This was such a striking finding this week I think it bears some more discussion. In a national poll released this week Gallup found that 76% of people were satisfied with how our health care system is working for them personally. Medicare and military coverage got similar high marks too despite the current problems in the VA. When asked about private health coverage through their job, 70% expressed satisfaction with our American health system.
There are a couple lessons here, the first of which has been true for a while – most Americans, whether getting coverage through Medicare, Medicaid or private health coverage are pretty satisfied with how the health system works. The obvious exception to this was found by Gallup as well: Only 36% of people without insurance were satisfied with how the health system treats them. So next time someone in the media – invariably with health insurance, often government-provided if they are a politician – is shouting from the rooftops about “the imminent demise of our entire health system unless [insert talking point here]” remember the vast majority of Americans with health coverage are pretty OK with the way they are being treated now.
The second lesson here is a little more subtle. Our Medicaid programs often serve as a punching bag proxy for other political disagreements. Why? Health care is expensive, phrases like “fixing what’s broken” and “reforming the system” always sound good, and the majority of people getting Medicaid are low income children and parents and therefore not exactly political movers and shakers who can complain. Despite all the hue and cry around Medicaid though, Gallup’s poll points out that more people with Medicaid coverage are satisfied with the health system than those with private health plans. This brings up the question as to whether we are thinking in the wrong way here when some states are rushing to make Medicaid look more like private health insurance. Perhaps there are lessons the private insurance industry can take from Medicaid in order to make our whole system work better for everyone?
Getting a handle on health costs and making the health system work better as we have been doing in this country in the last few years is no easy task, akin to watching an oil tanker do a three point turn. However, it pays to remember these high rates of satisfaction with the health system among people who have coverage and the abysmal rate among those who, thanks to state decisions not to expand Medicaid under the Affordable Care Act, still lack insurance. Getting people who are uninsured health coverage as fast as we can and applying improvement lessons from both public health programs and private health insurance seem to be more rational solutions even if they may not be well-suited for talking point-laden speeches and high political drama.