later.
All the Justice Department has to do is persuade the Times to reveal the names of the intelligence officials "who spoke on the condition that they not be named because of the sensitivity of the case," and it'll have cracked the case!

CNN Calls a Christian a Muslim
"A Muslim teenager from Ohio says her father threatened to kill her because she converted to Christianity," CNN reports:

Rifqa Bary, 17, ran away from her family in Columbus, Ohio, in July and took refuge in the central Florida home of the Rev. Blake Lorenz with the Global Revolution Church in Orlando.
The teen heard of the pastor and his church through a prayer group on Facebook. The girl's parents reported her missing to Columbus police, who found her two weeks later in Florida through cell phone records.
The teenager, in a sworn affidavit, claims her father, Mohamed Bary, 47, was pressured by the mosque the family attends in Ohio to "deal with the situation." In the court filing, Rifqa Bary stated her father said, "If you have this Jesus in your heart, you are dead to me!" The teenager claims her father added, "I will kill you!"
Mohamed Bary told CNN a lot of false information has been given and "we wouldn't do her harm." He knew his daughter was involved with Christian organizations.
"I have no problem with her practicing any faith," he said, but Bary admitted he would have preferred his daughter to practice the Muslim faith first.
We have no idea which side to believe in this dispute. Violence against so-called apostates is not unheard of in Muslim communities, even in the West. But then, hysterical exaggeration is also not unheard of among critics of Islam, especially in the West.

It does seem to us, however, that at 17 Miss Bary is old enough to make up her own mind about her beliefs--which makes CNN's description of her as "a Muslim teenager" inaccurate and perhaps invidiously so. She is, in fact, a Christian teenager who was raised as a Muslim.

Life Imitates Monty Python

• Man: "What's this, then?" Mr. Brown: "A liver donor's card." Man: "Need we say more?" . . . Mr. Brown: "Listen! I can't give it to you now. It says, 'In the event of death.' Uh. Oh! Ah. Ah. Eh." Man: "No one who has ever had their liver taken out by us has survived."--dialogue from "The Meaning of Life," 1983

• "Cass Sunstein, President Barack Obama's nominee to head the Office of Information and Regulatory Affairs (OIRA), has advocated a policy under which the government would 'presume' someone has consented to having his or her organs removed for transplantation into someone else when they die unless that person has explicitly indicated that his or her organs should not be taken. Under such a policy, hospitals would harvest organs from people who never gave permission for this to be done."--CNSNews.com, Sept. 4

http://www.cnsnews.com/news/article/53534

But the Reblicans are so much worse, you know.

The Sudertool|9.4.09 @ 4:30PM|#

WTF???

The Sudertool|9.4.09 @ 4:31PM|#

Just meant to post this:

Life Imitates Monty Python

• Man: "What's this, then?" Mr. Brown: "A liver donor's card." Man: "Need we say more?" . . . Mr. Brown: "Listen! I can't give it to you now. It says, 'In the event of death.' Uh. Oh! Ah. Ah. Eh." Man: "No one who has ever had their liver taken out by us has survived."--dialogue from "The Meaning of Life," 1983

• "Cass Sunstein, President Barack Obama's nominee to head the Office of Information and Regulatory Affairs (OIRA), has advocated a policy under which the government would 'presume' someone has consented to having his or her organs removed for transplantation into someone else when they die unless that person has explicitly indicated that his or her organs should not be taken. Under such a policy, hospitals would harvest organs from people who never gave permission for this to be done."--CNSNews.com, Sept. 4

The Sudertool|9.4.09 @ 4:32PM|#

I regret the error.

|9.4.09 @ 5:06PM|#

I regret the error.

So do we.

Sean W. Malone|9.4.09 @ 5:40PM|#

Sunstein & Thaler wrote "Nudge", which Reason covered a year ago, but which I regrettably read & reviewed at my parent's request here.

My folks claimed that they were "libertarians", annoyingly omitting the word the authors chose to describe themselves: "Libertarian Paternalists".

