Tuesday, January 18, 2011

Public Attitudes Towards the Health Reform Law

I've been pouring over an Associated Press-GfK poll done last week on health care reform.

Overall support for (40%) and opposition to (41%) the bill are in a statistical dead heat, but the number opposed is the lowest it's been since January 2009, which is surprising, given the drumbeat of Republican anti-reform rhetoric.

But with regard to the bill itself, 19% want Congress to leave it as it is, and 43% wish it did more to reform the health system! 26% want it to be repealed completely, down from 31% two months ago.

The poll showed strong public support for "requiring most medium-size and large companies to offer health insurance to their employees or pay money to the government as a penalty if they don’t," with 59% in favor and 32% opposed.
The individual mandate is by far the most unpopular aspect of the bill, with 59% against it and only 31% supportive. The fact that 50% favor "requiring insurance companies to sell health insurance to a person who is currently sick or has had a serious illness in the past," which isn't possible without bringing the full population into the risk pool, suggests that many do not understand the rationale for the mandate.

Approximately one third opposed (a) requiring medium and large employers to offer insurance, (b) requiring insurers to serve all comers, and (c) forbidding insurers from not reinsuring customers who develop a serious illness. It isn't clear what underlying perspectives drive these responses. Paul Krugman believes it's a matter of irreconcilable political philosophies:
One side of American politics considers the modern welfare state — a private-enterprise economy, but one in which society’s winners are taxed to pay for a social safety net — morally superior to the capitalism red in tooth and claw we had before the New Deal. It’s only right, this side believes, for the affluent to help the less fortunate.

The other side believes that people have a right to keep what they earn, and that taxing them to support others, no matter how needy, amounts to theft. That’s what lies behind the modern right’s fondness for violent rhetoric: many activists on the right really do see taxes and regulation as tyrannical impositions on their liberty.
My guess is that driving force is more a hatred of government than absence of caring about needy members of the population. For implementing the health reform law, it's important to understand the passion(s) the law has aroused.

I haven't seen any thoughtful alternatives coming from the Republican opposition. Their rhetoric appears to be catering to the keep-government-off-my-back sentiment. While there appears that a third of the population holds that view, a companion AP-GfK poll indicates that the public trusts Democrats (49%) over Republicans (37%) to do a better job handling health care.

The political theater over the Republican move to repeal the law will be a kind of national political Rorschach. The AP-GfK polling suggests that the Republican histrionics is not working. My guess, and hope, is that the strain of communitarian concern for our fellow citizens will outweigh our longstanding national anti-government tilt.

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