Debate must be refocused on health care, not health insurance.

President Obama may have secured reelection from the American people, but that doesn’t mean that they support his view that the federal government should have its hand in ensuring that all of its citizens have health insurance.

The Gallup poll indicates 54% of Americans believe guaranteed healthcare coverage is not the government’s responsibility while 44% believe it is – the first time since 2000 the Gallup poll trend has shown a majority of Americans feel the government should not be responsible for providing healthcare insurance coverage for all Americans.

Before 2009, a plurality of Americans believed the government should make sure all Americans have healthcare coverage but since then Americans have wavered in their support of the idea of government-guaranteed healthcare.

Whether this is simply an intuitive belief Americans hold or a reaction to reality as more and more provisions of Obamacare are implemented, it is not without sound reasoning.

In October, an article appeared in Forbes written by Avik Roy entitled, “Why Health Insurance is Not the Same Thing as Health Care.” It is a very informative read and I recommend reading it in its entirety.

The point which I would like to highlight here, however, is this. Government sponsored health care, such as Medicaid, has little impact on preventative care or rates of survival for the previously uninsured. [Emphasis added]

Just because you have a piece of paper that says you have “health insurance” doesn’t mean that you can see a doctor when you need to.

There are three major forms of health insurance in America: Medicare, our government-sponsored program for the elderly; Medicaid, our government-sponsored program for the poor; and private insurance for most everyone else. As I have described extensively on this blog, it’s much harder to get a doctor’s appointment if you’re on Medicaid than if you have private insurance, because Medicaid pays doctors so little that doctors can’t afford to see Medicaid patients. This, in turn, leads patients on Medicaid that are at best no different than being uninsured, and in many cases even worse.

Its not just access to preventative care that sees little improvement under government insurance. Survival rates are also only nominally improved.

To illustrate this, Roy shares this chart, obtained from Obama advisor Ezekiel Emanuel which deals with cancer survival rates in America for those having varying levels and types of health insurance.

In many respects, having government sponsored insurance such as Medicaid is of little or no improvement to those who were previously uninsured.

Roy argues that Obamacare, for all its intentions otherwise, only exacerbates this issue.

This, then, is the fundamental problem with Obamacare. It expands coverage, in large part, by pouring trillions of dollars into the Medicaid program, without making any meaningful improvements to the way that program is structured. And Scott Gottlieb and Tom Miller, of the American Enterprise Institute, fear that Obamacare’s private insurance exchanges will also suffer from poor quality and poor access, just like Medicaid.

The proper goal, then, is not merely to expand coverage out of some obsession with an arbitrary statistic, but rather to do what we can to make it easier for Americans to buy high-quality, private insurance.

The afformentioned Gallup poll suggests that Americans, broadly speaking, understand and agree with this conclusion.

The question is, can we refocus the American health care debate on health care, rather than health insurance, before it is too late?