Progressive Calendar 12.19.09
From: David Shove (shove001tc.umn.edu)
Date: Sat, 19 Dec 2009 04:20:25 -0800 (PST)
             P R O G R E S S I V E   C A L E N D A R   12.19.09

1. Peace walk        12.19 9am Cambridge MN
2. Hemsley home demo 12.19 10am
3. Homeless Latinos  12.19 10am
4. Book/bake sale    12.19 11am
5. Honduras          12.19 1pm
6. CUAPB             12.19 1:30pm
7. Northtown vigil   12.19 2pm
8. Venezuela         12.19 7pm
9. Pittsburgh G-20   12.19 9pm

10. Solstice         12.20 1pm
11. Stillwater vigil 12.20 1pm
12. MCRC party       12.20 2pm
13. Peace vigil      12.20 5:30pm
14. Peace walk       12.20 6pm RiverFalls WI

15. Kip Sullivan - Jacob Hacker's ambiguous polls  4/6

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From: Ken Reine <reine008 [at] umn.edu>
Subject: Peace walk 12.19 9am Cambridge MN

every Saturday 9AM to 9:35AM
Peace walk in Cambridge - start at Hwy 95 and Fern Street


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From: Roger Cuthbertson <rojo [at] visi.com>
Subject: Hemsley home demo 12.19 10am

This Saturday morning (tomorrow) at 10AM there will be a protest on the
ice of Lake Minnetonka in front of the $7.8 million stone mansion of
Stephen Hemsley.

Featured speakers will be Elizabeth Frost, MD, and Joel Albers,
Pharmacist.  Please come.  Dress warmly. Plan to hike .7 mi to the mansion
and .7 mi back on the ice.  Don't worry.  The ice is 6" thick. We will
walk pretty close to shore.  People are out on the ice fishing already.

Stephen Hemsley is the CEO of the largest health insurance company in the
United States, United Health Group, headquartered in Minnesota. Hemsley (I
am not going to say, earned) was paid a salary of $3.2 million in 2007,
which is nothing to sneeze at.  But his estimated $3/4 billion in stock
options in United Health Group nearly rivals the stunning figure of $1.6
billion of Hemsley's predecessor, William McGuire. McGuire left in scandal
after it was found out many of his stock options were improperly back
dated.  Now we find that Hemsley might have had something to do with back
dated stock options, too.

No wonder United Health Group's premiums are so high!  No wonder so many
people in this country cannot afford health insurance.  Who profits?  Who
dies?  Help us hold our 5 large banners that say, "DOWN WITH HEALTH
INSURANCE COMPANIES!", "SINGLE PAYER MED CARE FOR ALL!", "HEALTH IS A
HUMAN RIGHT!", and "HOME OF INS. BANDIT, S. HEMSLEY!"  Or, bring your own
sign or banner.

By 10AM we will be parked on Ferndale Road, West at the junction with
Shoreline Drive in Orono, just west of Wayzata, MN. For those who would
prefer an escort to this spot, some of us will meet at the Wayzata Beach
parking area, just a short block west of the depot in Downtown Wayzata at
9:45 and caravan to the Ferndale Rd/Shoreline Drive meeting place.

At 10 AM we will begin our hike.  Not far from the cars there is a place
where we can get on the lake where we will not be trespassing.  The
mansion will be easy to locate.  It is on Ferndale Road West, 6 houses
west of the outlet of Peavy Lake, which is just west of Lookout point on
the North Shore of Lake Minnetonka in Wayzata, near the border with Orono.
The total time for this protest will be 2 hours, including hiking time.

We hope you can join us. This event is sponsored by UHCAN-MN.ORG .  For
more information, call Roger Cuthbertson, 952-474-2476, or Elizabeth Frost
at 612-724-3995 or UHCAN-MN.ORG at 612-384-0973

More about this event from Elizabeth Frost:
Dear all:

I think most people can now see that health care reform has been hijacked
by the insurance and pharmaceutical industries to further their own agenda
- meaning profit.  In the past year the industry has spent something like
600,000 dollars per day in Washington, lobbying for their interests. This
is not OK.

This evening I was feeling depressed and dejected by all the bad new
coming out of the senate regarding health care reform (although I can't
say I am surprised by anything)  until I got a phone call from activist
Roger Cuthbertson.  He is taking matters into his own hands and protesting
the health care reform fiasco across the Twin Cities, including banner
dropping over highways.

