Who really has the public’s support on health care?

Who really has the public’s support on health care?

March 15, 2010

By Steven Kull

Originally published in the March 14th issue of The Baltimore Sun

Polls on health care can be confusing. At last month’s health care summit, Republicans repeatedly asserted that the majority is with them in their opposition to the president’s health care reform plan. President Barack Obama asserted that majorities support all the major specific elements of the plan. Can they both be right?

It is true that in numerous polls, a plurality or a slight majority say that they are opposed to the health care plan. But it is misleading to imply that this means that the public is aligned with the Republicans. In a recent Newsweek poll, only 21 percent approved of how the Republicans are handling health care.

More important, several polls reveal that many of the people who oppose Mr. Obama’s health care plan do so not because they fear it will go too far in changing the status quo but because they think it does not go far enough.

For example, similar to other polls, a Feb. 26-28 Ipsos/McClatchy poll first found that 41 percent said they favored the health care plan under consideration, while 47 percent were opposed. A follow-on question, though, found that many of those opposed to it (17 percent of the whole sample) did so because it did not go far enough. Only 25 percent aligned with the Republican position by complaining that it goes too far.

Rather than thinking of the public as divided along party lines, it is better to think of it as being like Goldilocks and the porridge. Twenty-five percent say the health care plan goes too far, 17 percent say it does not go far enough (some are still disappointed over the removal of the public option), while 41 percent say it is about right. Rather than being on one side of the spectrum, it appears that the proposed health care plan occupies the middle ground of the electorate.

This helps us understand how Mr. Obama can also be right when he says that the public supports most of the key elements of the plan. While many people are not satisfied with the plan overall, numerous polls have found that there does seem to be consensus about most of its key elements.

In a recent Newsweek poll, majorities supported insurance exchanges (81 percent); requiring insurance companies to cover people regardless of pre-existing conditions (76 percent); requiring most businesses to provide coverage (75 percent); and requiring all Americans to have health insurance, with the government providing subsidies for those who cannot afford it (59 percent).

A Kaiser Foundation poll found large majorities saying that it is at least somewhat important to close the Medicare “doughnut hole” (91 percent); expand the existing Medicaid program to cover more low-income, uninsured Americans (81 percent); limit future increases in Medicare payments to health care providers as a way to help pay for health reform (73 percent); and allow health insurers to sell health insurance across state lines (74 percent).

But this does not mean that the public is giving Mr. Obama the big “go ahead.” It really bothers Americans that the bill is not more bipartisan. A March 3-8 Associated Press poll found 61 percent saying bipartisan support is very important. Sixty-eight percent said the president should keep trying to make a deal with the Republicans. Americans also like some of the Republican proposals. Kaiser found 79 percent saying that tort reform is important.

At the same time, Republicans should not be overconfident. The public is watching them warily. Ipsos/McClatchy found that only 36 percent think the Republicans are working hard to compromise, while 57 percent think they are deliberately avoiding compromise to obstruct the bill in any form.

At some point, the public may give up on bipartisanship. Because, as AP found, only 15 percent say they are content to leave the health care system as it is now.

Steven Kull, director of the Program on International Policy Attitudes at the University of Maryland, has conducted several major studies of U.S. public attitudes on health care. His e-mail is skull@pipa.org.


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