PRINCETON, NJ -- A new Gallup Poll finds 26% of Americans mentioning "healthcare" when asked to name the most important problem facing the United States today. That is slightly lower than the 29% who mention the economy in general terms. Fifteen percent name unemployment specifically, while between 8% and 10% mention dissatisfaction with government, the federal budget deficit, and the Iraq war.
The Aug. 31-Sept. 2 poll was conducted prior to President Obama's nationally televised address to Congress Wednesday night laying out Obama's goals on healthcare reform. Momentum toward healthcare legislation appeared to stall during Congress' August recess, when many members heard strong opposition to some of the possible elements of a plan from constituents at town hall meetings.
"The level of concern measured in this month's poll is historically high, but still below what Gallup measured in the early 1990s, during the last major push for healthcare reform under the Clinton administration."
Although healthcare reform stayed in the news throughout August, the percentage of Americans naming it as the most important problem has barely changed from the prior survey's 25%.
Longer term, the issue has become more top-of-mind for Americans over the course of the year as the president and Congress have focused on crafting legislation that would expand coverage to the uninsured and attempt to rein in exploding healthcare costs. As recently as April, 7% of Americans named healthcare as the most important problem, and 4% did so just prior to Obama's taking office in January. This trend suggests the public may be taking its cues from government leaders as to the importance of the issue, rather than government leaders' acting in response to widespread citizen demands to address healthcare.
The level of concern measured in this month's poll is historically high, but still below what Gallup measured in the early 1990s, during the last major push for healthcare reform under the Clinton administration. In January 1994, 31% of Americans mentioned healthcare as the most important problem facing the country. Once the Clinton reform effort failed, concern about the issue faded, with roughly 5%-10% continuing to cite it as the most important problem from 1995-2008.
Economic Concern Fading
In recent months, Gallup has documented an uptick in consumer confidence. Coincident with that, Gallup finds a decline in the proportion of Americans mentioning "the economy" in general as the most important problem. In February, 57% of Americans did so, and the percentage has declined at least slightly each month since.
Also in February, 86% of Americans mentioned any economic issue -- including the economy in general, but also unemployment, the deficit, and inflation -- in response to this open-ended question. That combined percentage has also declined, and in September, just over half (57%) of Americans mention any economic issue.
Domestic Issues Dominate
The current "most important problem" data clearly indicate that Americans' attention is focused on domestic rather than international issues. Eight percent mention the war in Iraq -- which had been the top-rated issue for about four years, from 2004 to early 2008. Now, five domestic issues are more frequently mentioned. In addition to Iraq, 2% mention national security, and 1% each say terrorism, the military and national defense, the situation in the Middle East, and foreign aid.
Party Differences
The economy in general and healthcare are the top two issues among all party groups, with healthcare eclipsing the economy among Democrats, while the reverse is true among Republicans and independents.
There is greater variation by party on the next tier of issues, with unemployment a greater concern for Democrats, and the federal budget deficit and dissatisfaction with government greater concerns for Republicans and independents.
Bottom Line
President Obama's speech on healthcare could represent a pivotal moment in the drive for healthcare reform. The issue ranks near the top of Gallup's most important problem list, although it is unclear whether that status indicates a strong desire for reform among the American public, or merely reflects what Americans are hearing in the news.
As of early September, public opinion about passing a healthcare reform plan is sharply divided, with 37% in favor, 39% opposed, and 24% unsure.
It will be important to see how Americans respond once Obama and his working legislative coalition draft and promote a specific plan that they will try to pass through Congress.
Survey Methods
Results are based on telephone interviews with 1,026 national adults, aged 18 and older, conducted Aug. 31-Sept. 2, 2009. For results based on the total sample of national adults, one can say with 95% confidence that the maximum margin of sampling error is ±4 percentage points.
Interviews are conducted with respondents on land-line telephones (for respondents with a land-line telephone) and cellular phones (for respondents who are cell-phone only).
In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.