This Saturday I plan to join him in trip to Lake Minnetonka to protest by
the mansion of America's greatest crook - United Health Group CEO Stephen
Hemsley.  We plan to bring banners and walk out onto the ice and spend an
our our two showing him how we feel about health care reform.

Please join us!  We will have banners available.  It will be from
approximately 10am-12pm.  Please let me know if you are interested!  I
plan to bring snacks and hot chocolate to help make it a good time. There
are ice fishermen on the ice already, and we plan to keep a legal
distance.  If not, please keep an eye on the evening news.

Questions?  Call me at (612) 724-3995
Elizabeth Frost


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From: Jason Stone <jason.stone [at] yahoo.com>
Subject: Homeless Latinos 12.19 10am

Coffee Hour: Homelessness in the Minneapolis Latino Community  - Dec. 19

Saturday, December 19th
10am-Noon
At the Resource Center of the Americas

ACTION ALERT: Please bring donations of gently used hats & gloves, NEW
thermal underwear, deodorant, and travel size shampoo.

A facilitated discussion on homelessness in Minneapolis and how it affects
the Latino community led by advocates from Simpson Men's Shelter. The
discussion will include a short video titled "The Land of 10,000 Homeless"
and information about services provided by Simpson Housing Services to the
Latino community in Hennepin County.

Guest speakers: Amanda Lube & Wendy Thomas from Simpson Housing Services
Guest speaker contact info:
alube [AT] simpsonhousing.org
wthomas [AT ] simpsonhousing.org
612-874-0306
Presented in English

The Resource Center will accept donations for Simpson Housing clients on:
    * Saturday 12/19 10am-Noon
    * Monday 12/21 8:30am-Noon
    * Wednesday 12/23 8:30am-Noon
    * Monday 12/28 8:30am-Noon
We are at 3019 Minnehaha Ave, Suite 20, 1/2 block south of Lake
Street. Park on the Minnehaha side of the building.


--------4 of 15--------

From: Eric Angell <eric-angell [at] riseup.net>
Subject: Book/bake sale 12.19 11am

Holiday sale and fundraiser--15% off everything in the store...20%
off for Friends of Arise!  [Not to celebrate the rampant commercialism of
the holiday season, but cuz we gotta keep our doors open somehow. So we're
gonna have fun doing it!]
Saturday & Sunday from 11am-9pm.

It gets better, though! On the 19th, we're also selling home-made baked
goods starting at 11am.
PLUS: music starting at 5 p.m. featuring Nikki Schultz, Heidi Barton
Stink, and Sorry OK.
PLUS: Women's Prison Book Project, which operates out of Arise!, will be
having a used book sale starting at 11 a.m. on the 19th.

Arise! Bookstore is an all-volunteer, collectively run bookstore,
infoshop, and resource center that has been serving the radical and
progressive communities of the Twin Cities since 1993.


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From: Women Against Military Madness <wamm [at] mtn.org>
Subject: Honduras 12.19 1pm

Panel on Resistance Struggle in Honduras
Saturday, December 19, 1:00 to 3:00 p.m. Mayday Books, 301 Cedar Avenue
South, Minneapolis.

Hands off Honduras will host a panel and discussion on the current
situation of the resistance against the coup d'etat in Honduras. As Manuel
Zelaya, the elected president had yet to be reinstated at the time of the
recent elections, the resistance movement in Honduras does not recognize
Porfirio "Pepe" Lobo as president and is calling for international
support. Hundreds demonstrated against the elections and refused to vote
despite military and police repression and negative economic consequences.
Come and hear about the continued resistance of the Honduran people
against the military coup, and the continued U.S. de facto support of the
coup regime.

Panelists will include Joe Shansky, Democracy Now en Espanol
correspondent; a representative of FMLN Minnesota and a member of the
Anti-War Committee. There will also be a Skype hook-up with a member of
the Resistance Front in Honduras who will give an up-to-the- minute report
on the resistance and will answer questions from the audience. Sponsored
by: U.S. Hands off Honduras Coalition. Endorsed by: WAMM. FFI: Call
612-702-5637 or visit http://hondurasfreedom.blogspot.com .


