If You’re a Californian Who Likes Health Care Reform Raise Your Hand

Interesting panel discussion today in Sacramento that accompanied the release of the latest Field Poll gauging the attitudes of Californians toward health care reform. There were some surprising results in the poll, and some intriguing takes on what those numbers mean.

Kim Belshé, Secretary of the California Health and Human Services Agency, put it this way: “How can so many people (in California) feel optimistic about the promise of health care reform, and at the same time so many think health care reform won’t really help them personally?”

But first, as they say, let’s do the numbers:

• Of the 1,522 registered California voters contacted in the survey, 52% of them support health care reform legislation, which is a higher approval rating than most other states;
• A majority of those polled, though, believe that health care reform will raise their taxes, cost more for California and a majority believe they will have to pay higher out-of-pocket costs, too;
• 58% said it’s just a first step, and that more changes to the health care system will be needed;
• 60% labeled themselves as knowledgeable about health care reform. And yet a sizable number of people were misinformed about the requirements of the new law;
• And it’s not the same exact people, but 6 out of 10 people also said they received most of their information about health reform legislation from television reports.

“There’s a good deal of optimism out there,” Secretary Belshé said. “But while there is support, achieving a social consensus still isn’t apparent. It’s clear that successful implementation requires a public that’s well-informed.”

Civil Debate, Better Care

That was certainly the social consensus of the panelists — that the scope of health care reform is so wide and affects so many people, it will need to be a collective process, rather than the partisan battle it became in Congress.

“The people generally get it right,” said Sharon Levine of the Permanente Medical Group. “And the results of this survey reinforce that. But politicians really have to understand, to the extent that politics is polarized, that has a huge influence on how the body politic see and understand things.”

Carmela Castellano-Garcia of the California Primary Care Association said that politically-charged misperceptions about the reform law could undermine it, and that once people understand the promise and reality of health care reform, approval for it will only increase.

“We need to build greater support leading up to 2014 (when the health care reform law will be implemented),” she said. “There’s a need for people to understand that the government is not going to get involved in personal decisions like choosing a provider.”

“What we need,” Belshé said, “is not the politics of reform but the policy of reform.”

Quick, Tell Me Why Individual Mandate’s Important

Just how Californians are going to become educated about health reform issues is a grand unknown, the panelists agreed. One of the best comments came from the director of the Field Poll, Mark DiCamillo.

“Who is it that’s going to convey this information to the public?” he asked. He pointed out that polling data shows a high level of cynicism and distrust among Americans toward government representatives. “In terms of educating the public,” he said, “information shouldn’t come from top-down policy and government people. It needs to come from educators and health care providers.”

Or from media sources that cover more than just the winners and losers of the political fight over health care reform, Sandip Roy of New American Media said. And with health care in America, he said, there’s a cultural attitude of entitlement that could be a big barrier to implementing health care reform.

“One of big problems is, absolutely everyone agrees there’s way too much waste,” Roy said. “Have to get rid of the waste. You know, we know there are just way too many tests, we have to stop all those tests — but not on me.”

The odd dynamic in California, he said, is reflected in the poll results that show support for reform that most respondents don’t feel will not personally help them. 

“There is a sense of greater good here,” Roy said. “A sense that even if it’s not better immediately, I still think it’s better for California as a whole. And that’s very encouraging.”

Belshé said that the lack of knowledge in the poll about the importance of the individual mandate is a troubling sign. Without an individual mandate requiring that people sign up for insurance, it would be nearly impossible to set up a new health system that works smoothly and efficiently, she said.

“We need to create a culture where insurance is valued, expected, available and affordable,” Belshé said. “We really have our work cut out for us. But I am ever optimistic. And I can’t think of an area that’s more important, in the state and in the country, than health reform.”