Friday, March 05, 2010

Poll deception

Charles Krauthammer takes on an annoying argument that the Democrats have been spouting. They keep saying that polls show that the American people like every element of their program so it really is popular. They just leave out the question of cost. When cost is added or when people are asked about the whole shebang and start thinking about how it's going to be paid for, suddenly they're not so favorable to the Democrats' plans.
Unfortunately for Democrats, that seven-hour televised exercise had the unintended consequence of showing the Republicans to be not only highly informed on the subject, but also, as even Obama was forced to admit, possessed of principled objections -- contradicting the ubiquitous Democratic/media meme that Republican opposition was nothing but nihilistic partisanship.

Republicans did so well, in fact, that in his summation, Obama was reduced to suggesting that his health-care reform was indeed popular because when you ask people about individual items (for example, eliminating exclusions for preexisting conditions or capping individual out-of-pocket payments), they are in favor.

Yet mystifyingly they oppose the whole package. How can that be?

Allow me to demystify. Imagine a bill granting every American a free federally delivered ice cream every Sunday morning. Provision 2: steak on Monday, also home delivered. Provision 3: a dozen red roses every Tuesday. You get the idea. Would each individual provision be popular in the polls? Of course.

However (life is a vale of howevers) suppose these provisions were bundled into a bill that also spelled out how the goodies are to be paid for and managed -- say, half a trillion dollars in new taxes, half a trillion in Medicare cuts (cuts not to keep Medicare solvent but to pay for the ice cream, steak and flowers), 118 new boards and commissions to administer the bounty-giving, and government regulation dictating, for example, how your steak is to be cooked. How do you think this would poll?

Perhaps something like 3 to 1 against, which is what the latest CNN poll shows is the citizenry's feeling about the current Democratic health-care bills.

Late last year, Democrats were marveling at how close they were to historic health-care reform, noting how much agreement had been achieved among so many factions. The only remaining detail was how to pay for it.

Well, yes. That has generally been the problem with democratic governance: cost. The disagreeable absence of a free lunch.
Reality. What a bummer. Where is that reality-based community these days?

35 comments:

Tacitus Voltaire said...

Imagine a bill granting every American a free federally delivered ice cream every Sunday morning.

well, this is an improvement on the former rhetoric about how HCR meant that obama wanted to kill your grandmother with death panels! imagine that, progress!

but, ya know, ice cream is still very popular, even though people have discovered that you have to pay for it

equitus said...

Where is that reality-based community these days?

Haven't you heard? They are smashing windows and starting fires in Berkeley.

tfhr said...

TV,

Hooray! Free Ice Cream! (It's an upgrade from Government Cheese)

mark said...

"Deception" is an accurate word to use for this post as Krauthammer lied in a previous column when he said we have the best health care in the world. A blatant lie that conservatives are willing to spread.
Putting that aside (as well as his idiotic analogy to free ice cream) I wonder why Krauthammer and so many are panicked about the dems using reconciliation. If this bill really is such a turd, why not let dems pass it and face the wrath of the voters. Repubs would clean up in the elections and Obama would be a one-termer. Repubs could then dismantle the law.
Seems like a win-win for the repubs, assuming this isn't just about bringing down Obama.

Mark said...

The core issue should always be who pays, who benefits and who gives in these bills. Government, like business, needs more transparency, less legalese and less anecdotal "proof points" of what the american people allegedly want.

Pat Patterson said...

This is what Krauthammer said, "The United States has the best health care in the world — but because of its inefficiencies, also the most expensive." How exactly is that a lie?

Bachbone said...

Krauthammer used absurdity to illustrate absurdity, which mark, ever the loyal reader of leftist propaganda, ought to have recognized as Alinsky's Fourth Rule (ridicule) for Radicals, and just as Alinsky predicted, it "infuriated" (Alnsky's term) poor mark. Now that's really funny. Alinsky's methods used on Obamacons and they don' even know it.

Let's paraphrase mark and answer his own question(s) (cleaned up a bit) with the effort : "If this (eight years of Bush) really is such a [boondoggle], why not let [the GOP go at] it and face the wrath of the voters. [Dems] would clean up in the elections and [Bush] would be a one-termer. [Dems] could then dismantle [everything].
Seems like a win-win for the [Dems], assuming this isn't just about bringing down [Bush]
.