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From: Michelle Gross <mgresist [at] visi.com>
Subject: CUAPB 12.19 1:30pm

Meetings: Every Saturday at 1:30 p.m. at Walker Church, 3104 16th Avenue
South http://www.CUAPB.org

Communities United Against Police Brutality
3100 16th Avenue S
Minneapolis, MN 55407
Hotline 612-874-STOP (7867)


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From: Vanka485 [at] aol.com
Subject: Northtown vigil 12.19 2pm

Peace vigil at Northtown (Old Hwy 10 & University Av), every Saturday
2-3pm


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From: Becky Ellis <bellis48_205 [at] msn.com>
Subject: Venezuela 12.19 7pm

Behind record sales of Pathfinder books at the recent
Venezuela International Book Fair:
Growing interest worldwide in communist ideas

Hear: Maggie Trowe, who was part of the Pathfinder Press participation in
the book fair in Caracas, Venezuela last month

Thousands of people attended the Fifth Annual Venezuela International Book
Fair in Caracas last month. Pathfinder Press had a stand staffed by
communist workers from the United States and the United Kingdom, where
more than 2,000 books were sold, breaking previous records and
demonstrating the worldwide development of a layer of vanguard workers.
Come hear a participant in the book fair describe her experiences.

Saturday, December 19,
Dinner 7 p.m.    Program 8 p.m.
1311  E. Lake St., Minneapolis
Suggested donation: $5 dinner $5 program
For more information call 612-729-1205 or email
militant.labor.forum [at] gmail.com



--------9 of 15--------

From: Eric Angell <eric-angell [at] riseup.net>
Subject: Pittsburgh G-20/CTV 12.19 9pm

Minneapolis Television Network (MTN) viewers:
"Our World In Depth" cablecasts on MTN Channel 17 on Saturdays at 9pm and
Tuesdays at 8am, after DemocracyNow!  Households with basic cable may
watch.

Saturday, 12/19, 9pm and Tues, 12/22, 8am
"National Special Security Events and Independent Media"
Footage from and analysis of recent National Special Security Events
including the G-20 in Pittsburgh. Interview of Pittsburgh and Twin Cities
Indymedia journalists.


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From: Sue Ann <seasnun [at] gmail.com>
Subject: Solstice 12.20 1pm

Celebrate Winter Solstice at Sacred Coldwater Spring
Sunday, December 20, 2009 at 1 PM

Ritual: an active rite including altar building with found materials and
tying down the sun (an old Scandinavian custom so the sun will not go
farther away) Dress: for outside Bring: (optional) a gift for the land
(sage, flowers, tobacco), a chair, wood for the fire

[Could we tie down the government so it would not go even further away
from service to the people? Harder than to tie down the sun, we know. -ed]

Directions: Coldwater is south of Minnehaha Park, in Minneapolis. From Hwy
55/Hiawatha, turn East (toward the Mississippi) at 54th Street, take an
immediate right, & drive South on the frontage road for -mile past the
parking meters, through the cul-de-sac & the gates, & past the abandoned
buildings. Follow the curvy road left & then right down to the pond, next
to the great willow tree. Info: www.friendsofcoldwater.org


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From: scot b <earthmannow [at] comcast.net>
Subject: Stillwater vigil 12.20 1pm

A weekly Vigil for Peace Every Sunday, at the Stillwater bridge from 1- 2
p.m.  Come after Church or after brunch ! All are invited to join in song
and witness to the human desire for peace in our world. Signs need to be
positive.  Sponsored by the St. Croix Valley Peacemakers.

If you have a United Nations flag or a United States flag please bring it.
Be sure to dress for the weather . For more information go to
<http://www.stcroixvalleypeacemakers.com/>http://www.stcroixvalleypeacemakers.com/

For more information you could call 651 275 0247 or 651 999 - 9560


--------12 of 15--------

From: Nik <kreuzauge [at] gmail.com>
Subject: MCRC party 12.20 2pm

This Sunday, December 20th, is MCRC's 2nd annual Holiday Party at the MCRC
headquarters. 2-7pm. There'll be food, beverages, prizes, and lots of
holiday cheer! Bring a dessert to share if you want to, donations are
always welcome, but mostly just come and celebrate the resurgence the
Republican Party and conservatism in Minneapolis! [United in trying to
sweep out the corrupt power-mad Mpls city council/mayor/hacks. -ed]

800 North 3rd Street
Minneapolis, MN (one block south of Washington Ave.).
Ample on-street parking is available.
Map:
http://maps.ask.com/maps?a=&a1=800+N+3rd+St&a2=Minneapolis&a3=Minnesota&a4=&btnGetMap=Get+Map&qsrc=106&q=


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From: Women Against Military Madness <wamm [at] mtn.org>
Subject: Peace vigil 12.20 5:30pm

Winter Solstice Peace Vigil

Sunday, December 20, 5:30 to 6:30 p.m. Corner of Summit and Snelling
Avenues, St. Paul. Bring a candle and join neighbors from throughout the
Twin Cities to quietly witness for peaceful solutions to world problems.
After the vigil, warm up and socialize at a local Grand Avenue restaurant
or coffee shop. Sponsored by: Merriam Park Neighbors for Peace. Endorsed
by: WAMM. FFI: Call 641-641-7592 or email infor [at] mppeace.org .


