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David Moore

David Moore

Posted: September 23, 2009 11:30 AM

Those Bobblehead Polls on Health Care

What's Your Reaction:

A recent series of polls brings to mind a bobblehead doll, whose head wags from side to side and from front to back in a random fashion. That disconnected movement seems to be a visual representation of what the polls have been saying about the general public and its views of President Obama's efforts to reform the health care system.

Before the president's nationally televised speech to a joint session of Congress, for example, several polls announced that either a majority or plurality of Americans disapproved of the president's performance on health care. They didn't tell us if the people were dissatisfied because he was trying to do too much, or because he wasn't trying to do enough. All we got was the dismal information about how the public felt let down by the president.

Then, on the Friday after Obama's speech, a CBS poll declared that the public had rallied in favor of the president. A majority of the public now approved of his handling of health care by a 14-point margin, compared to a week earlier when a plurality disapproved by a 7-point margin. That represented a 21-point swing in opinion, which is no mean feat for one speech. (For all poll results, except where noted otherwise, see pollingreport.com.)

But early the following Monday, an ABC/Washington Post poll announced a different opinion. The "bottom line views on health reform," according to the analysis at ABC, "failed to improve since President Obama addressed the nation." His approval rating on health care was essentially unchanged since mid-August, contradicting the CBS finding of a 21-point swing.

Then at 3:00 PM on Monday, CNN revealed that Obama's approval rating showed a 13-point favorable swing over the previous week. Now a majority approved of the president's handling of health care policy, 51 percent to 47 percent, a reversal from a couple of weeks earlier when people disapproved by 53 percent to 44 percent. Not only that, but "strong" opposition to Obama's "plan to reform health care" had dropped by 9 points.

The very next day, a USA Today/Gallup poll asserted that (contrary to CNN's poll) Obama's speech "didn't change minds," and that "for the first time" a majority of Americans disapprove of the way the president is handling health care policy.

Since all these polls were conducted in roughly the same time frame, it makes one wonder if they were all talking about the same public. After all, the pollsters all claim to be using scientific methods of choosing their samples, so that they can interview a representative group of American adults. Could a rational and informed public provide such different scientific measures of its opinion on health care to these four polling organizations?

Perhaps a key to the dysfunctional results can be found in a question that was not reported on CNN's website, politicalticker, but was posted in its archive. When asked how much they knew about the details of Obama's health care proposals, almost six in ten respondents admitted that they knew little to nothing -- after having just opined about them during the previous twenty-minute survey. Only 11 percent said they knew "a good deal."

The ABC/Washington Post poll found a slightly more informed public, with just 44 percent knowing little to nothing about Obama's proposals, and 19 percent saying they knew "a great deal." But a previous poll by CBS perhaps best describes the state of the public: Less than a third said they understand the health care reforms under consideration by Congress, while two-thirds, 67 percent, said the proposals are confusing.

No wonder the polls seem like a bobblehead. Most of the public is confused about the health care debate, and a substantial segment -- a large minority or even a majority, depending on the poll -- doesn't know much about the specific proposals. When these people answer the detailed and arcane questions posed to them in the polls, they respond in an almost random fashion, their answers influenced by the way a question is worded or by the previous questions that have been asked.

Public opinion is not irrelevant in this debate. The public can provide an overall direction to its leaders, and here the polls are useful. They all show a widespread public consensus that the health care system is in great trouble and needs substantial reform. They also show that large majorities of Americans believe that all people should be covered by health insurance and that the government has a responsibility to ensure such coverage. Most Americans also believe that health insurance companies should not exclude people from coverage because of prior medical conditions nor drop people who become sick.

But it is ludicrous to place confidence in polls that ask the general public about the specific details of plans under consideration, when most people don't have that kind of detailed knowledge or at the very least are confused by the many contradictory proposals. The bobblehead public is an illusion created by pollsters who refuse to acknowledge the limits of their craft.

 
 
