Online survey shows support for health premium

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This article was published 02/10/2017 (3083 days ago), so information in it may no longer be current.

Has Premier Brian Pallister waded into a political quagmire?

Preliminary results of an online survey about the introduction of a health care premium suggest Manitobans are deeply divided on the prospect, government sources confirm.

The survey, launched online in mid-September by the provincial government, immediately following Pallister’s stunning announcement that he was considering a new health tax, reveals a solid 40 per cent of Manitobans would endure cuts to existing health services to avoid having to pay any new any kind of premium.

Perhaps even more surprising, the sources said 40 per cent of respondents would gladly pay a “small” premium to avoid any cuts to services, and another 14 per cent were willing to pay a “large” premium to get enhanced services. That is a clear majority in favour of some level of health premium.

The survey results need to be viewed cautiously. Online polls are much less accurate than more scientific polls that sort and weigh respondents to ensure a representative sampling based on geography, gender, age, education and income level. This survey only records the responses of those who logged into the province’s online portal. As such, it’s impossible to ensure the results haven’t been tilted.

The survey could, for example, include a disproportionate number of older respondents who make more regular use of the health-care system. Or, it could be heavily weighted with the responses of people who work within the health-care system. It’s even possible that special interest groups — unions or anti-tax lobbyists — have flooded the survey.

The survey is also hilariously vague. Respondents were asked to pick between a “small” premium, a “large” premium and no premium. The survey does not try to define small and large, and includes only scant details of the premium paid by residents of British Columbia and Ontario, the only two provinces that currently charge a premium.

The survey suggests the maximum premium paid in other provinces is about $900 a year for a two-income family.

That is also a bit misleading, as in most instances the premiums are income tested, meaning some people pay much less while others pay nothing at all.

Mitigating these empirical shortcomings is the fact the province has received more than 10,000 responses in just two weeks.

In addition, there have been hundreds of other comments sent into the premier’s office by mail. That is an extraordinary result, and provides a sample much larger than weighted surveys which utilize about 1,000 respondents to gauge public opinion on any particular issue in Manitoba.

“The premier’s goal as to engage Manitobans in a conversation about health care and we believe we’ve succeeded in that,” one source said. “This is exactly what he had hoped for.” 

Maybe so, but if the results are taken at face value, it suggests that Pallister has taken on an issue fraught with political peril.

Successful politicians typically try and avoid getting involved in an issue where citizens are almost equally divided. This is largely because whatever decision you make, just as many people will be angered as pleased. That is not a recipe for a long and fruitful career in electoral politics.

Health premiums are a particularly risky issue for Pallister because Manitobans are almost naturally skeptical about the Progressive Conservative government on the issue of health care.

Much of the apprehension dates back to policies of the government of former premier Gary Filmon in the 1990s. While many of the allegations levelled against Filmon are of questionable veracity, he did cut health funding in a bid to balance the budget. Largely because of the legacy of the Filmon government, the issue of health care remains an Achilles heel for the Tories.

Pallister seems to be willing to ignore the baggage left to him by past Tory governments. Even so, there remains quite a bit of debate about how serious he is about introducing health premiums.

Some Tory insiders believe Pallister summoned the spectre of an additional tax is being to dull opposition to his government’s recent cuts to health services. The online survey results show that a solid minority of respondents preferred service cuts to paying more tax.

Others have theorized the health premium idea is evidence that the premier finally realized that he cannot cut his way to a balanced budget.

In his first two budgets, Pallister has focused solely on controlling expenditures. Unfortunately, that strategy has produced little progress on the deficit. In raising the prospect of a health premium, Pallister could be acknowledging for the first time that he believes higher taxes of some sort will be needed to balance the budget.

Government sources were adamant that Pallister wants the debate on health premiums to continue for the time being. That having been said, rumours are running rampant in political circles that he is not serious about proceeding with a health tax, and is looking for an opportunity to walk-back the idea with minimal muss and fuss. 

The only thing certain right now is that these survey results, on their own, should not be used to inform the premier’s final decision.

As noted above, the results are not an accurate representation of public sentiment. While the online survey could be used to conclude that the issue is divisive, it certainly would not be helpful in determining which option is the least unpopular.

Ultimately, Pallister would need a referendum to determine the public’s appetite for health premiums. And that raises the spectre of another possible political dilemma: current legislation only requires a non-binding referendum on proposals to increase income and retail sales taxes. Would Pallister try to skirt the spirit of that legislation by introducing a health premium without a plebiscite of some sort? The possibilities could make for an intriguing political drama.

History may very well show that it was foolish for Pallister, a die-hard fiscal conservative with an acute aversion to tax increases, to float the idea of a health premium when he had no serious intention to follow through. A bait-and-switch of that magnitude is quite likely to anger core Tory supporters, the kind of people who raise money for election war chests.

Whether he proceeds or not, Pallister has sparked a fascinating public debate about taxes, health care and fiscal priorities. All he has to do now is survive the final outcome.

dan.lett@freepress.mb.ca