In my last post, Maybe we are ready for Universal Healthcare? I revealed results from a survey conducted by our USA Healthcare group. USA stands for Universal, Simple, and Affordable, which is a formulation designed to help us talk about healthcare reforms that keep us moving forward, regardless of whether they are massive, like Medicare-For-All, or incremental, like Medicaid expansion or Medicare Pharmaceutical Price negotiations.
In this piece, I want to talk about the “S” and the “A” results – what did our group of 252 self-identified Republicans think about simplicity and affordability in American healthcare? Here are what I think are the key findings:
- 69% of our cohort thought the cost and way we pay for healthcare was poor or awful.
- 95% thought American healthcare needed to change a little or a lot.
- Among the biggest barriers to change in American healthcare, 34% feared lower quality, like longer wait times and 22% were fearful of paying more.
- Those who feared paying more were split between paying higher premiums or paying more in taxes. Fear of subsidizing others was a very small minority as I expanded upon in my last post.
- 70% thought we could afford to make healthcare affordable for all Americans.
- 95% agreed that American healthcare should be simple (smaller number of plans, straightforward medical bills, less administrative work).
- A third picked the answer that simpler healthcare would lower costs, and the other two thirds chose answers focusing on the burdens of the complexity itself (knowing if doctor and hospital are covered, complexity of the medical bills and plans).
- 91% agreed that the complexity of paying for healthcare makes it harder for some to access care.
- 60% agreed that the lack of universality – not everyone having coverage – makes things more complicate and costly for everyone. But 40% disagreed.
- 99% agreed healthcare should be affordable (OK, duh.) 43% recognized medical bankruptcy as a real possibility and 44% thought prices were too high, even for simple things.
- 64% of our cohort thought prices were “very high,” and 31% thought “a little high.” Only 5% disagreed.
- An interesting breakout on who conservatives blame for the high costs:
- The most common answer (37%) was healthcare companies and professionals.
- 24% thought the government was failing by not doing enough, while 7% blamed governmental administrative burden!
- 15% blamed private insurance administrative burden.
- 17% blamed unnecessary services by providers or excess demand from patients.
- 96% agreed that healthcare should be simple (Duh, again.) with smaller number of plans, straightforward medical bills, less administrative work. High costs caused people to buy inadequate coverage or go without altogether.
- 43% thought private insurers did a better job administering insurance than the government and only 15% favored public insurers (Medicare and Medicaid).
These self-identified Republicans recognize that American healthcare is way too complicated and way too expensive. The reasons are a bit more complex than the relative unanimity we found in these conservatives’ feeling about universal access described in my last post.
There is less unanimity, but still plenty to work with. Wendell Potter has pointed out that, "Health insurers have been successful at two things, making money and getting the American people to believe they're essential."
The responses given reflect decades of relentless messaging by the foot soldiers of the industries: “Be afraid!” That is why so many believe that private insurers do a better job than government run ones, despite the contrary evidence found both in the US and abroad. No healthcare insurance system in the world functions even remotely as inefficiently as our private systems.
Given the recognition by this cohort of the complexity (too many plan choices, administrative burden, etc.) of our private systems, this gives rise to a potential to create cognitive dissonance and active thinking about why they hold these contradictory thoughts. This will be on us, of course, to cognitively press these issues, while the contrary, massively funded opposition messaging machine will be gainsaying it all!
But more than half do make the connection that our prices are too high due to healthcare professionals and companies and health insurance administrative burden. Our job is to help them make the connections that private health insurance is not the solution, private health insurance is the problem, to paraphrase Ronald Reagan.
A quarter already recognize that one of the reasons w have such high costs is that government is not doing enough!
I find the results of our survey to be very encouraging. I have expounded at length on how to adapt the techniques of cognitive psychology to the fight for universal healthcare here: Cognitive Science and Universal Healthcare.
I also have some ideas on how to get these messages some traction here: Creating Change: Healthcare in America Commission.
I tried to keep this short and sweet, but I would love to have a discussion with you all about what you think! I am also looking for collaborators in using cognitive science in this area, so please reach out if you have an interest in this as well!
Cheers,
CMH