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From: Nancy Holden <d.n.holden [at] comcast.net>
Subject: Peace walk 12.20 6pm RiverFalls WI

River Falls Peace and Justice Walkers. We meet every Monday from 6-7 pm on
the UWRF campus at Cascade Ave. and 2nd Street, immediately across from
"Journey" House. We walk through the downtown of River Falls. Contact:
d.n.holden [at] comcast.net. Douglas H Holden 1004 Morgan Road River Falls,
Wisconsin 54022


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Two-thirds of Americans support Medicare-for-all (#4 of 6)
Jacob Hacker's ambiguous polls
By Kip Sullivan, JD

In Part 2 and Part 3 of this series I reviewed rigorous evidence from
multiple sources supporting the statement that somewhere between 60 and 80
percent of Americans support a Medicare-for-all system. A reasonably
conservative averaging of the more rigorously conducted research I
reviewed - the citizen jury results and the results of polls that asked
accurate and relatively informative questions - indicates two-thirds of
Americans support a single-payer or Medicare-for-all system.

In this part and in Part 5, I will examine the basis for the claim by
representatives of the "public option" movement that only a minority of
Americans support single-payer and a majority are opposed. The basis for
that claim consists primarily of several papers written by Jacob Hacker
and "research" done for the Herndon Alliance by pollster Celinda Lake.
Until about two years ago, Hacker wrote about health policy primarily for
the academic community; since then he has published frequently in the lay
media. Since its formation in 2005, the Herndon Alliance has sought to
create "research" that could be used to persuade the public, especially
legislators and political activists, that single-payer should be taken off
the table and the "public option" should be put on the table. I review
Hacker's work in this paper and Celinda Lake.s in Part 5.

               Expediency-driven health policy

It may sound sacrilegious to say this, but the greatest lesson of the
failure of the Clinton health plan is that reformers pay too much
attention to policy and too little to politics. If real estate is about
location, location, location, health reform is about politics, politics,
politics.

Thus spake Jacob Hacker in a paper published in Health Affairs in 2008
entitled, "Putting politics first". Hacker argues that anyone who wants to
achieve universal health insurance must somehow separate "politics" from
"policy" and give highest priority to politics. If Hacker had merely said
that anyone who seeks to achieve universal health insurance should devote
resources to building public pressure for it, his statement would be
incontrovertible. It would be a truism. But Hacker's "politics, politics,
politics" statement went beyond the truism that "reformers" must build a
movement for universal health insurance.

Hacker's demand that we distinguish between politics and policy and give
high value to one and low value to the other is nonsensical. It's
equivalent to saying that process is separate from and matters more than
outcome, or that means are separate from and matter more than ends. To
make such a distinction amounts to an endorsement of opportunism and
expediency. We will see in the remainder of this article that in fact
that's where Hacker's "put politics first" mantra leads him. It leads him
to attribute to the public anti-single-payer, pro-insurance-industry
attitudes based on polling data that are so abstract they offer no
guidance at all. As the events of 2009 have demonstrated, the exaltation
of expediency - dressed up as political science - produces neither good
policy nor good political strategy.

Unlike the Herndon Alliance, which commissioned its own polling and focus
group "research," Hacker relied on existing polling data to support his
conclusion that single-payer is not feasible while the "public option" is.
Hacker cites different types of polls depending on whether he is
addressing the general public or health policy experts. His 2006 article
for Slate cited one set of polls. A 2007 paper that he co-authored with
Mark Schlesinger ("Secret weapon: The 'new' Medicare as a route to health
security," Journal of Health Politics, Policy and Law 2007;32:247-291)
cited another set of polls. Inexplicably, neither paper discussed the
Jefferson Center jury results I discussed in Part 2 nor the polls showing
large majorities for single-payer that I discussed in Part 3 of this
series.

In the course of examining these two papers, I will review in detail seven
polls that Hacker cites. This may get tedious, but it's important that you
see for yourself how nebulous Hacker's "evidence" is. Once you behold
Hacker's "evidence" directly, you realize that Hacker's belief that
Americans oppose single-payer is based entirely on polling results that
resemble a Rorschach ink blot. You can see in them what you want to see.
Where you and I might discern a public ready to support single-payer,
Hacker discovers hulking impediments to single-payer.