 
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HUFFPOST SUPER USER
T4
Entreprenuer and financial consultant
07:14 PM on 09/30/2009
Followup: healthcare bil that is not health and making insurance companies more money. Now let's look at health realities to understand why this bill is fiscally irresponsible and a political football. Demand for medical services is driven by demographics (expanding and aging pop), American lifestyle choices (e.g., diet), and system overuse (e.g. drug company ad stimulation). You can;t do much about #1 but the bill does nothing about the other two. Can elaborate more on other posts if u want as this a fact based assessment. So no demand control - this is why costs spiral - not magic and not insurance. Increased demand drives increased costs which have been exploited by docs, hosps and drug cos. Premiums have risen as a results of exploding costs. I am not saying insurance cos are good guys just that this is a clear business chain. Without demand management - nothing will materially change except your taxes will go up, specialists and hosp and insurance execs will get richer.
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HUFFPOST SUPER USER
T4
Entreprenuer and financial consultant
07:00 PM on 09/30/2009
The reason people are confused is because they hear the words healthcare and think your talking about well.. caring for their personal health. Sorry this legislation and this entire national debate has had notihing to do with healthcare - it has to do with price controls on the payment, administaration and delivery of medical services. Price controls won;t work to lower prices when costs are out of control because of skyrocketing demand. Healthcare is personal - medical serivces is a business. Insurance is a price subsidy and disguises costs so people are ignorant and never question costs until they are confronted with a catastopic situation and then they complain about insurance whenthey should be asking why the hell does this cost so much! The most bizaar recent argument- insure everybody and costs will go down because insurance companies will have people to spread the risk. What drivel - insurance companies have never said they will lower premiums. They will simply make more money from a larger base.
10:09 AM on 09/30/2009
What a relief to see this post. As someone who works in research, I've been extremely frustrated with the incessant interpretations and endless narrative-creation that far too many in the media are using to enlighten us on the issue of health care reform and basing them (badly) on poll results. I'm a big believer in mixed-methods--qualitative (focus groups, interviews, etc.) and quantitative (surveys, etc.) strategies--to understand and interpret data, beyond just determining the "how much/how many" which is all we get with these endless string of polls alone. If more holistic studies are being conducted, nobody seems to be talking about them.
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HUFFPOST SUPER USER
T4
Entreprenuer and financial consultant
07:23 PM on 09/30/2009
As someone who is in research you know the easiest thing to manipulate is numbers - it's all about knowing the assumptions around the numbers that form the basis for the analysis. Focus groups and interviews would be worthless as they would reflectthe assumptions of the info gatherers. When you start from the framework of talking about healthcare you immediately obscure the data because the definition of the term is too vague. It's like "public option" - the term is meaningless without definition. Who cares if 30 million people do or don;t have insurance? What are you imputing from that staement? And if you do establish some value - does the bill actually change the value.
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HUFFPOST SUPER USER
Ohio5470
12:15 PM on 09/24/2009
As one who actually sits at a phone and makes the calls for a major network public opinion poll I can only say that David Moore is exactly right. The questions are ill phrased to begin. In the survey I worked on the same question was essentially asked twice but with slightly different wording and a slightly different empahsis. The responses were amzaingly different. Both had to do with the respondents' view of the public option. In one question the public option lost out 48-46 whereas in the other similar question it won out by 73-23.
But the most important aspect is that the public thinks it is important that we all have a choice between public or private (second question) whereas their personal preference as whether to establish a public option is revealed in the first question.
However I am not really sure whether that nuance was understood by the respondent.
My gut reaction is that the media has done a poor job of explaining the nature of the debate and have merely concentrated on the the rhetoric of the opposing sides, he said, they said, she said, blah blah blah.
12:49 AM on 09/24/2009
Yes, the people are too stupid to understand that the government is trying to help everyone.
02:38 PM on 09/23/2009
Finally, someone has said it! It doesn't take an expert on polls to see that they are usually nonsense. I remember a major poll stating that "moral values" were the most important issue to Americans in 2004. The media used this finding to conclude that the religious right dominated politics. Never mind that as an atheist, I can say that "moral values" was my most important issue. For example, its important to have an antiwar president, and a president that supports vast majority that are working class over the corporations.
02:33 PM on 09/23/2009
Here's the thing. Not one single solitary poll concerning Health Care ever is, ever has been, or ever will be accurate.

Because not a single solitary poll ever conducted concerning health care has ever taken into account the people who actually use health care the most, the disabled and critically and chronically ill.

In my 36 years of life, in and out of hospitals and doctors visits and ER visits, not once have I ever seen, let alone been approached by a pollster asking about my satisfaction regarding my health care.

The one time I did receive a call asking about my satisfaction of my health care, the questioner only ever wanted to know about insurance. I told her flat out

"My insurance doesn't matter, cause I'm disabled whether I have insurance or not, and I'm terminally ill whether I have insurance or not"

She said "I'm sorry, Sir" and hung up on ME

True story
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HUFFPOST SUPER USER
LeftRight
TANSTAAFL
02:02 PM on 09/23/2009
Not to mention the fact that a small scale study was done, showing that opposition to the Obama plan before the speech was not really there. What the pollsters were asking was "Do you support the Obama plan?" and people were saying no.

When asked about specifics of the plan, more than 85% of people who responded LIKED the plan, they just knew that they didn't like "the Obama plan"....
01:39 PM on 09/23/2009
I think the media has an agenda to confuse people. Polls and stories could easily be better constructed to be informative. I think the dissembling is malice for its own sake.
12:27 PM on 09/23/2009
1) People are fed crap
2) People regurgitate crap
3) Republicans take regurgitation of crap as proof that people independently believe crap is good for you and eat it of their own free will, rather that being force fed.

Or.. something...