A majority of  the people of this state-no, make that a huge if not an immense, majority-favor raising taxes on either tobacco,  the very wealthy, or both, “in order to keep Catamount Health, Dr. Dynasaur and other state health care programs affordable for low income Vermonters.”

It’s in a poll. The poll was taken by Macro International of Burlington, a respected firm whose surveys have been used by businesses and advocacy groups in Vermont for years.

Here are the results: Seventy-seven percent of those surveyed would support a temporary state income tax surcharge on those earning more than $500,000 a year. Eighty-two percent would support raising the cigarette tax by a dollar to subsidize the health care programs.

That sounds impressive. Actually, it sounds unbelievable. It’s hard to get a 77 percent majority-much less 82 percent-for almost anything. Asking a random sample of people whether they approve of motherhood and apple pie would probably get more negative responses than these two questions did.

The questions  on the income tax surcharge the cigarette tax were inserted into a broader survey that Macro takes four times a year on behalf of various clients, according to Stephanie Ezzo, the company’s assistant research manager.

“I bought these two questions,” said Peter Sterling, the Executive Director
Vermont Campaign for Health Care Security.

Sterling bought them and wrote them. He is an advocate, not a pollster.

“It is not a neutral question,” Sterling acknowledged. “The question is worded in a way that elicits a greater understanding of the issue. I honestly say that because I don’t believe people think about their taxes going to specific programs. They think their taxes are going to some guy sitting behind a desk.”

The wording of the questions breaks one basic rule of polling-asking respondents only if they would support the higher taxes. A polling question should ask whether the respondents support (or favor)  or oppose. Presenting only the favorable option “leads the respondent by suggesting the position … of an authority with which it might be difficult for the respondent to disagree.”

That’s the fancy language  the American Association for Public Opinion Research (AAPOR) uses to explain that some respondents, when hearing only one option, tend to assume that it is the “correct’ or expected choice.

In addition, the questions linked the proposed tax hikes to Catamount Health and Dr. Dynasaur, two of the most popular programs in the state. Dr. Dyanasaur, which has provide health  coverage for low-income children for more than a decade, has acquired a reputation in the state close to that of…well, motherhood and apple pie. Catamount Health is much newer. But according to a poll taken for the state by Lake Research Associates a year ago, it is overwhelmingly popular.

Had the questions just asked about “health programs for low-income people”  without mentioning the popular Dr. Dyanasaur and Catamount Health “brands,” the results might have been different.

Furthermore, respondents can be influenced by the questions that came earlier in the survey. These are not being released. Stephanie Ezzo said she could not divulge the other questions in the survey, taken for other clients, mostly businesses. She would not even say whether any of the earlier questions had dealt with health care, poverty, or tobacco, subjects that could have altered the outlook of some respondents.

“Other clients can participate so (the survey) oftentimes jumps from subject matter to subject matter,” she said.

According to the AAPOR, earlier questions can set up a “context effect.”  For example, according to its web site, “if you ask questions about a specific issue like the economy before asking what the most important problem is facing the nation, respondents will be more likely to name the economy in that subsequent question then they would have been without having that context set up for them.

In that statement, the AAPOR was talking about deliberate distortion. That is not the case here. Neither Sterling, who said his organization paid $1,000 to get the two questions in the poll, nor Macro International is guilty of unethical conduct.  Sterling does not seem to have been trying to pull a fast one. He apparently did not know the basic rule about asking “support or oppose.”

Nor does there seem to be any reason to doubt Ezzo’s assertion that “everything we do is methodologically sound.”  Macro International is a reputable company, and “piggy-backing” questions into a larger poll seems to be standard practice in Vermont.

It’s just that the results aren’t really credible thanks to the flawed wording and the mystery about what questions may have preceded the two about tax hikes and health care.

From various polls it’s reasonable to assume that a majority of Vermonters-but not three quarters or 80 percent majorities — would in fact favor both those tax increases to keep the health care programs affordable for poor and low-income people. In neither case would the tax hikes violate the fabled wisdom of the late Sen. Russell Long of Louisiana, for years the chairman of the Senate Finance Committee. The typical American’s tax preference, Long said, was “Don’t tax you. Don’t tax me. Tax that fellow behind the tree.”

Most people in the state do not smoke, and only a tiny percentage earn close to $500,000 a year. Few, then, are that fellow behind the tree.

And clearly most Vermonters are pro-health care. That Lake Research Partners study found that a large majority agreed that “the state should help people get affordable health coverage if they cannot afford health coverage on their own or get it through a job.”

Still, Vermonters, like other Americans, retain a visceral distaste for higher taxes, even if they are not the ones being taxed. So the huge pro-tax margins in this poll seem…well, too huge.

But Sterling did at least try to find out whether voters would consider some selective tax increases to finance social programs. On the other side of the debate. Gov. Jim Douglas and his aides simply keep asserting that Vermonters are opposed to any and all tax hikes, making no attempt whatever at providing anything resembling evidence.

