Americans Favor Free Market Approach to Health Care


Jeffrey H. AndersonMay 5, 2011 2:21 PM

Likely voters’ responses to two questions in a recent Rasmussen poll highlight both the challenge that Paul Ryan and the House Republicans face in persuading Americans to support their proposed budget, and why it’s likely that they will ultimately prevail. Rasmussen asked likely voters what they think of Ryan’s proposed Medicare reforms, without explaining at all what those reforms entail.  The question and the answers were as follows:

4. Do you favor or oppose the plan for changing Medicare that is included in the Ryan budget proposal? 

21% Favor
39% Oppose
40% Not sure

In the very next question, Rasmussen asked likely voters how we can hope to bend the health care cost curve downward.  Here’s the question and the answers:

5. What would do more to reduce health care costs — more free market competition between insurance companies or more government regulation?

51% More free market competition between insurance companies
31% More government regulation
18% Not sure

I take the first question (#4) as an indicator that Americans knee-jerk response is to oppose seeing “Medicare” and any derivative of the word “change” in the same sentence. This is surely even truer when people are not particularly familiar with a proposal in play. (The fact that people aren’t yet familiar with Ryan’s proposal is indicated by the whopping 40 percent tally for “not sure.”)

But the second question shows that Americans already approve of Ryan’s approach for bringing down health costs. In fact, that question perfectly highlights the choice between Ryan’s and Obama’s respective approaches: greater competition among private plans and more options from which people can choose, or 2,700 pages worth of consolidation and centralization of power in Washington, capped by Obama’s recent proposal to give even more essentially unchecked authority to Obamacare’s unelected Independent Payment Advisory Board. 

This second question also shows why Obamacare is so woefully unpopular: It employs a senseless mode of dealing with health costs, one that fewer than a third of Americans believe in — and which would not be conducive to liberty even if it were conducive to achieving its goal.

So the Ryan camp, and the GOP in general, has two challenges ahead — and one major advantage that should see them through. The first challenge is to convince the American people that Medicare costs really do need to be lowered; that Medicare is poised to bankrupt us; that it is unconscionable to let our $14 trillion in national debt, and the program that will be our principal driver of future debt, continue to spiral out of control. This can perhaps best be conveyed by highlighting that the president’s own budgetary projections show that, in 2011, mandatory spending alone will exceed total federal receipts. In other words, even if we weren’t spending a penny this year on homeland security, interstate highways, national parks, or even national defense, we’d still be running a deficit. 

The second challenge is for Republicans to convey what their proposal entails — namely, direct premium support from the government to help future seniors (those currently under 55) to purchase private health plans from insurers who will compete for their business. This is much like how Medicare Advantage, the Medicare prescription drug benefit, and the health care system for members of Congress, all work. The proposal would also give substantial additional support to the poor. 

Those are their two challenges. Their major advantage is this: The public debate about how to lower health costs has essentially already been won. Americans know that competition and choice, not 2,700 pages of almost unfathomably excessive government regulation, is the ticket to lowering health costs without having to ration care — and without having to deprive Americans of their liberty.

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