             Polls Hacker cited in his Slate article

Hacker's article for Slate bore the condescending title, "Better medicine:
Fixing the left's health care prescription". The problem in need of
"fixing," according to Hacker, was "the left's" support for single-payer.
Hacker urged "the left" to support instead his proposal to "give employers
the option of providing" coverage to their workers through a new public
program modeled after Medicare. or through the insurance industry, a
proposal that would, by 2009, be called "the public option" for short.

Hacker grudgingly acknowledged single-payer's advantages, but then claimed
single-payer advocates were "biting off too much".

Americans like Medicare, and yes, Medicare is easy to explain. But that
doesn't mean most people are ready to say everyone should be covered by
Medicare. Many of us remain stubbornly attached to employment-based health
insurance, and proposing to abolish it entirely is likely to stir up fear
as well as gratitude.

He hyperlinked the words "stubbornly attached" to an article in Mother
Jones written by the Century Foundation. (In the fullness of time, the
Century Foundation became a passionate advocate for the "public option".)
The Century Foundation article reviewed several polls on American
attitudes about "universal coverage". Amazingly, one of them was the 2003
Washington Post/ABC News poll showing 62 percent support for a
Medicare-for-all system that I discussed in Part 3. Does Hacker read the
documents he cites as evidence for his own claims?

Before we examine the Century Foundation's article, I want call your
attention to three features of Hacker's argument.

First, he practices "put politics first". He says that even though
single-payer is a good proposal, it should be rejected entirely. It would
be one thing to counsel single-payer advocates against trying to get a
full-blown single-payer system enacted in a single session of Congress and
to plan instead for a multi-year campaign (which is fact what the
single-payer movement has been doing for two decades). But Hacker is not
doing that. He is urging progressives to reject single-payer completely.

Note second that Hacker urges us to accept whatever polls say as the final
arbiter of what is politically feasible. Hacker has no interest in a very
obvious question: If everyone who supports universal coverage threw their
weight behind the campaign for single-payer, how much higher could public
support for single-payer be raised?

Third, Hacker can't bring himself to say how many Americans are
"stubbornly attached" to employer-based health insurance. He can only
bring himself to say "many". If Hacker is going to rest his entire
argument that the "left" should abandon single-payer on the premise that
"we" are "attached" to the current system, why is he so vague about what
proportion of the populace he is talking about?

I urge readers to examine the Century Foundation article for yourself.
Focus on the "What we know" section (it's only a page long), which is
where the poll results are discussed. It will become obvious quickly that
this article provides no basis at all for Hacker's claim that Americans
are "stubbornly attached" to the current system. At most, only three
paragraphs have any relevance to that claim, and these paragraphs produce
results that are at best ambiguous and at worst (from Hacker's point of
view) supportive of single-payer.

Consider the two excerpts from the Century Foundation summary I quote
below. The first asserts the public wants to replace "the current
employer-based system" (yes, the very same "employment-based" system to
which Hacker says "many of us remain stubbornly attached"). The second
excerpt, which appears barely a half-page later, asserts just the
opposite.

[Excerpt 1]
The public wants the government to play a leading role in providing health
care for all. For example, in an October, 2003 Washington Post/ABC poll,
by almost a two-to-one margin (62 percent to 33 percent), Americans said
that they preferred a universal system that would provide coverage to
everyone under a government program, as opposed to the current
employer-based system.

[Excerpt 2]
The public generally wants to build on, rather than eliminate, the current
employer-based private health insurance system. In a January, 2000 Kaiser
poll, they preferred building on the current system to switching to a
system of individual responsibility (54 percent to 39 percent) and in a
November 2003 Kaiser poll, they preferred keeping the current system to
replacing it with a government-run system (57 percent to 38 percent).
(emphasis added)

How does one make any sense of these conflicting statements? How does
Hacker find in these statements proof that Americans (a) like the current
employer-based system, and (b) like it so much they would oppose a
single-payer system? In these excerpts, the author of this summary, Ruy
Teixeira, gives us not only two contradictory statements to sort out (the
public does and does not want to replace the "current employer-based
system"), but we're supposed to understand what "a system of individual
responsibility" and "a government-run system" means.

If we track down the polls these excerpts refer to, we discover that we
have already encountered these polls, or polls like them, in Part 3 of
this series.

