We would like to address the second statement that a sample from an online panel can be made “non-random” due to the non-coverage issues. If the non-coverage argument is considered the standard, it would then follow that telephone-based samples would be non-probability samples, because their coverage is also not perfect and therefore has to be compensated by weighting the data. Increasing issues with non-coverage and self-selection due to caller id, do not call lists, and mobile phones replacing landlines across all demographic groups, make a principled distinction between these two methods more difficult to draw.

Zogby International is not suggesting that we throw all caution to the wind and call every convenience sample “probability sampling”. We do suggest that we in the industry recognize the shortcomings that exist currently in all facets of market research, whether face-to-face, mailing, telephone or Internet.

AAPOR does call attention, however, to the inappropriate reporting of a margin of error for a non-probability sample. Samples from online panels, due to coverage and self-selection issues, are non-probability samples. Non-probability samples do not have underlying sampling distributions. The concept of sampling error or margin of error therefore does not apply. When using non-probability samples, researchers should not claim or imply representativeness of a broader population with any known statistical evidence or confidence.

Unfortunately, there is a great gulf of misunderstanding separating public opinion and the multitude of factual information and misinformation swirling around this issue. In an elected representative system such as ours public opinion is important, but history has many examples of public opinion being wrong, sometimes seriously wrong with bad consequences, regarding many issues. I can think of several but as a child of the Sixties the Vietnam conflict and Civil Rights movement come immediately to mind.

I’m only a layman, but over the last year or two I have done a lot of homework about health care reform and have posted endlessly about the subject at two different blogs, most recently at Newshoggers. Not to put too fine a point on it, what I have found is an incredible level of ignorance, arrogance and deliberate deception on the part of many players. I will charitably allow that many are innocent but it is abundantly clear that the really big movers of public opinion are backed by vast sums of money and more conflicts of interest than anyone wants to think about. And yes, that includes many of our elected representatives as well as a large group of medical professionals as well.

Phrases such as government-run health care, affordable coverage, cutting doctor payments, or taxes on high earners may seem innocuous but are already prejudicial in the very language. These terms predispose the person being interviewed in an already negative direction. There is already confusion enough without polls that muddy the water further. The same people who are satisfied with Medicare and Social Security for some reason cringe at the notion of “government interference” in anything. And it is a common belief that both Medicare and Social Security are “going broke.”

My guess is that nine out of ten people could not describe the difference between Medicare and Medicaid and in most conversations no one seems to mention that it is payroll taxes, not income taxes that support Medicare and Social Security. (One of the best-kept secrets in the country is the cap on Social Security “contributions” because the majority of working people take it for granted that everyone is taxed just as they are no matter how much they make. I know better because I paid the max into the system in the food business over twenty years but everyone working around me never made that much.)

Just this morning I came across a string of words and phrases relevant to the discussion all with important meanings, and most of which rarely, if ever, appear in everyday reports either in print or the broadcast media….
# Universal Coverage
# Single-payer System
# Insurance Reform
# Play or Pay
# Individual Mandate
# Insurance Exchange
# Guaranteed Issue
# Community Rating
# Payment Reform
# Medical Home
# Bundled Care
# Accountable Care Organizations
# Medicare Sustainable Growth Rate and Geographic Disparities
# Independent Medicare Advisory Commission
# Public Option
# Health Care Cooperatives

I don’t want to take anything from the hard work represented by this post, but please don’t let the vast gulf of public ignorance be the deciding variable in whether or not health care reform is needed. It is needed more now than at any time in our lifetime.

My personal opinion is that the burden of the costs is about to be shifted to the states in the form of enhanced Medicaid, allowing the federal dollars to continue flowing into national coffers to be spent (as usual) for other appropriations less likely to get much concentrated public attention (except in an abstract way, like waving the flag for wars or, in the case of a health care issue, funding the NIH which used to be doing research for the public domain but which now sells their discoveries at wholesale to be patented and sold for profit by drug cartels before they get to the public domain stage.)

There is much more to be said, but I think this is enough for one comment. Thanks for the forum. I have a high opinion of Health Affairs Journal and have linked here several times since I found it.