Thursday, October 18, 2007

Moving on with SCHIP

Dave Budge did the heavy lifting of responding to Jay at LITW, so there isn't much to add there.

Dave states that 85% or so of people with insurance are either "satisfied or very satisfied with their coverage." That probably isn't terribly off.

Of course, everyone would always like to have more and better coverage while paying less for it. But most people also know that you don't get something for nothing.

And reading Ed Kemmick today, we are reminded that there is by no means agreement in Canada on whether that country's system actually provides what it claims to provide by comparison with the American system.

The observations made by the Canadian blogger Ed cites are backed up by our own anecdotal observations based on former Canadians with chronic health problems who have moved to the U.S. -- namely that they discovered that they were getting significantly inattentive care for those chronic diseases back in Canada, and that in moving from a major metropolitan area in Canada to lowly Billings, MT and coming under private American insurance, their management of those chronic diseases and attention to preventing complications improved dramatically.

But back to SCHIP: What is interesting is that even though the Presidential veto was sustained in the House, as everyone knew it would be, we have our senior Senator in denial:

"This fight is so far from over. The fat lady isn't even warming up," Baucus said. "It just means we need to regroup and bring more people to the table. It means we need to tweak the bill slightly while making sure it does what we need it to do, cover more uninsured kids."

Tweaking it slightly?

Somehow we doubt that that will cut it -- unless the real point is to make more political hay, rather than to pass a working SCHIP bill.

Which may very well be the case.


Jay Stevens said...

I'm sorry you linked to Dave's reaction to that post instead of writing your own rebuttal; I was hoping for a reasoned analysis of my comments.

I'm also a little disappointed that you haven't commented on the NPR/Kaiser poll, which did put the questions and numbers into context, and is probably a much clearly snapshot on how people feel about the CHIP bill that Bush vetoed.

You'll notice in that poll that 65% of respondents still support the current CHIP bill, even after conservative arguments are fairly presented to the respondent.

Also, in that poll is a similar reluctance about the threshhold of income. Only 32 percent of respondents support an income threshhold of $60K a year -- but 43 percent supported covering families at 3X the federal poverty level, and 55 percent worry the CHIP bill doesn't go far enough to cover uninsured children.
In short, it's clear that the income numbers are meaningless to respondents when taken out of context. Do the respondents know that states are setting the threshholds for their areas, and that the highest threshhold -- 60K -- is likely to be used only in the most expensive neighborhoods? I doubt it.

But all the peripherals show that my original claim is correct: this CHIP bill polls well, scary well.

Montana Headlines said...

I apologize for not having time to do due diligence to the NPR poll that you cite.

It certainly shows that polling is highly dependent on what questions are asked and how they are asked -- which was the point to my own post. And even if I were to agree that the NPR poll questions resulted in a more educated pollee than the Gallup poll questions produce, these questions were also inadequate by way of education.

For instance, while it asked whether they were worried about people dropping their private insurance to go onto SCHIP, wouldn't it have been a good idea to include the CBO's own analysis of how many families would drop their private insurance and how much that switch would cost the taxpayer?

I don't have the numbers to hand, but it was fairly high -- particularly under the Congressional Democrat version that was everyone's baby on the left and in the press when this all started.

And I note that while a majority backs the 2x poverty level standard that Republicans support, only a minority backed the 3x poverty level that the Democrats wanted (actually, the original goal was 4x poverty, as I recall.) So while this may be a better way of asking the question, it didn't change what the majority thought.

You are right that income levels are meaningless outside of context. Is this why there seems to have been an absence in Montana of Democrats giving specific figures for our own state?

I finally note that you didn't comment on the question of the political implications. When asked what they would do if their Congressman were opposed to SCHIP expansion, here were the percentages that either said it wouldn't make any difference to them in their voting decision, or would make them more likely to vote for that Congressman:

Republicans: 76%

Independents: 62%

Democrats: 49%

Put in the reverse, only 45% of Democrats -- would be somewhat or much more likely to vote against their Congressman who opposed SCHIP expansion.

So while the theoretical support fo SCHIP expansion polls "scary well," 60% of voters overall either say it would make them more likely to vote for their Congressman who opposed expansion or it wouldn't make any difference in their decision on how to vote.

Given that about the same number said they disapproved or strongly disapproved of the President's veto, this is a curious factoid. Perhaps the numbers of support for the program indicate the warm fuzzies that helping children produce in us all, perhaps the disapproval of Bush's veto reflects general dissatisfaction with the President more than disapproval of any specific action -- and perhaps the fact that voters are apparently going to ignore this issue by and large when deciding how to vote reflects how they really feel about it when the rubber hits the road.

No wonder the Congressmen who voted against this particular bill didn't find the prospect particularly scary.