I discussed in Part 3 of this series the 2003 Washington Post/ABC poll
that Teixeira cites in the first excerpt. That poll found 62 percent
support for a single-payer system, described in that poll as "a universal
health insurance program, in which everyone is covered under a program
like Medicare that's run by the government and financed by taxpayers". So
how does Teixeira account for the difference between the 62 percent
support for single-payer he reports in the first excerpt and the 38
percent level of support one or both of two Kaiser polls (Teixeira isn't
clear which) reported for a "government-run system" in the second excerpt?
He doesn't say.

The Kaiser poll search engine (using the phrases "individual
responsibility" and "government run") and a Google search turned up only
one of the two Kaiser polls Teixeira refers to in excerpt 2 above - the
January 2000 poll. That poll, which Teixiera cited as evidence that
Americans prefer "the current system" to a "system of individual
responsibility," reads as follows:

Which of the following, option one or option two, do you think would be
the better way to guarantee health insurance coverage for Americans?
Option One is, building on the current system in which employers
contribute to their employees' health insurance, which they get through
their job, and the Government covers the cost of insurance for the poor
and unemployed, or Option Two which is, switching to a system in which all
individuals would buy their own health insurance but would receive a tax
credit or subsidy to help them with the cost of the plan.

Fifty-four percent chose "the current system" versus 39 percent who chose
what Teixeira called "a system of individual responsibility".

In my last installment I discussed polls quite similar to the other (2003)
Kaiser poll Teixeira cited (the one my search failed to turn up), a poll
which, according to Teixeira, asked respondents to choose between "the
current system" and "a government-run system". The ominous phrase
"government-run system" sounds very much like the frightening phrase
"government-run health care system" conjured by the Gallup poll (discussed
in Part 3). The 38-percent level of support Teixeira reports is within the
range of Gallup poll results over the last decade - 32 to 41 percent -
that I reported. This strengthens my hypothesis that the question Teixeira
claims Kaiser asked in 2003 was very similar to the Gallup question. (It
would help if people who urge readers to rely on polls for any reason
would link readers to those polls or give more precise source
information.)

The only other shred of information in the Century Foundation article that
might give a "yes but" comfort was this excerpt, which again contained
contradictory statements:

In a December 2003 Harvard School of Public Health/Robert Wood Johnson/ICR
poll, 80 percent supported expanding Medicaid/SCHIP; 76 percent supported
employers being required to offer a health plan; and 71 percent supported
a tax credit plan. Trailing these options, but still garnering majority
support, were a universal Medicare plan (55 percent) and an individual
coverage mandate plan (54 percent). .. (Note: one of the only options that
didn't garner majority support - was a single or national health plan
financed by tax payers that would provide insurance for all Americans [37
percent to 47 percent].)

Once again, Teixeira juxtaposes a poll showing majority support for
single-payer (55 percent) with another poll showing 37 percent support,
and offers no explanation for the difference. As you can see, the two
single-payer questions Teixeira refers to appear to have been part of a
line-up of another half-dozen questions or so, including questions about
proposals that wouldn't come close to achieving universal coverage and
none of which would cut costs.

To sum up, the Century Foundation article Hacker linked his readers to for
evidence of our "stubborn attachment" to the current system demonstrated
nothing of the sort.

             Polls Hacker relies on in his 2007 paper

In the paper he published in the Journal of Health Politics, Policy and
Law in 2007 with Mark Schlesinger, Hacker argued for the "public option"
and against single-payer. As he did in his Slate paper, Hacker argued that
the "expectations" and "values" of the American people, not the insurance
industry, constitute an intractable obstacle to single-payer. At the
outset of this paper, in a section entitled, "Prevailing American values
as barriers to universal health insurance," Hacker sought to make two
arguments: Americans value choice of health insurance company, and they
are scared of their government. The data he relied on to make this case
were even more abstract and ambiguous than the data he relied on in his
Slate article. I'll review the evidence he cites for his claim that
Americans value choice among insurance companies first, and then examine
the data he cites for his claim that Americans are afraid of a
single-payer system.

Hacker's argument that Americans value choice of health insurer (as
opposed to provider) consisted almost entirely of these statements:

During the debate over health reform in the early 1990s, 81 percent of the
public reported that it was important or essential for a proposal to give
"people a choice of different types of health insurance plans" (Louis
Harris and Associates in 1994). When asked whether "seniors should have
the option of picking a private health plan approved by the Medicare
program to provide their health benefits," 82 percent of the public
endorsed these choices (Zogby International 2003). Americans embrace
choice of insurance not because they favor markets in health care per se
but because they have so little trust in government, employers, or private
insurance and want protection against problematic experiences (Blendon et
al. 1998; Jacobs and Shapiro 1999).