So, mark, tell us why you, the DNC, Soros, Michael Moore, WaPo, NYTimes, Dan Blather, ABCBSNBCNN, Hollyweird and every other media source didn't follow that advice? Why didn't Bush have eight years of utter silence from all of you? You've answered your own question.

Also, if you bothered to read more than leftist-approved publications, you'd know there were, and may still be, portions of the Health Care Bill (we haven't seen Obama's yet) that prevent future changes to, and revocations of, its provisions. And since the vast majority of our esteemed politicians admit they haven't bothered to read it, they don't even know it. That's one big reason the GOP wants to stop it before it become law. If it passes, its constitutionalty will be tested, as well, but no one wants to depend on SCOTUS after some of its recent rulings and the possibility that Obama is going to get the chance to appoint Holder and Hillary to it before he gets tossed out of office..

John Cunningham said...

Mark is clearly a stooge for the moveon.com, Soros crowd. the key fallacy of the Obama plan is his claim that it will provide more coverage, no limits, and 30 million more people covered for less money.
How likely is this in real life?

Sokmnkee said...

I'm getting really tired of some people. I drive a 10 y.o. and always "paid for" Honda. It's still a great car. I'm a working stiff that's grateful to have a job that I go to every day. I do love my job. Across the way from my office is a government office where they're well known for passing out entitlements to the "so-called less fortunate." Yes, I know there is real poverty and I would never begrude those people assistance. We're on the brink of it every day trying to pay our taxes, insurance, bills, etc., and still feed ourselves. However, when some of these people roll up in Escalades, Hummers, BMWs, Lexuses, Jaguars, etc., and get out wearing some brand name designer duds, I get really steamed. I call them "entitlement monkeys" scoping out the government cheese. When we see the traffic we say, "It must be free government cheese day."

John A said...

Actually, even without costs, skew is easy.

"Imagine a bill granting every American a free federally delivered ice cream every Sunday morning. Provision 2: steak on Monday, also home delivered. Provision 3: a dozen red roses every Tuesday."

Many, even most, would be OK with free ice cream. But some would object to having someone work on Sunday, some would object to animal products. And yes, in re costs, when it is pointed out that the "free" ice cream you could buy for $1.20 would instead cost $4.75 in taxes and fees...

Same with steak delivery. Vegetarians and "animal rights" persons would be against it, no matter the monetary costs.

Many would like roses. I am not one, and I doubt I am alone - consider the pollen factor, for example. And yes, the cost!!!

So, overall, excluding costs I might like two of the three of his suggested "free" items. But put the three together, and I would not be entirely in favor. Too, there is sure to be a subset of people who would not like ANY of the three. And again, yes, costs! I am not quite stupid enough to believe that there is actually such a thing as a no-strings-attached free lunch.

mark said...

John,
You must be chilly. How about throwing a shirt on?

Tacitus Voltaire said...

I call them "entitlement monkeys"

humph. some real charmers you got around here

Tacitus Voltaire said...

half a trillion dollars in new taxes

from whom and over what period of time?

how much has bush's medicare drug benefit cost and how did we come up with the money?

how much did the iraq & afghanistan wars cost since 2002 and how did we come up with the money?

Pat Patterson said...

Which is the child's defense for committing a bad act. "Well, they did it first."

dave™© said...

However, when some of these people roll up in Escalades, Hummers, BMWs, Lexuses, Jaguars, etc., and get out wearing some brand name designer duds, I get really steamed.

Dear Penthouse...

Towering Barbarian said...

@ Mark of 7:51 PM. Krauthammer lied "...in a previous column when he said we have the best health care in the world. A blatant lie that conservatives are willing to spread."


With all due respect, if you truly think it a lie then why don't you just go ahead and name a nation that you think has better health care than we do? o_O

mark said...

