The Statistical Truth Nonrandom Thoughts and Data 

by Matt Carlson

March 15, 2010
Is Health Care Reform Popular?

Yes, it is. The American people favor the Democrats’ health care reform plan, substantively. They don’t know what's in it. And they don’t know that they like it. But they like it. So why does everyone think Americans oppose health care reform? Because when asked to say, up or down, whether they favor it, a plurality of Americans says they don't:


(But note the apparent narrowing of the gap in recent weeks.)

And how do we know Americans really favor the plan? Well, here are four pieces of evidence that make it plain:

1. Wall Street Journal/NBC Poll

In a series of Wall Street Journal/NBC polls conducted last year, Americans were asked the following question:

“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 insurance coverage. Some of the funding for this plan would come from raising taxes on wealthier Americans. Do you favor or oppose this plan?”

And here are the results:

 

So when people are told what’s in the plan—rather than asked to say, up or down, whether they favor something called “health care reform”—they like it. (For some reason the pollsters discontinued this question in subsequent versions of the poll.)

2. Kaiser Health Tracking Poll

In a Kaiser Family Foundation survey of January of this year, the legislation was divided into 27 features, most of them components of the bill, some not, but all in the discussion about health care. In view of the fact that “many Americans remain unaware of the specific content of the legislation,” a “subset of Americans were told the proposed legislation included each provision and asked whether that particular element made them more likely to support health reform, less likely to support it or didn’t affect their views.” Here are the results (which I’ve re-graphed for ease of comprehension):

 

Note well: The red lines are longer than the blue ones in 22 of 27 cases. And the exceptions are unsurprising:

*Basic benefits package, defined by the government: Smacks of an enlarged government role, which has negative connotations for Americans conditioned by decades of demonization of government (some of it deserved, much of it part of a cynical “starve the beast” strategy). But of course a government-defined benefits package is an essential consumer protection. Every state has one. Many women, for example, will be thankful to discover that their insurance plan was required to cover breast cancer care.

*Cadillac-plan tax on insurers: Anything with the word “tax” in it is unlikely to poll well. (Still the Cadillac-plan tax is a good idea that sadly has been watered down.)

*Not take full effect until 2013: But the only reason this would be a negative is that the bill is viewed favorably overall.

*Individual mandate/penalty: No doubt requiring people to buy insurance (or anything) feels like (a) an infringement on liberty and (b) a potential source of economic hardship. But the question is meaningless unless conjoined with two other questions: the question about guaranteed issue, since we can’t have guaranteed issue without the individual mandate, and the question about subsidies, since the point of the subsidies is to make the mandate workable. Putting these three components together, we have:

My guess is that Americans would accept the mandate as part of a package that includes guaranteed issue and subsidies that help people pay their premiums. (See the question about the mandate and subsidies in the Newsweek poll results below.)

*Cost at least $871 billion over 10 years: An abstract question about the cost of anything not explicitly tied a benefit will always poll badly.

3. Newsweek Poll

Very similar results were found in a recent Newsweek poll (PDF of topline results here). As Newsweek notes, “The majority of Americans are opposed to President Obama's health-care reform plan—until they learn the details.”

The pollsters first asked respondents whether they favored or opposed the bill. They found that 40 percent favored it and 49 percent were opposed. They then asked the respondents whether they favored or opposed eight specific proposals that are in the plan. Here are the results:

(Note: The red lines are longer than the blue ones in all but two cases.)

Finally, the pollsters asked: “Now please think about the proposals I just described to you. ALL of these proposals are included in Barack Obama’s health care reform plan. Having heard these details, what is your OVERALL opinion of Obama’s plan – do you favor it or oppose it?”

The results: 48 percent in favor; 43 percent opposed. And remember, this swing occurred among respondents who had answered the same question just minutes before.

4. Popularity of the Massachusetts Health Care Reform

Then there is the Massachusetts health care reform plan, nearly identical to the national one proposed by the Democrats, and generally popular. A poll by the Harvard School of Public Health and The Boston Globe, for example, found that Massachusetts residents favor the plan by 59 to 22 percent and that 79 percent want the law to continue while just 11 percent want it repealed. Support is even stronger among physicians. A New England Journal of Medicine poll found that physicians favor the plan by 70 to 13 percent and that 75 percent say the law should continue while just 7 percent want it repealed.

In Sum

The plan is obviously a political winner. And the Democrats will get credit for it for years to come (as with FDR and social security and LBJ with Medicare). The Republicans know this and so must demonize it and kill it if at all possible. Before the bill passes, before the public knows much of anything about it, this is still possible. After the bill passes, I trust the Democrats will never let Americans forget who pulled out all the stops to kill it.

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Where the Economy is and Where It's (Apparently) Going
Some Reality about Deficits

Armageddon: The Aftermath
The Hype

Is Health Care Reform Popular?
How to Explain It
The Point of the Public Plan
The Context of Health Care Reform
Addendum
Is Low Life Expectancy the Fault of Our Health Care System?
What Americans Believe
American Health Care: Best in the World?
Is 76.5 Large?
NBC-WSJ Poll
Inside the Asylum
More About Bubbles
Why Has Monetary Policy Been so Ineffective?

The Geithner Plan
Is 22.2 Large?
Economics: A Theoretical Divide
The New Deal and the Great Depression
Stimulus By the Skin of Our Teeth
The Interregnum
Postmortem
Obama and McCain on Tax Cuts and Health Care
Religion and the New Atheism
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