Neither of the two polls and neither of the two papers Hacker cites
support his conclusions. The papers deal exclusively with the backlash
against managed care that occurred in the late 1990s. Those papers say
nothing that could be construed as evidence that Americans "embrace choice
of insurance" and have "little trust in government". To give you some idea
of how badly Hacker misinterpreted these papers, I have presented the
abstract of the paper by Blendon et al. in the appendix to this paper (the
Jacobs and Shapiro paper did not contain an abstract).

Now let's look at the two polls Hacker cited to support his claim that
Americans value choice of insurance company. The 1994 Harris poll posed
this question:

As the Congress debates health care reform, they must consider several
different goals. Please say for each of the following whether you think it
is absolutely essential, very important, or not important .. Giving people
a choice of different types of health insurance plans?

Thirty-six percent said "choice of" plans was "absolutely essential" and
45 percent said it was "very important". But does this poll demonstrate
that Americans value choice of insurance company?

This poll was conducted during May 23 to 26, 1994, while the debate over
the Clinton bill - a bill which would have pushed middle- and lower-income
people into HMOs and other tightly managed health insurance companies -
was still in full swing. The poll question deliberately asked respondents
to think about the current debate in Congress and the "goals" that
"Congress must consider". The context in which this poll question was
asked, and the opening statement to the question, must have induced all or
most respondents to think they were being asked whether they would approve
of Congress reducing their choice of insurance companies. It is not
surprising they said no to this question. But saying no cannot be
construed as "attachment" to the current system, and certainly not
opposition to Medicare-for-all. Hacker's claim to the contrary is
equivalent to saying prisoners in a gulag are "stubbornly attached" to
gulag food because they told a pollster they would object to being given
less of it. (This question and the responses were emailed to me by the
Roper Center for Public Opinion Research at the University of
Connecticut.)

The other poll Hacker refers to - a Zogby poll - misled respondents. The
poll, conducted June 18-21 2003, asked if "seniors should have the option
of picking a private health plan approved by the Medicare program to
provide their health benefits". But the poll failed to ask respondents if
they would feel the same way if they knew that allowing insurance
companies to insure Medicare beneficiaries raises the cost of the entire
Medicare program. This is a very well documented fact; every expert knows
it to be true. Even Hacker and Schlesinger acknowledged it. How far
support would have fallen had respondents been informed that their taxes
would have to go up to give seniors the privilege of leaving the
traditional Medicare program and enrolling with an insurance company? We
don't know. Zogby didn't ask, possibly because the conservative Galen
Institute was the sponsor of the poll.

Now for Hacker's and Schlesinger's claim that Americans are afraid of a
government-financed single-payer. This claim relied primarily on two polls
conducted over several decades: the "General Social Survey," conducted by
the University of Chicago, and the "National Election Studies" survey
conducted by the University of Michigan.

Hacker and Schlesinger claimed the General Social Survey supported the
following baffling statement:

"[W]hile approximately 80 percent of the public endorses some collective
responsibility for health care finance, support for a completely
collective role rarely garners majority support and, if so, then for only
brief periods of time (see Figure 1)" (page 252).

What does "some collective responsibility" mean? How does it differ from
"complete collective responsibility"? The latter seems to mean government
pays for 100 percent of the national health care bill. But no country in
the entire world does that. What does "health care finance" refer to?
Universal coverage? Less-than-universal coverage? A single-payer system?
The current multiple-payer system?

The figure Hacker and Schlesinger refer to as evidence for this baffling
statement is a bar chart, based on the General Social Survey, showing bars
for various years broken down by the proportion of the populace who
support "collective," "individual," and "split responsibility for medical
care". The figure indicates that from 1975 through 2000 roughly 50 percent
of Americans supported "collective responsibility," 30 percent supported
"split responsibility," and 20 percent supported "individual
responsibility". How any reasonable person can conclude from these data
that Americans oppose single-payer because they fear government and value
choice of health insurance company is beyond me. If we really must ask
whether such ambiguous data dictate that we abandon or support a
Medicare-for-all system, it would seem more reasonable to interpret these
data to say a majority of the public will support Medicare-for-all.

