Of those who could accept higher taxes to finance a new system, most are thinking of higher taxes on someone else. As the researchers explained, "The only options with majority support were those likely to impact the fewest people, in particular smokers and the wealthy."
Even among the uninsured, the enthusiasm for insurance is muted. When another Kaiser poll asked uninsured adults how much they would be willing to pay to get coverage, only 64 percent would fork out $100 a month and just 29 percent would pay $200. Given that most are not poor, why is it so important to provide the uninsured with something they don't value highly?
One way to bring down the cost of health insurance is to limit access to certain doctors, treatments and medicines. But the Kaiser/Harvard poll found most people are averse not only to paying more but also to anything that would "involve government limiting or dictating their choices."
Or anyone else, by the way. Most people have forgotten that in the 1980s, the private sector devised an ingenious way to reduce medical outlays. Known as managed care, it put modest restrictions on the freedom of patients to get care from specialists, limited hospital stays and gave doctors incentives to choose less costly therapies. It saved money, and it didn't appear to reduce the quality of care.
It was a perfect remedy, except for one thing: Patients and doctors hated it. Why? Because it kept them from behaving as though cost is no object.
So managed care is history. But the dilemmas it addressed are not.
One of these days, we'll have to address them, but not now. The administration would rather pretend we can get generous government-sponsored coverage for everyone without higher taxes, higher insurance premiums or rationing of health care. In short, it refuses to treat us like grownups. I wonder why.