Friday, October 27, 2006

Good News: Redux

We've had an overwhelming response to Bob's post (well over 100 comments), and for that we're most grateful to our talented and insightful IB readers.
One particularly industrious poster, John Fembup, has gone beyond the call, and analyzed both the survey we posted and its 2004 predecessor. Originally posted in the aforementioned comments section, John has graciously consented to post his analysis on the front page:
So now there are TWO Kaiser Family Foundation surveys on the table, one from 2004 and one from 2006. BTW, here is a link to the actual 2004 Kaiser survey.
At the risk of triggering another 100 comments [ed: fine with us!], here is what I’ve read so far.
1. The 2004 KFF survey reports people’s responses about quality across the US, and it also reports their responses about the quality of their OWN health care. These responses differ significantly. That is an obvious disconnect. Does the abc news summary mention that disconnect? No.
The percentage of people who reported in 2004 they were dissatisfied with their own health care is shown on page 15 of the 2004 survey, split by ethnic group. Note for backs and whites, the dissatisfaction with "own care" is very significantly LESS than the answer respondents gave for the nation as a whole. This is the identical pattern reported by KFF in 2006. [That is not the case for the 2004 latino sample which suggests an important area for further research; I don't yet find any mention in the KFF report] These difference constituted a huge disconnect in the 2006 KFF survey. The same disconnect was reported in the 2004 survey.
2. The 2004 KFF survey reported that "Four in ten say the quality of health care has 'gotten worse' in the past five years" [since 1999] and the same survey also reports "When asked in an open ended question to name the most important factor in determining the quality of health care patients receive, there is no general consensus"
So the survey reported .. . what, exactly? That people who don’t agree on what quality is, nevertheless believe that whatever it was had declined sharply over the prior 5 years? And where would they get that idea? From their OWN care? From personal knowledge? Clearly Not. (page 15 again). From where then? I think from the uninformative – worse, misleading - media reporting on health care.
3. Page 9 includes this:
"After being read the following definition of a serious medical error: 'Sometimes when people are ill and receive medical care, mistakes are made that result in serious harm, such as death, disability, or additional or prolonged treatment. These are called medical errors. Some of these errors are preventable, while others may not be.' About one in three say that they have experienced a medical error in their own care"
In politics, this technique is known as "push-polling" and is considered unethical because the interviewer influences the response in a particular direction. In this case the interviewer prompts the reporting of an error. It is hard to avoid suspecting that the pollsters were pushing for answers that included reports of errors and worries about quality. That is a newsy result. But how truthful?
Having read the first 20 pages of the 2004 survey, I am now going to watch the world series. So far, I would say the most significant findings in 2004 were:
1. People were much more satisfied with their own care and costs than they thought other people were. This is the same finding as reported in the 2006 Kaiser survey. It is also consistent with findings from health care polling that I have seen since the 1970’s. I still think this disconnect results from the continual, breathless media reporting of a "crisis" in US health care.
2. People were surprisingly ignorant about health care and the cost of health care. When asked to rank quality factors by importance, they tend to rank in reverse order – this is true for both the 2004 and 2006 polls. Why would this be? Again, I think this reflects what people think they know, and what they think they know reflects the faulty media coverage of health care.
3. By 2004, people were beginning to use the internet to obtain health care information. This received almost no attention in the 2004 survey – just a small remark. But I think this was the appearance of a very important trend, because information is power. "Info to the people!"
So far I have not found information that contradicts the 2006 Kaiser survey. There ARE however contradictory statements in the abc news summary of the 2004 survey. The abc summary is skewed by its failure to point out any of the above findings. I think that the skewed abc news summary supports the point I’ve been making about the media having bungled the reporting of health care over the past several decades.
Thanks, John!
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