TB

As I've said before, the World Health Organization ranked the US 37th. I lack the resouces, intelligence and interest in trying to replicate all that would go into rating the countries. I would say the responsiblitiy to back his claim is Krauthammer's or anyone who claims we are number one.
That's the problem with Krauthammer and so many here. If they personally have good health-care, everybody else must, too. It's a simplistic, selfish way of looking at things. but that is what it has come to: "I've got mine, so screw you." And then demonize those without as "entitlement mondeys" and "undeserving" as was stated here. (To be fair to skay, she partially walked back her "underserving" comment when I pointed out that some of the stimulus money helped memebers of the military. I guess children are still classified "undeserving" in her book).
1 France
2 Italy
3 San Marino
4 Andorra
5 Malta
6 Singapore
7 Spain
8 Oman
9 Austria
10 Japan
11 Norway
12 Portugal
13 Monaco
14 Greece
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany

Pat Patterson said...

Until either the US uses the WHO methadology or the world adopts the American methadology those lists are basically useless.

For example France does not count aliens, legal or not, nor does it include children under five in its reports. Thus two of the highest risk groups for health problems are simply not counted. It's as if the US used 15-year old girls as the study group for breast caner but didn't include any female over forty-five.

This is much like the articles that appeared over the last five years that claimed the Dutch were now taller than citizens in the US. Accept the Dutch used estimated heights and the US used reported heights. The Dutch could very well be taller but unless the numbers are arrived at the same way the comparison is useless.

Tacitus Voltaire said...

why, imagine that! towering barbarian and pat are experts on world health ranking with better information than the WHO. well, since they know so much and are certain that the u.s. has the best healthcare in the world, then surely they wouldn't mind giving us their rankings, along with the details of how their comparisons were superior to the WHO. please, go right ahead!

tfhr said...

mark,

This must be why millions of people travel to Colombia(#22) every year from around the world to partake of their superior medical care. Maybe if we could get the Dems to approve the fair trade agreement with the Uribe government, we could start sending our medical problems down there for treatment!

Look at that UN list, mark. Do you really believe that Colombia has better medical care than Germany but worse than the UK?! Does that make any sense?

And what a list it is!
The combined populations of:
San Marino 31,358
Monaco 32,812
Andorra 85,505
Iceland 322,691
Malta 408,712
Luxembourg 486,184
totals 1,367,262 which is larger than Hawaii or Rhode Island but not the two combined and only just larger than Maine's population. Your list is as useless at the source that provided it, mark.

Tacitus Voltaire said...

nor does it include children under five in its reports

what an astonishing fact! you know, pat, i had no idea that you spend your spare time doing detailed studies of how different countries in the world collect their health statistics, and how the WHO used these statistics to do their rankings!

imagine that! no information on children under five is included in any health statistics available in france! that is truly an Amazing Fact! or, did the WHO neglect to use health information about children under 5 in france in it statistics? i wonder which sources of data did the WHO use for france, anyway - pat? what were the factors that went into the overall rankings - pat? you know all about it, of course, pat, since you can tell that the ranking is basically useless

and there are 35 other countries that the WHO has ranked before the united states in overall quality of health care. gee, what about them?

we all look forward, i'm sure, pat, to your detailed analysis of the inadequacy of data collection and ranking methodology as it relates to each country that the WHO has compared the u.s. to

i'm confident you wouldn't have delivered your authoritative verdict on the usefulness of the the WHO ranking unless you knew

Pat Patterson said...

Well, why don't you look at the WHO methadology to verify that indeed children under five are not counted as live until after their fifth birthday. And you can check the statistics that France uses in its census to discover that unlike the US where all residents are counted France only counts citizens.

As to the other countries they also use the rather loose methods acceptable to WHO when reporting these numbers. While the US, Canada, Japan and Australia use the same methadology.

Sorry to burst your bubble but in this case you should have checked for contradictory information instead of believing what you read on a web site.

Tacitus Voltaire said...

Well, why don't you look at the WHO methadology to verify that indeed children under five are not counted as live until after their fifth birthday. And you can check the statistics that France uses in its census to discover that unlike the US where all residents are counted France only counts citizens.

As to the other countries they also use the rather loose methods acceptable to WHO when reporting these numbers. While the US, Canada, Japan and Australia use the same methadology.


well, that certainly looks to me like a detailed dissection of the data sources and methodologies used to arrive at the rankings of the 36 countries that are judged to have better health care overall than the united states. it's almost like you actually made an effort!

yep - a couple of things pat read on some web site somewhere makes the whole WHO effort "essentially useless". what impressive research, pat!

