As we discussed last week (see "Views on Healthcare by Party Affiliation" in Related Items), Republicans are far more likely to give positive assessments of healthcare quality and coverage in the United States than are Democrats or independents, and Democrats are far more likely than Republicans to say that the U.S. healthcare system is in a state of crisis.
There are a number of possible explanations for these differences, but one of the most likely is that Democrats tend to personally have less access to quality medical care than Republicans, and this difference in access to care may affect people's perceptions of the state of the country's healthcare. Another possible factor is the tendency of Democrats and Republicans to retain different media messages about the state of healthcare in the country according to their ideological perspective.
Recent Gallup Poll data on Americans' ratings of their own healthcare and healthcare coverage suggest that both these explanations play roles in the differing views of Republicans, Democrats, and independents.
Democrats, Independents Personally Receive Lower Quality Care and Coverage
According to a Nov. 11-14, 2002, Gallup Poll*, far more Democrats and independents report receiving low-quality medical care than Republicans. About one-fifth of Democrats (20%) and independents (21%) report that the healthcare they receive is fair or poor in quality, versus just 10% of Republicans. Democrats are also more likely to report that they have only fair or poor quality health coverage than Republicans, by a margin of 28% to 21%.
Better in My Backyard
One's perceptions of the overall state of healthcare in the country are strongly related to perceptions of the quality of healthcare they receive. But it's not a one-to-one relationship -- among people who say that the quality of healthcare they personally receive is excellent or good, 63% say that the quality of healthcare in the country is excellent or good. Among people who say that the quality of healthcare they personally receive is fair or poor, just 22% say that the quality of healthcare in the country is excellent or good.
The tendency to rate an issue more positively with regard to one's personal situation or immediate area than with regard to the country as a whole is fairly common in survey research. It shows up in ratings of education quality, crime, race relations and the economy -- respondents typically perceive the situation in their own backyard to be better than average, given what they are hearing about the country as a whole.
That tendency is clearly evident in these healthcare data as well. Overall, only 17% of respondents rate the quality of their personal healthcare services as fair or poor, while 24% say the same about their medical coverage. When they rate the nation on healthcare quality and access to healthcare coverage, those numbers jump to 44% and 68%, respectively.
Key Points
These findings confirm that there is a strong relationship between the quality of healthcare one personally receives and one's perceptions of the country's healthcare status. Differences in access to high-quality medical care surely contribute to the gulf between views of Democrats, independents, and Republicans on the state of America's healthcare system.
*Results are based on telephone interviews with 1,001 national adults, aged 18 and older, conducted Nov. 11-14, 2002. For results based on the total sample of national adults, one can say with 95% confidence that the maximum margin of sampling error is ±3%.