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Tuesday, March 30, 2010

Two Conclusions About Healthcare Reform

Two conclusions about healthcare reform reinforced by our weekend USA Today/Gallup poll:

a) Americans tend to believe the most positive benefit of the bill will be to extend healthcare coverage to those who don’t have it.

b) Americans tend to view the most negative aspect of the bill as its cost.

These have been fairly consistent findings in recent months.

When supporters of the bill have been asked to justify their position, they are most likely to refer to the bill’s extension of insurance to those who don’t have it. Our cui bono (who benefits) question sequence of a few weeks ago found Americans most likely to say that lower income people and those without insurance would benefit from the new bill. The just-completed weekend survey found that Americans are most positive about the extension of healthcare coverage to Americans.

Discussions of costs are ubiquitous in our data. These show up in response to each of the several open-ended questions we have asked Americans about healthcare. Costs are the number one reason given open-endedly by those who oppose the bill. Over the weekend, concern about costs were clearly seen as the most negative aspect of the bill.


These findings have implications for President Obama and those who are continuing to push the virtues of the bill that is now more than a week old. The administration would like the public to see the bill as legislation that is going to benefit all Americans (except, perhaps, the rich). And one that is going to save money rather than cost money. (“Reform will make health care more affordable, make health insurers more accountable, expand health coverage to all Americans, and make the health system sustainable, stabilizing family budgets, the Federal budget, and the economy".)

On the other hand, to repeat (and generalize a bit), the public tends to see the new bill as a Medicaid-type bill that is going to be very expensive.

However. It’s not necessarily bad for proponents of the bill if people don’t believe it will benefit them personally. It appears to me that quite a few Americans support the bill because it benefits others - not them.

Here is one of the most interesting findings from our weekend poll. Forty-seven percent of Americans favor the bill. Just 22% of this same sample say the bill will make their own healthcare situation better. In other words, less than half of those who say the bill is a good thing appear to hold that position because they think the bill will make their own personal healthcare situation better.

Here are some numbers. We interviewed 1,033 people in the weekend poll. Out of the 480 people we interviewed who say that healthcare is a good thing, 233 say that it will make no difference to their personal healthcare. Another 16 of those who are positive about the bill say it will make their personal situation worse. That’s 249 out of 1,033 people we interviewed who like the bill but don't see positive benefits in it for them (a projected 24% of Americans). That’s slightly more than the 21% of Americans intervieweed who say the bill is a good thing and (more predictably) say that it will benefit them personally.

Refer to opening paragraphs in this post. A lot of eleemosynary people out there. A good number of Americans are supporting the new healthcare reform bill for reasons other than direct benefit for them personally.

On another note, take a look at the tables on page 2 of the story I wrote yesterday on people’s views of the new bill -- the data showing trends in questions asking Americans about their views of the benefits of the bill.

What struck me forcefully is how little any of these attitudes have changed from last fall to the present. There has been an incredible focus on healthcare in the time period between the surveys represented in these data. Hundreds of millions of dollars have been spent on lobbying and advertising. The issue has dominated both the Democrats' and the Republicans’ agendas and speech-making. Healthcare reform has been the number one issue debated in Congress. And probably the number one political issue focused on by the news media.

And yet.

Very little has changed in how the average American views the benefits of the legislation. Plus, more generally, after a gain in our Monday night poll taken just after the House passed the bill, overall support and opposition for the bill have settled back down to about where they were in previous months.

The views of Jane and Joe Doe out there across the country appear to have been pretty much unaffected by all of the healthcare Sturm and Drang.

3 comments:

Anonymous said...
April 2, 2010 at 11:01 AM  

I would be interested in a poll that somehow measures how secure those already insured feel about the future of their plans. To say that most people view this as only beneficial to those without insurance is to tell only half the story. No one, save members of congress, before this reform bill, was guaranteed health insurance.

Ruth said...
April 2, 2010 at 3:27 PM  

I feel much more secure now that I kow if I get sick I will not be pushed away for running out of coverage.

I believe there will be a positive outcome in the end and all of the noise will go away as it did for SSI and Medicaid in the past.

Anonymous said...
April 30, 2010 at 9:53 AM  

Interesting that some feel more secure with the passage of this law. We have very affordable health insurance provided by a smaller insurer, and with this bills passage, I'm MORE concerned my costs are going to go up, or stipulations will put my insurer out of business. With more people on a medicaid type system, which systemically underpays doctors, I'm also concerned medical costs will rise, as they have done in the past, and for the same reasons: doctors are tying to recoup some of their lost profits by treating those in the government-run system.

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