Tacitus Voltaire said...

wait - i'm gonna call the WHO research staff and tell them to call off their efforts because something vague about the way france registers children under 5 and small countries are small hahaha!

oh, and evaluating the overall delivery of health care to all citizens rich and poor is stupid because i read about some rich person coming to the united states for hospital care hahahaha plus columbia is some funky country somewhere where everything sucks nothing works there hahaha!

i can haz science?

Tacitus Voltaire said...

and before we move on to the ever popular and highly scientific I Think I Read A Story About Wealthy Foreigners Flying To The U.S. For Hosptal Treatment method for evaluating the quality of medical care worldwide, here's a little tidbit:

“ We used to hustle over the border for health care we received in Canada. And I think now, isn't that ironic? ”
— Sarah Palin, former Alaska governor and U.S. vice-presidential candidate


http://www.theglobeandmail.com/news/national/sarah-palin-sees-eye-to-eye-with-albertans-in-calgary-speech/article1492634/

Pat Patterson said...

I sais absolutely nothing about the quality of care in any country but pointed out that those who use that list as proof simply are gullible enough to believe anything. The health care of these countries can't be compared unless they measure the same things. The WHO numbers on infant mortality for one are simply a lowest common denominator that allows some of the undeveloped countries to pump up its figures by removing that group that is the most at risk for health complications. Maybe instead TV should simply go to the WHO, which does not do research but merely collates national reports, site and read what they ask for in reporting. And to be aware that the US simply reports the numbers differently. And as I mentioned in regards to The Netherlands these other countries may have better numbers but until everybody counts infant mortality and longevity the same then the numbers are useless.

And the best you can come up with is a throw away line in a public appearance by Gov Palin in Whitehorse where she also mentioned that she remains a "... vocal opponent of health-care reform in the U.S. [and that she] steered largely clear of the topic except to reveal a tidbit about her life growing up not far from Whitehorse." Which by looking at a map was closer than Fairbanks and its hospitals.

tfhr said...

TV,

Find the country that has the best mental care - go there - get help. You have become a ranting fool.

Tacitus Voltaire said...

I sais absolutely nothing about the quality of care in any country

you can say that again

The health care of these countries can't be compared unless they measure the same things

you know, pat, i asked you to provide some proof of your contention that the list is "useless", as you put it

you could at least make an effort!

Tacitus Voltaire said...

Which by looking at a map was closer than Fairbanks and its hospitals

b-b-but american health care is The Best In The World, and canada's single payer system is awful and everybody is dying in the waiting room there because socialism

right?

Bachbone said...

If all the WHO ranking measured was "health," the "H" in WHO might be more accurately construed. But like most things, there is more to the WHO than "health," and a lot of it is political. And where politics are in play, so is bias.

In the survey mark cited, "...62.5 percent of their weighting concerns not quality of service but equality. In other words, the rankings are less concerned with the ability of a health system to make sick people better than with the political consideration of achieving equal access and state-controlled funding."

25% of the weighting depends on "Financial Fairness" of the nation's funding. In other words, charging the rich a health tax gets that country a higher ranking irrespective of whether it improves the actual health outcome, thereby biasing the rankings. Taxpayer-funded systems are favored inherently.

"Health level" and "resposnsiveness" are included in the rankings. "Health level" includes life expectancy, which the WHO associates with (and openly campaigns against), tobacco usage, diet and obesity, things the US (as yet) leaves to individual conscience, not government control. "Responsiveness" was taken from a completely separate "Respect for Persons" survey that sought to measure "speed of service," "convenience" and "choice," but even in it, "equality" was 50% of its weighting.

The WHO ranking is biased by its own politically influenced definitions of what constitutes good "health care," and by its use of surveys tossed together to get where it wanted to go.

See WHO Survey Bias.

Tacitus Voltaire said...

here, a little light on the subject of what the list represents and how the ranking was arrived at, from the WHO's explanation of exactly the list that mark posted

The report indicates – clearly – the attributes of a good health system in relation to the elements of the performance measure, given below.