Go figure.

The Angry Optimist|9.4.09 @ 6:21PM|#

Dude, "Sudertool", God damn you.

Seriously. Stop mucking up the threads.

Damn|9.5.09 @ 3:19AM|#

I just checked Facebook and scrolled through the old posts to see if anyone I knew posted that tripe. I was happy to see none of my friends were that stupid... Then I got to where my aunt posted that drivel. She's a teacher. I should have suspected as much.

Sean W. Malone|9.5.09 @ 4:22AM|#

Sadly... many of my friends posted that shit. Of course, many of my friends are musicians, filmmakers and college students.

Mike Laursen|9.5.09 @ 10:07AM|#

Of course, many of my friends are musicians, filmmakers and college students.

Sorry. I'm sure they're fun friends in lots of other ways.

I'm practicing keeping my mouth shut on this one, but the best response I've thought up is to post the same blurb on my status ... along with the address of a local medical-treatment-for-kids charity we have in our county.

|9.5.09 @ 8:19PM|#

Eat a bag of dicks. You suck!

|9.5.09 @ 9:24PM|#

And what is with all the Suderman bashing?

Art-P.O.G.|9.6.09 @ 4:15AM|#

sage,

I guess Suderman doesn't stroke their widdle egos.

Art-P.O.G.|9.6.09 @ 4:18AM|#

Tag leakage? You fiend!

Art-P.O.G.|9.6.09 @ 4:20AM|#

The h? Did that just work?

Some Guy|9.6.09 @ 8:34PM|#

"Do you think Democrats in Congress should pick your doctor?" (Even more embarrassing: The largest percentage of respondents said "yes.")

It had better be. Anyone who receives a call with a question like that and doesn't have fun with the pollster seriously needs a sense of humor.

"Yes, of course I want death panels. And they should be just like American Idol!"

Chad|9.7.09 @ 8:17PM|#

I think the poll asks the wrong question. Most people are probably "satisfied" with their insurance when they have it. What would you expect when it is paid for by someone else 90% of the time? It's actually pretty sad that a quarter of people are dissatisfied with their insurance plans. That's an awful statistic for any consumer product.

The problem is our system of obtaining and paying for insurance, which is one step short of ludicrous, insecure, and absurdly expensive.

Chad|9.7.09 @ 8:23PM|#

BakedPenguin | September 4, 2009, 3:10pm | #

Another GOP poll ominously questioned, "Do you think Democrats in Congress should pick your doctor?" (Even more embarrassing: The largest percentage of respondents said "yes."

That's creepy on many different levels.

What's "creepy" is this GOP moron (am I being redundant) does not seem to realize that

A: Just about every private insurance plan in the country DOES put significant restrictions on which doctors you can see

B: Just about no major national plan does

Due to the absurdity of the current system, my current insurance doesn't allow me to use any local doctors without out-of-network penalties (because I have moved), yet I can't switch without the price going through the roof. So instead, I face the choice of paying a big out-of-pocket cost to see a doctor for non-emergencies, or driving several hours to see my old doctor.

Bleeping brilliant!

|9.8.09 @ 1:49PM|#

I was polled by Gallup, regarding something or other. Don't even remember what it was.

However, one question sticks in my mind.

Are you:

1. Extremely conservative
2. Conservative
3. Middle-of-the-road
4. Liberal
5. Extremely liberal

I said, well, none of the above. Ask me about drug policy, I'm to the "left" of NORML. Guns? I'm to the "right" of the NRA. Gay marriage? No problem. Government spending? It's WAY too high.

She seemed befuddled.

I said I was a libertarian.

She said, "Extremely liberal, then?"

Polls, even if not "biased", can present false dichotomies. Sometimes, the whole poll is a set of false dichotomies.

supra shoes|9.9.09 @ 3:46AM|#

I'm practicing keeping my mouth shut on this one, but the best response I've thought up is to post the same blurb on my status ... along with the address of a local medical-treatment-for-kids charity we have in our county.