We write just about every day on what the experts think about health reform, and we've also highlighted the Kaiser Family Foundation polling on what the public thinks about the health care system. Now Kaiser CEO, Drew Altman, takes a useful look at the gaps between the two views—and reminds us why political leaders will have to address that gap if they want to maintain, or build, public support for health reform and the hard choices it entails. For starters, experts say with increasing certainty that less is more in health care. The public, alas, seems to still believe that more is more. And they want more for less

Drew writes:

People are likely to be perplexed when they hear experts say controlling health care costs may mean difficult tradeoffs in the high tech care they get or how much they have to pay out of pocket, because they don't see the need for tradeoffs; more than anything else they blame waste and fraud and high profits made by insurance and drug companies for high health care costs. They don't relate well to delivery reform because they don't see problems in health care as systems failures as experts do and can't easily see how delivery reform will help them with their day-to-day problems paying for care.

Here's his chart:

In a perfect world, maybe we could clone and miniaturize OMB director, Peter Orszag, and have him pop out of everyone's cereal boxes in the morning and explain the health care system (he seems to have gotten through to an awful lot of members of Congress). But we don't think even all the stimulus money Arlen Specter sent to the NIH could accomplish that (but you've got to admit it's more appealing than Drew's idea of bringing back Ross Perot and his pie charts). Alas, we don't think all 300 million Americans are reading health policy blogs or Drew's columns, or are even as tuned into NPR as some second-graders we know. So that's going to leave it up to our political leaders to make the case to voters, to the industry leaders to make the case to individual providers, to doctors to make the case to patients (yeah, we know that's a tough one) and advocates to make the case to the grassroots. It's got to be an honest conversation. As Altman writes: "As long as people think we can solve the problem of rising health care costs simply by eliminating waste, fraud and profiteering, the hard choices they hear experts and leaders talking about will not make much sense to them."