Overall Level of Health:

A good health system, above all, contributes to good health. To assess overall population health and thus to judge how well the objective of good health is being achieved, WHO has chosen to use the measure of disability- adjusted life expectancy (DALE). This has the advantage of being directly comparable to life expectancy and is readily compared across populations. The report provides estimates for all countries of disability- adjusted life expectancy. DALE is estimated to equal or exceed 70 years in 24 countries, and 60 years in over half the Member States of WHO. At the other extreme are 32 countries where disability- adjusted life expectancy is estimated to be less than 40 years. Many of these are countries characterised by major epidemics of HIV/AIDS, among other causes.

Distribution of Health in the Populations:

It is not sufficient to protect or improve the average health of the population, if - at the same time - inequality worsens or remains high because the gain accrues disproportionately to those already enjoying better health. The health system also has the responsibility to try to reduce inequalities by prioritizing actions to improve the health of the worse-off, wherever these inequalities are caused by conditions amenable to intervention. The objective of good health is really twofold: the best attainable average level – goodness – and the smallest feasible differences among individuals and groups – fairness. A gain in either one of these, with no change in the other, constitutes an improvement.

Responsiveness:

Responsiveness includes two major components. These are (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider).

Distribution of Financing:

There are good and bad ways to raise the resources for a health system, but they are more or less good primarily as they affect how fairly the financial burden is shared. Fair financing, as the name suggests, is only concerned with distribution. It is not related to the total resource bill, nor to how the funds are used. The objectives of the health system do not include any particular level of total spending, either absolutely or relative to income. This is because, at all levels of spending there are other possible uses for the resources devoted to health. The level of funding to allocate to the health system is a social choice – with no correct answer. Nonetheless, the report suggests that countries spending less than around 60 dollars per person per year on health find that their populations are unable to access health services from an adequately performing health system.


two minutes on google and a person could come up with a fact or two, fercrissakes

The U. S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of gross domestic product (GDP) on health services, ranks 18th

http://www.photius.com/rankings/who_world_health_ranks.html

Towering Barbarian said...

Mark,
I'm aware of the 2000 WHO ranking but would be more impressed were it not that I have reason to know about something that happened with the nation they ranked at #1 in 2003;

http://theironscroll.blogspot.com/2009/10/chapter-of-history-in-french-health.html#links

The thing that stuck in my mind is that after this happened there were some apparently irony-free Frenchmen on the Yahoo International News message boards who had the gall to cite the WHO study you referred to as a reason not to think there anything wrong with the way the French Health Care system handled things and to be quite indignant at the idea that a massive dieoff among one's patients might be any reason for a physician to postpone his month-long vacation. The fact that the other Euro leftists who cropped up in those MBs, some of whom I had previously respected, started agreeing with him in insisting that a preventable massive dieoff was somehow not a blackmark against the system made me wonder more than a little about the health care systems of their nations as well. A strange scepticism concerning the trustworthiness of WHO in this matter to permeated my mind after that even more than it would have if I were not conscious that a lot can change in the ten years that has now passed after such a ranking is made.

From the admittedly incomplete research I've since done I suspect that Mr. Krauthammer is completely correct. France, Great Britain and Canada have been weighed in the balance and found wanting. I haven't gotten around to posting what I found on Canada yet, in part because too much of it seems to be a repetition of what's been going on in Britain, and in part because after a while contemplating the ways in which government health care systems screw up gets to be just plain depressing but I probably should some time. All the same, I consider Britain, France and Canada between them to be an adequate sample of what foreign HCSs have to offer and nothing I've seen gives me any reason to believe that America is not genuinely the best in this regard.

Pat Patterson said...

And as usual TV provides reams of non-data doesn't address my original point. That unless the numbers are gathered using the same methadology the conclusions are basically whatever someone wants them to be.

It's too bad that TV didn't spend two minutes at least reading this caveat concerning the rankings, from 2000, "The World Health Organization's ranking of the world's health systems was last produced in 2000, and the WHO no longer produces such a ranking table, because of the complexity of the task."

Bachbone said...

Nothing in the WHO's "explanation" disproves the bias in the surveys or WHO's use of them. Period.

Pat Patterson said...

I might not claim the WHO has an institutional bias, mainly from some personal knowledge of some of its researchers, but I believe the phrase, "...garbage in, garbage out" is the best explanation. And the fact that the left loves to use these type of results to create the perfect society.