Can’t get no satisfaction

Equivocation occurs when you fudge on the meaning of a key term.  Say, for instance, you want to say that there is no war in Afghanistan because "wars" must be declared, therefore, etc.  If you wanted to apply similarly twisted logic to the health care crisis, you might argue as Michael Gerson has done:

And so Barack Obama's address to Congress on health care, at a minimum, must answer the question: What is the crisis? When individuals can't get needed health care, it is certainly a crisis for them. This, Obama might argue, creates moral responsibilities for the rest of us to help. But this would argue for a more incremental approach, adding coverage for the working poor instead of remaking the American health system for everyone.

The overwhelming majority of Americans, by the definition of denied care, do not face a health-care crisis. Most polls show that about 80 percent are "very" or "somewhat" satisfied with their health plans. Those in the greatest need are often the most satisfied — 90 percent of insured Americans who suffered serious illnesses are satisfied with their health care. According to a study published by the Cato Institute, a very small percentage — even of the uninsured — are "dissatisfied or highly dissatisfied" with the health care they get in other ways. On health care, the American public brims with satisfaction — though most are concerned about rising costs.

So perhaps this is the crisis: rising costs that will eventually overwhelm state and federal budgets and consume more and more of individual paychecks. But this is precisely the area where current Democratic approaches are least credible. Obama abandoned his pledge to reduce the government's health costs long ago; now he aims only at budget neutrality. But every pending health-reform bill in Congress would increase both short- and long-term deficits, failing even on Obama's modified terms. Americans get the joke. While Obama has made cost control a centerpiece of his public message, only about 20 percent of Americans, in one poll, believe Obama will keep his promise not to increase the deficit with health reform.

This is very very confused.  According to Gerson, a "crisis" means when people are "dissatisfied" with their health care.  People may indeed be satisfied with their health care on an individual level–they like the nurses and doctors who take care of them–but that is rather different from whether the system, the way health care is paid for, packaged, and delivered is in crisis or not.  That's not a question of perception at the individual level.  Most people seem to understand that and support health care system reform.

Indeed, had Gerson read the article he cites as evidence for his position, he would have noticed the following:

The reason for the apparent paradox is that even though most people are satisfied with their insurance, they harbor deep concerns about losing their coverage or their ability to afford it and medical care if costs continue rising. 

I have to wonder whether this shift in focus in the debate is not intentional.  Every adult knows what the issue at hand is.  It's not whether people like their doctors, or whether they like their current insurance coverage (when they have it).  

We have been talking about this issue for almost one hundred years in this country.  Other countries have figured out that you can get more, pay less, not euthanize your grandmother, and continue to maintain access to clinics that do not allow poor people.

3 thoughts on “Can’t get no satisfaction”

  1. I’ll be so glad when Obama reveals his vision of what he thinks health care reform should look like tonight. Then we won’t have all this debate over potential plans, but there can be some actual discussion regarding details or approaches (Not saying that’s what the media will do, but I can dream.)

  2. He’s not even right on the numbers. The Cato Institute “study” that he references actually tried to interpolate numbers from a Kaiser Foundation survey.
    The Kaiser survey reported satisfaction for various measures and gave results in percentages for ALL respondents and for INSURED respondents. Cato then attempted to interpolate the results for UNINSURED respondents.
    But they made a complete hash of their calculations, computing nominal values which they then quoted as percentages.
    For example, they computed that 10% of the uninsured were somewhat or very dissatisfied with the costs of health care.
    In fact, since 13% of respondents where uninsured, the number is 10 people out of every 13 uninsured, or *80%* of the uninsured, who were somewhat or very dissatisfied!

  3. Actually, I take that back…partially: the “study” correctly shows how many Americans are uninsured AND dissatisfied with their care but the data is presented in the context of a discussion about how many UNINSURED Americans are dissatisfied with their care. (which would be like trying to discuss the percentage of red apples that are tasty by showing the percentage of ALL apples that are both red and tasty)
    Gerson also appears to get tripped up by this subtle misdirection by suggesting that the percentage of the *uninsured* who are dissatisfied is very small when, in fact, that’s not true at all.
    In any event, John’s point still stands regardless of the fact that Gerson’s support for his equivocation is based upon a misinterpretation of the underlying data.

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