Update: The People and Healthcare Reform

The New York Times reported on Sunday that "The administration had to devote the early part of September to trying to change public opinion . . . because opposition at angry town-hall-style meetings in August had been so damaging." The piece quotes Drew Altman, chief executive of the Kaiser Family Foundation, as saying: ". . . public opinion is still somewhat up for grabs." The story's author, Katharine Seelye, also reports: "Voters may support individual components of a healthcare bill, but no clear majority seems convinced of the merits of an overhaul."

Then, we find the following observation embedded in a piece by Ben Pershing in Saturday's The Washington Post, "Polls have shown broad support for the general idea of health-care reform, but opinion is more mixed for specific proposals such as the public option."

We thus have it from The New York Times that public opinion is up for grabs, juxtaposed with the assertion carried in The Washington Post that there is broad support for healthcare reform. And The Times says that voters support "individual components" of a healthcare bill, while The Post says that opinion is more mixed for "specific proposals."

These two characterizations of public opinion on healthcare reform appear to be reaching somewhat divergent conclusions.

To some degree, as is true with Talmudic scholars and Supreme Court justices, the issue is one of interpretation. What exactly does Pershing mean by "broad support for the general idea of health-care reform?" For that matter, what does Altman mean when he says public opinion is up for grabs?

We don't know for sure. But scanning across the existing corpus of public opinion data on the topic, I see more evidence for the "up for grabs" assertion than for the "broad support" assertion.

Our deliberately straightforward question on healthcare reform here at Gallup asks: "Would you advise your member of Congress to vote for or against a healthcare bill this year, or do you not have an opinion?" This phrasing includes a behavioral aspect, much like a classic vote choice or referendum question. This gives respondents a straightforward way of thinking about the situation.

The results from Oct. 1-4 show that 40% of Americans would tell their representative to vote for, 36% against, and 25% no opinion. (Support is higher when those who are undecided are asked which way they lean). A recent Pew poll showed the public opposed by a 47% to 30% margin when asked: "As of right now, do you generally favor or generally oppose the healthcare proposals being discussed in Congress?" Other recent polls are a little more mixed, but it's hard to find a poll showing "broad support." If by "up for grabs" we assume Altman meant that there is no clear-cut majority supporting a new healthcare bill, I would think he's right.


Now, on to Pershing's second point, in which he says that support is ". . . mixed for specific proposals such as the public option." We could ponder this statement for a while. Broadly speaking, the assertion is hard to argue with. There are many specific proposals that have been tested in the research. Support is indeed mixed, at the least in the sense that support varies across the proposals.

Pershing mentions only one such specific proposal, the public option. Narrowing our focus just to the public option, we find that opinion is not so much mixed as it is broadly supportive. Most polls show the public option, variously described, gains the favor of clear majorities of Americans. For example, recent polling by Altman's organization, the Kaiser Family Foundation, finds support for the public option across two different ways of asking about it. (Kaiser asked half of respondents in their poll to say yea or nay to this proposal: "Creating a government-administered public health insurance option similar to Medicare to compete with private health insurance plans," with the other half responding to the same proposal but without the ". . . similar to Medicare" phrase. The two alternatives get 57% and 59% support.)

Bottom line: No broad or overwhelming support from Americans for the general idea of new healthcare legislation, but fairly strong support for many specific proposals, including a public option.