To enhance your impression of how flimsy this bar chart is, consider the
actual question asked by the GSS survey:

In general, some people think that it is the responsibility of the
government in Washington to see to it that people have help in paying for
doctors and hospital bills. Others think that these matters are not the
responsibility of the federal government and that people should take care
of these things themselves. Where would you place yourself on this scale
[respondents were handed a card showing numbers running horizontally from
1 to 5], or haven't you made up your mind on this?

Above number 1 on the card is the label, "I strongly agree it is the
responsibility of government to help" and above number 5 is the label, "I
strongly agree people should take care of themselves".

Similarly, Hacker and Schlesinger use data from the National Election
Studies survey that is at best ambiguous and at worst (from Hacker's point
of view) favorable to single-payer to spin a picture of Americans so
"deeply divided" about the role of government that single-payer isn't
possible. They claim that a single question from this survey supports the
following conclusions:

"Americans have long been deeply divided about their preferred approach to
expanding health insurance... Americans - split evenly between those who
favor administration of insurance benefits by the government and those who
prefer subsidies for private insurers (table 2). (page 255).

The table they refer to shows that over the last half century roughly 45
percent favor "government insurance" versus about 40 percent for "private
insurance". Here is the question:

Some people feel there should be a government insurance plan which would
cover all medical and hospital expenses for everyone. Others feel that all
medical expenses should be paid by individuals, and through private
insurance plans like Blue Cross and some other company paid plans. Where
would you place yourself on [a seven-point] scale.. ?

There was, of course, no other information to help respondents interpret
the key phrases in this question including "government insurance plan".
Respondents had to rank themselves as a "1" if they were strongly in favor
of a "government insurance plan" that paid all expenses for everyone, and
7 if they felt strongly in favor of "individuals and private insurance
plans" paying some unspecified portion of expenses, or some number in
between if they felt less than strongly about their opinion. Hacker and
Schlesinger treated everyone who ranked themselves as a 4 as undecided,
and then treated all the 1, 2, and 3 people as for "government" and all
the 5, 6, and 7 people as for "private insurance".

Summary

Even if we didn't know that Hacker was an avid proponent of the "politics,
politics, politics" mantra, and that this mantra amounts to little more
than an excuse to make policy decisions based upon ambiguous and
cherry-picked polling data, we might reach these conclusions simply by
reading the two papers by Hacker I have reviewed here. In his 2006 article
for Slate, and his 2007 paper for the Journal of Health Politics, Policy
and Law, Hacker urged his readers to abandon single-payer based on poll
results that were not merely cherry-picked (with one unintended exception
he excluded polls that showed two-thirds support for single-payer), but,
even after careful cherry-picking, were still unclear in their
implications.

I am not saying polling data reveal that only a single-payer system
attracts majority support. A fair reading of the polls (although not the
citizen jury results) suggests that Americans would accept a variety of
solutions to the health care crisis if they could be convinced that they
would cover everyone and bring costs down.

I strongly disagree with Hacker, however, that the polling data
demonstrates a majority wants to defend the current employer-based
multiple-payer system and oppose a single-payer system. And I strongly
disagree with the assumption that people who care about solving the health
care crisis should examine polls first and then decide how to solve the
health care crisis. If we must put our finger in the wind before we decide
whether to support single-payer, then let us at least consult research
that used rigorous methodology, e.g., the citizen juries, and polls that
inform their respondents about actual proposals. Let us not consult polls
that use vague phrases like .people should take care of these things
themselves..

~~~~~~~~~~~~~~~~~~
Appendix: Abstract of one of two papers Hacker misrepresented

In his paper with Mark Schlesinger published in the Journal of Health
Politics, Policy and Law in 2007, Hacker cited two papers for support of
this sentence: "Americans embrace choice of insurance not because they
favor markets in health care per se but because they have so little trust
in government, employers, or private insurance and want protection against
problematic experiences". Neither paper discussed lack of trust in
government or employers. Both papers were about public hostility to the
insurance industry. Below I present the abstract of one of the two papers
(there was no abstract for the second one).

This paper examines the depth and breadth of the public backlash against
managed care and the reasons for it. We conclude that the backlash is real
and influenced by at least two principal factors: (1) A significant
proportion of Americans report problems with managed care plans; and (2)
the public perceives threatening and dramatic events in managed care that
have been experienced by just a few. In addition, public concern is driven
by fear that regardless of how well their plans perform today, care might
not be available or paid for when they are very sick. (Robert Blendon et
al., .Understanding the managed care backlash,. Health Affairs
1998;17(4):80-94))

Stay tuned for Part 5: Celinda Lake's "research" for the Herndon Alliance


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