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Friday, January 8, 2010

Readers Ask: What's Behind Objections to Healthcare Reform?

Several readers have asked questions about our characterization of what's behind opposition to a new healthcare reform bill.

The recurring strain in these queries: opposition can come not only from conservatives worried that the bill would go too far, but also from liberals worried that the bill doesn’t go far enough. And, that we don’t acknowledge this in our analysis.

For example:
This analysis leaves out some important objections to the health care bill that distort the conclusions. After saying that people on the left and right oppose the bill, the author states only the right wing objections (government involvement and cost). Many on the left object to the lack of a public option (which would mean more government involvement) or even an extension of Medicare. There is also the issue of the excise tax, which will fall squarely on the middle class, the lower third of which can hardly afford it.

Why is it that Gallup does not ask whether voters oppose the health care bill because it does not go far enough? I think that a binary question of supporting or opposing it provides an insufficient understanding of the American public's opinion on the bill and supports the illusion that more people support the beliefs of the Tea Party protesters than actually do.

These are good points. Obviously, one can oppose a new piece of legislation for a variety of reasons. Gallup has not explicitly asked opponents if they oppose because the bill goes too far or because it does not go far enough. (More on this below.)

However, we have covered this area pretty thoroughly in several write-ups of open-ended questions. These questions ask respondents to explain their position on healthcare reform in their own words.

Here we analyzed responses to this question: “Regardless of whether you favor or oppose healthcare legislation, what are some of the concerns you would have if a new healthcare measure is passed into law?”

The results?

Just 12% of all concerns focus on “making sure everyone is covered/has access.” This is the category of responses I think would be closest to the “doesn’t go far enough” attitude. We broke out responses among those who (in a separate question) favored and opposed the legislation. Just 4% of those who oppose healthcare reform legislation mentioned that their biggest concern was that not enough people would be covered.

On the other hand 19% of those who favor new healthcare reform legislation say that access/making sure everyone is covered is their top concern.

In other words, it doesn’t appear that a great deal of opposition is based on the "doesn’t go far enough" issue. Instead, it appears that a lot of people with this concern are still in the “favor” camp. (There may be some hidden "doesn’t go far enough" responses in these open-ends. But none that appear immediately obvious.)

We got at this slightly differently earlier this year. We asked opponents of healthcare legislation to explain "why" in their own words. You can review the categories of responses here. I don’t see any of these categories which immediately suggest opposition based on worries that the bill doesn’t go far enough.

As noted, we at Gallup have not to date asked opponents to tell us explicitly if their opposition is based on the fact that the bill goes too far or doesn’t go far enough. We may in the future. Meanwhile, other polling organizations have.

A December CNN poll, for example, shows that about one out of four opponents of a new healthcare bill say it is because the approach is “not liberal enough.” (The exact wording of the CNN question: "As you may know, the U.S. Senate is considering a bill that would make major changes in the country's health care system. Based on what you have read or heard about that bill, do you generally favor it or generally oppose it?" If oppose: "Do you oppose that bill because you think its approach toward health care is too liberal, or because you think its approach toward health care is not liberal enough?" The exact answers: 42% favor, 39% oppose/too liberal, 13% oppose/not liberal enough).

An earlier Ipsos/McClatchy poll is a little more direct. But found roughly the same results. This poll’s question asked those who were opposed to a new healthcare reform law whether it was because the proposals didn’t go far enough, or because they went too far. By a 66% to 25% margin, opponents said they were against the bill because the proposals “go too far” rather than “don’t go far enough.”

Bottom line: Some segment of those opposed to new healthcare legislation base their concern on the fact that it is too watered down/doesn’t go far enough. Available data suggest, however, that the substantial majority of opposition is based on concerns that the bill goes too far/does too much/would cost too much/would involve too much government intervention/is too liberal.


Anonymous said...
January 8, 2010 at 2:13 PM  

Instead of trying to explain what the answer to the question might be, by making inferences from related questions, just go out and ask the question.

And you should probably point out that the results of the CNN and the Ipsos poll are that a MAJORITY of the people support Obamacare or something to the left of it.

And that is opposite from the impression that your analysis tends to give.

Anonymous said...
January 8, 2010 at 3:34 PM  

It is true that a much smaller percentage of people do not favor the bill because the bill is not liberal enough. But this is a very significant percentage. One has to assume that those who would like the bill to be more liberal than it is would actually favor it over no bill at all. Their opposition is that they would rather have a bill that stronger than the one asked about. Generally speaking, then, these folks, one would think, will be happier if the bill passes than if it doesn't. If you look at the CNN figures, this means that 55% or the people will be happier to have the bill pass, while only 39% would be happier if the bill were killed.

Anonymous said...
January 8, 2010 at 7:48 PM  

"Liberal" has become a pejorative term. You can't ask people if they oppose it because it isn't liberal enough. That naturally poisons the well.

Anonymous said...
January 12, 2010 at 3:00 PM  

Confirmed by polling, the American people are for a public option. I think that the American people would have been for Medicare for 55+ had it been on the table longer, another proposal. Not being more specific than "more liberal, less liberal" indicates nothing to me. I have been for requiring everyone to have insurance, a boon to the insurance companies, but not without the public option. The new customers to the insurance companies is/was the bargaining chip.

Anonymous said...
January 12, 2010 at 5:09 PM  

Any CNN poll is going to result in a majority saying the healthcare bill does not go far enough. A FOX poll will likely result in a majority saying it goes too far. Why not focus on ASKING THE SPECFIC QUESTIONS. Example: If you do not favor the healthcare spending bill, indicate the response closest to your beliefs in a dropdown box below:
a. It's unconstitutional X
b. It does not cover everyone
c. It costs too much and our country can't afford
d. etc. etc.


Anonymous said...
January 15, 2010 at 4:23 PM  

I think discussing health care reform in terms of liberal and conservative is misleading and unproductive. If you don't think the proposed healthcare bill does enough to control costs, does that mean you think it is too liberal or too conservative? Is it a liberal or a conservative view to think health care reform should; 1) ensure that all Americans have health care, 2) improve the quality of health care while reducing costs, and 3) not add to the deficit? The size and role of government is definitely a liberal vs. conservative view. But the fact that we have a dysfunctional healthcare system that needs fixing is not. There are a number of proposals about how to make that fix, but it seems like the only proposal that's made it into the polling questions is the public option.

Laurie Norton said...
January 18, 2011 at 3:39 PM  

Both because people are like sheep and because conservative legislators continue to justify their opposition to the Health Care bill by insisting that the American people reject "Obamacare," it is VERY important that this poll be accurate and complete.
You say the percentage of people who oppose the bill because it doesn't go far enough is fairly small. CNN recently confirmed this by reporting that 13% of the overall public reject it for that reason. Your poll of January 7 indicated that 46% opposed and 40% supported the bill. If we assume 13% of your undifferentiated 46% oppose it because it's not liberal enough, the actual percentage who want the reform eliminated or scaled back is 40% and those who support it or want it expanded is 46%, completely reversing the results of your poll!
As a previous comment said, "just go out and ask the question."!

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