Mark Blumenthal | February 1, 2010
Topics: Health care , Health Care Reform , Kaiser Family Foundation , National Journal column , Pew Research Center
My column for this week looks at how Americans came to believe what they do about health care reform, with a focus on this puzzle: If American's followed news coverage about the health reform debate as closely as the Pew Research Center news interest surveys say they did, why are so many "unfamiliar with key elements of the major bills," as reported by the Kaiser Family Foundation survey last month?
The short version is that perceptions of health insurance reform appear to have been shaped by both the typically process-oriented coverage of the health care debate and the larger context of double-digit unemployment and massive increases in government spending over the last year. I end the column with the obvious conclusion: Months of more legislative wrangling on this issue is unlikely to change impressions or increase awareness of what's actually in the bill. Please click through for the whole thing.
But what about the question of greatest consequence right now? What if Congress were to quickly pass the existing legislation or, alternatively, just let it drop? How would voters react? This topic was the subject of a lot of discussion over the past week, from voices such as Megan McArdle and (since I filed the column) from Nate Silver and Jonathan Chait.
Looking forward, we are on much more shaky and speculative ground but I find Chait most persuasive in arguing that the rationale for Democrats to move forward and pass the bill is that they've already voted for it and thus "already own the downside." They will be attacked for "having voted for tax hikes and Medicare cuts and death panels" regardless of the outcome. He continues:
Suppose there's no upside at all to passing health care reform. McArdle assumes, without explicating her reasons, that walking away from the issue is a way for Democrats to cut their losses. Why, though, would that be the case? Passing the bill may or may not make it more popular, letting it die is surely going to make it less popular. If the bill dies, then it's the subject of lengthy, painful postmortem coverage detailing its flaws and mistakes. It becomes the symbol of big government run amok, and the 60 Senate Democrats and 220 House Democrats who voted for it will suffer politically all the more. Moreover, the already-demoralized liberal base would become apoplectic with the Democratic Party. 1994 was bad, but passing a bill through both chambers then sitting by and letting it die is the kind of behavior that makes even the most pragmatic Democratic voter want to punish his own party.
It's hard to guess at where public opinion will move next, but if I were still offering political advice to Democrats, I'd side with Chait.