Mark Blumenthal | July 30, 2009
Topics: Barack Obama , Health Care Reform
With the remarkable number of national polls fielded in the last week and released in the last 48 hours, we should have as clear a sense of public opinion on the health care debate as ever. Yet based on some of the claims and poll references I've seen today, it seems that many are as confused this aspect of health care reform as they are about the details of the plans themselves. So let's take a closer look.
1) Opinions of "Obama's Plan" - Probably the best general measure of what American's think about Obama's health care plan is a question that asks just that, using as few words as possible. No, Obama has not endorsed a specific plan from among the many bills working their way through the committees of the House and Senate, so some very well informed and highly opinionated Americans might have trouble answering such a question, but it is the best way to get a general sense of Americans' impressions of whatever they believe "Obama's plan" to be.
Fortunately for us, five organizations (that I am aware of) asked such a question on polls released in the last week, and while all the gaps are narrow, all five show more Americans expressing opposition to either "Barack Obama's health care plan," the "proposals being discussed in Congress" or similar words to that effect.
NBC/Wall Street Journal and Rasmussen Reports are the only two that have been tracking these questions over the last few months, and both show increasing opposition since June. Note also that the biggest change on the NBC/WSJ survey is a steady decline in the percentage who "have no opinion either way" (something they prompt for) from 41% in April to 22% last week.
So opinions have been forming and, for some, deepening. Still, the wide variation in uncertain responses, from a high of 22% on the NBC/WSJ survey to a low of 3% on the Rasmussen survey tells us that opinions on this topic are still very soft, with many Americans still forming their opinions.
Starting today, we have created a new chart to track these questions and others like them. Like all of our other charts, this one will update regularly as new data becomes available and includes links to source documents.
2) Reactions to detailed descriptions - Three organizations have provided longer descriptions of the key elements of the sort of plan that Obama and the Democrats support and asked samples of adults for their reactions. I provide the text of the three questions after the jump below, but all three attempt to provide balanced descriptions. The questions from NBC/Wall Street Journal and ABC/Washington Post describe the key elements of the plan, while the NPR question presents arguments pro and con. Although the elements described by these questions differ, their overall results are remarkably similar. All three show a slight majority (ranging from 51% to 56%) in favor, with fewer (ranging from 38% to 43% opposed).
Also note that the NBC/Wall Street Journal poll has asked the same question three times since April. The find a level of support that has remained consistent, but gradually increasing opposition (from 33% to 38% since April).
Of course, we need to remember that these questions measure reactions more than existing opinions. They tap into what the legendary political scientist V.O. Key described as latent opinion, attitudes that might be stirred up if -- and it's a big if -- Americans come to see the Obama/Democratic proposals the way these questions describe them.
While the levels of support and opposition are consistent across the three pollsters, we should also assume that we could get different results by tinkering with the verbiage. See, for example, how easily the recent survey by the Kaiser Family Foundation pushes large numbers of respondents to shift their opinions on elements of health care reform in the face of counter arguments.
Nevertheless, the fact that three sets of pollsters made an honest attempt to describe and frame the proposals or the debate fairly, and obtained very similar results, tells us that more Americans might support the reform proposals if they knew more about them. More important, perhaps, is that the gap between potential support and current skepticism shows, as my colleague Ron Brownstein puts it, "how the White House is losing the message war in health care."
3) Why The Gap? - For all the polling data dropped on us this week, we have surprisingly little to help us assess just what Americans are hearing about the health care debate. We do know, thanks to the Pew Research Center, that health care reform is now the story named most often (31%) as the news story Americans say they are following most closely (with the percentage who say they are following it "very closely" rising to 44% from the mid-twenties in the last two weeks). However, we do not have tracking data on the specifics of what Americans are hearing and learning about health care reform.
We do get a hint from an open-ended questions asked by the Pew Center on their larger political survey last week. They asked those who said they generally oppose (46%) health care reform to explain their opinion (they asked supporters the same question, though I am omitting it here). The two concerns offered most often, as their report notes, are the cost and the impact on the budget and taxes (26%) and the potential for too much government involvement and bureaucracy (18%).
Also, as summarized in my post yesterday, these surveys also that few Americans see a clear benefit to them personally from the health care proposals. The clearest result on this score comes from the CBS/New York Times poll released yesterday: Only 31% of Americans say that "the health care legislation under consideration in Congress" will "benefit you personally;" 59% say it will not.
None of this should be particularly surprising, given the news of the last few months. Americans have heard about new government spending in the trillions to pay for bailouts of banks and automobile companies, to "stimulate" the economy and now to fund health care reform. Only a tiny sliver of Americans are in a position to personally benefit from this spending, and the impact on the overall economy appears (for the moment at least) to be negligible. So skepticism about more spending seems entirely rational. With respect to health care, the results above are consistent with the substance of a debate in Washington centered on the price tag of reform (see Tuesday's post) rather than on the more concrete benefits.
The case against health care reform is getting through; the case in favor is not.
Text of the questions described in #2 above:
NBC/Wall Street Journal - Now I am going to tell you more about the health care plan that President Obama supports and please tell me whether you would favor or oppose it. The plan requires that health insurance companies cover people with pre-existing medical conditions. It also requires all but the smallest employers to provide health coverage for their employees, or pay a percentage of their payroll to help fund coverage for the uninsured. Families and individuals with lower- and middle-incomes would receive tax credits to help them afford nsurance coverage. Some of the funding for this plan would come from raising taxes on wealthier Americans. Do you favor or oppose this plan?
ABC/Washington Post - Thinking about health care, one proposal to insure nearly everyone would require all Americans to have health insurance or pay a penalty on their income tax, excluding those with lower incomes. It would require most employers to offer health coverage or pay a fee. There would be a government-run plan to compete with private insurers. And income taxes on people earning more than 280-thousand dollars a year would be raised to help fund the program. Taken together, would you support or oppose this plan? Do you feel that way strongly or somewhat?
NPR - Now let me read you two statements about Obama and the Democrats' health care plan. After I read these statements, please tell me which one comes closer to your own view, even if neither is exactly right.
Democrats say if we don't reform the health insurance system premiums will keep doubling every five years, more companies will drop coverage, and insurance companies will keep using the fine print to deny care when people need it. This plan shifts the power from the insurance companies to you and your doctor, gives you the peace of mind of knowing that you won't lose your coverage if you get sick or lose your job, and guarantees that if you like your doctor you can keep them. And it cuts costs by encouraging prevention and allowing people and businesses to comparison shop for the best and most affordable plan.
Republicans say we need to first control health care costs and require insurance companies cover everyone, so there is no reason to rush through a plan right now that has so many problems. Under this plan, people will have fewer choices. It will not only limit access to quality care and result in rationing, but it will bust the budget by increasing spending when we are already spending too much on unproven programs like the stimulus. We shouldn't have a government-run health care plan where patients can't go to the doctor they want and government bureaucrats decide who gets which treatments.