Beware! Dangerous rhetoric ahead.

Subject: health care for the poor and near-poor.

Prospects: More and more over-heated rhetoric ahead, at least until a State budget is approved.

Possible side effects for innocent bystanders: drowsiness, dyspepsia, confusion. Sometimes ignorance.

This rhetoric will come from both sides of the political spectrum; from conservatives warning that the state budget must be trimmed, from liberals warning that the proposed trims will cause unacceptable human suffering.

Both sides could be right.

Or, just as (more?) likely, both sides could be wrong.

Let’s examine some of the rhetoric we’ve already heard. From Richard Davis, the executive director of the Vermont Citizens Campaign for Health, the cuts in health care services proposed by Gov. Jim Douglas would cause “more people to suffer and die.”

But perhaps the only alternative to these budget reductions is higher taxes, and Douglas’s Administration Secretary, Neale Lunderville said. ‘The governor does not believe Vermonters have a capacity to pay more in taxes.”

For now, Davis’s statement can be neither confirmed nor refuted. If the cuts are made, it should be possible to determine after a year or so whether they actually killed anyone. But it’s hard to see how and why they would. Suffering is quite a bit more subjective; one person’s suffering is another’s inconvenience.

Lunderville’s statement is no doubt true, but meaningless. Gov. Douglas has made his belief abundantly clear. But belief is not evidence. There are tens of thousands of affluent Vermonters and thousands of downright rich ones who no doubt have the capacity-though perhaps not the willingness-to pay higher taxes.

So far, then, we have learned nothing, except that people on both sides of this debate overstate their case.

Somewhat milder opposition to health care cuts came from Peter Sterling, executive director of the Vermont Campaign for Health Care Security, who worried that if  low-income Vermonters had to pay more for their own premiums and health care services, many of them would decide they couldn’t afford it, and drop health insurance altogether.

“No one drops their health insurance because they don’t like the benefits,”  Sterling said. “They drop their insurance because they can’t afford it anymore.”

True, but at the risk of seeming harsh, that’s their choice. People who “can’t afford” higher premiums or higher co-pays when they visit the doctor can’t afford it because they’ve chosen to live in a certain house, drive a certain car, and engage in other pursuits that leave them  without enough money for health care. They could find a cheaper apartment, drive a cheaper car, do less of whatever else they are doing so they could keep their health insurance.

It isn’t as though Douglas is proposing huge increases in premiums or copays. For children and the poorest adults, monthly payments would return to their 2007 levels. There are no records of Vermonters starving in the streets or dying for lack of health care two years ago. Some premiums would rise as little as four dollars a month; others as much as $40 a month.

That won’t be easy for some people. But to claim that they absolutely can’t handle it seems exaggerated. The same is true for the slightly better-paid people who are in the Catamount Health program

The fact is that there are two-bedroom apartments  available (from a quick Internet search, meaning cheaper ones are probably there for the more determined seeker) in the Burlington area for $750 a month. They’re probably not  very nice apartments, but nobody really needs a very nice apartment. With that apartment and an old car with a low(or no) loan, a $30,000-a-year family of three (that’s about the poorest not eligible for Medicaid) can pay several hundred dollars a month for health care and still have almost $1,000 a month for food and other necessities. Not much, but it’ll do. Those who choose to spend the money on something besides health insurance, have…well,  so chosen.

OK, the previous four paragraphs do not simply seem harsh. They are. And they do not apply to all those recently laid-off people who had insurance and a house and a car and their other pursuits ,and were going about life quite responsibly, only to find themselves out of work and uninsured at about the worst possible time to try to sell a house and move to a cheaper place.

The point here is not to endorse Douglas’s proposed cuts. It’s to caution against accepting any faction’s rhetoric at face value. These cuts may be a bad idea. They are not likely to kill anyone. Nor will they actually force anyone to drop his or her health insurance.

On the other hand, they may be very bad for the state’s economy. An analysis of 29 studies in 23 states (not including Vermont) by the Henry Kaiser Family Foundation found that cutting Medicaid spending “has an impact on the larger state economy” which leads to “declines in economic activity” in the state.

The analysis doesn’t claim to be conclusive proof. But the studies it cites are from prestigious universities, business schools and journals. Besides, it makes sense. Medicaid effectively gives money to poor people. And as the late comedian Pat Paulson noted, “if you give money to poor people, they’ll just use it to buy food and clothing and pay the rent.”

In other words, they’ll consume more, just what the economy needs right now. Cutting health care for low income people means giving them  less money. So they’ll consume less.

Of course the alternatives proposed by health care advocates-such as a one percent income tax surcharge on those earning more than $500,000 a year-would also take money out of the private economy where it could be used for consumption. But at that level, a lot of money is saved, not spent. At times, encouraging more saving is desirable. In a recession, consumption is key.

The proposed health care cuts might do less harm to the people directly affected than one side’s rhetoric claims, but more harm to the economy-and therefore to the taxpayers-than the other side’s rhetoric would lead one to believe.