When it comes to health care reform, chances are pretty good that you either support it or you don’t. Not too many people fall into the “indifferent” camp these days. Chances are even better that you have seen a poll–from one source or another–that shows that the American people either do or do not support health care reform.
The fact that the polls aren’t all in agreement–or even something closely resembling it–underscores a very important point: polling is a highly variable method of collecting information. While some polls are more methodologically rigorous than others, all polling efforts are subject to a variety of biases that can alter their findings.
For instance, how the questions are asked can change a person’s response, even if the underlying point is the same in each case. So, too, can the length of the poll. People get bored easily, become impatient, and are more likely to answer hurriedly towards the end of a poll that is too long. Sometimes people don’t really even understand what they’re being asked. How can we really trust their responses in those cases?
Keep in mind that this has nothing to do with the margin of error polls typically report. That figure is simply an indication that the poll was conducted in a small sample of the population, and that the laws of statistics help us to project from the sample onto the larger population, but only within a given range of accuracy. If a poll is biased, it is simply biased, and its findings then fall anywhere from less accurate to meaningless.
David Brady and Daniel Kessler conducted a study that attempted to cut through the murkiness of the polling data. How did they do it? By conducting a survey, of course. But what they found was both predictable and fascinating. On the predictable side, people who were older, higher income, and Republican were less likely to support health care reform. On the fascinating side, income was the strongest predictor of support for health care reform. The authors write:
“[First,] the difference in support between a respondent in the top versus the bottom income bracket (more than $100,000 annual household income versus less than $25,000) is significantly greater than the difference between a Republican and a Democrat. In addition, income (and party affiliation) are much more important determinants of support than age, although older and middle-aged Americans are less supportive of reform than younger Americans. Second, the negative effects of income on support for reform start early in the income distribution. Depending on the reform, respondents with family incomes from $25,000–$50,000 are 19.7 to 21.6 percentage points less likely to support reform than those with family incomes under $25,000. Increasing income beyond $25,000–$50,000 reduces support for reform, but at a declining rate.”
My take on their findings is simple: People are inherently white-knuckled and short-sighted. People with higher incomes feel more secure in their own right and simultaneously more threatened by the idea that reform means they will be forced to pay for those who have less. The fight over health care reform has less to do with political philosophies and differences of opinion over the role of government and more to do with greedy, selfish, self-centered people with an everyone for themselves attitude. If it didn’t, income wouldn’t be so negatively correlated with support for reform. That’s the white-knuckled part–holding on to what’s “theirs” for all they’re worth.
The short-sighted part is that people fail to realize two very important things. First, that they may fall victim to misfortune and may suddenly find themselves without the incomes they now enjoy. In need of health care, but without the means to obtain it, they will suddenly be at the mercy of a public that doesn’t care to lend them a hand. In an eye-opening moment of clarity, the proverbial shoe will be on the other foot.
But that assumes that some unforeseen circumstances befall the wealthy person. Such an event may never come to pass. Still, there is another way in which people are short-sighted. They miss the point that when the society as a whole is less than whole, all the people suffer in some way. We all shoulder the burden of the costs of uncompensated care, the effects of medical bankruptcies, and denials of insurance coverage through higher premiums, greater business expenses, and the rising cost of all of our goods and services. In short, our economy suffers as the maligned health care system staggers onward. There is a very real cost associated with doing nothing. As Brady and Kessler find, however, the wealthy have yet to feel those effects enough to do something about them.