Is the Public Now Ready for Health Care Reform?

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To those of us who follow the way media reports on public opinion polls, it is no surprise to find out that the headline and lede are generally cherry-picked from among the poll's finding.  So that the reporting on the NY Times/CBS poll on health care focused on the finding that 72% of Americans favor "a government administered health insurance plan -- something like the Medicare coverage that people 65 and older get -- that would compete with private health insurance plans?"

 

That is a striking number.  But it is hard to know whether, as Paul Krugman suggests, it represents a fundamental change in public attitudes since the last time the Democrats tried to reform the health care system.  That's because the question had not been asked before.

 

But the survey did ask many questions that were asked back in the 1990s.  Looking at those questions gives a much more mixed picture of the changes in public opinion about health care reform.  There are a few questions that suggest substantial change over the past few years.  The public does trust the government substantially more than private insurance companies to provide coverage and hold down costs than it did in 2007.  But we did not have a comparable question from the 1990s.

 

On the questions that were asked in the current survey and the 1990s, the picture is one of tremendous stability in public opinion rather than marked change.  Some highlights:

 

  • On the question of whether the health care system required major reform, 85% of the current respondents said it required "fundamental changes" or needed to be "rebuilt completely."  But 90% said this on the eve of the failure of Clinton-care.  Indeed even at the height of the Republican takeover in 1994, 79% felt health care needed significant reform.
  • 57% trust the Democratic Party most to reform health care.  But 59% felt the same way in 1994.
  • 48% of the current respondents are dissatisfied with health care generally.  The number was 55% in 1993. 2003.
  • Today 57% of Americans are willing to pay higher taxes for universal coverage.  64% were in 1993.

 

What is more interesting is that neither 1993 nor 2009 are close to being peak years for public acceptance of health care reform.  Based on the questions asked at regular intervals, the peaks years seem to be the late 1990s and early 2000s.  Many of the questions were asked only in 2007 and 2009.  The public was generally more concerned about health care in 2007.

 

There are many reasons why health care reform may be more successful now that it was sixteen years ago.  But it does not appear that a sea change in public opinion is one of them.

 

CORRECTION:  My original post stated that 55% of Americans were dissatified with health care in 1993.  I missread the poll results.  That number came from a 2003 poll and I do not believe that question was asked before that.  My basic point stands.  

2 Comments

"Polarized America: the Dance of ideology and Unequal Riches" is an interesting scholarly work. The thesis of the book epitomized by its polarization index, however, does not seem to track with the results of efforts to pass universal health insurance legislation, which is at its root redistributive. (Note the repeal of the Medicare Catastrophic Health Care legislation.)
Franklin Roosevelt withdrew health legislation when the "index" was roughly 0.50. Medicare was legislated in 1965 at about the same index level. S-CHIP was passed in 1997 when the index value was roughly 0.80. President Obamna has had initial success while the index is at record levels.
The only mention of Medicare is your acknowledgement that Congressional behavior around Medicare and Social Security is different from other issues such as the minimum wage, income taxes, and the estate tax. You attribute this difference to concerns about risk. While I don't disagree about the importance of risk,the polarization model does not seem to fit very well at all. For example, why is middle class health risk a more salient problem after Congress passes health legislation than before?
One of the threads of thought in the book is the lag in policy corrections. For example,you mention the financial regulation of the thirties remaining unchanged for several decades. It may be that universal insurance coverage falls into this category. If so, it may be that a lagged polarization index may be a useful model to explore.
Yours truly,
Doug Wilson

i can't fine no country that have government health care plan that working good for their citizen.
The British health service continue to announce that the official list of those waiting for care is shrinking. in 2001 the wall street journal reported that the British national health service had nearly one million patients waiting for treatment. 40,000 of these waiting for surgery for over a year. i rather the private health care plan

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