The ACP Advocate Blog

by Bob Doherty

Tuesday, January 19, 2010

Losing and winning the battle for public opinion

I am not going to speculate - yet - about the meaning of the Massachusetts' special election to fill the vacancy created by Ted Kennedy's passing, mainly because I'd rather wait until the votes are cast. I'll have something to say about it, tomorrow.

But I don't think anyone can reasonably dispute the fact that public opinion, in general, has swung against the pending health reform bills. And the reasons for this require some thoughtful analysis by the health reform advocates if they hold out any hope of turning opinion around. Blaming the polls on "scare tactics" gives too much credence to the worst of the opposition's arguments, while suggesting that the public doesn't "understand" the benefits of reform is condescending, and even more to the point, ineffective. You are not going to win over the public by calling them dupes (to the health care lies) or ignoramuses (because they aren't smart or informed enough to see the benefits to them). At the same time, though, the critics of the health reform bills should think twice before prematurely concluding that the public has decisively bought into their view they will lead to "government-run" health care.

Real Clear Politics reports that when the results of nine different polls, conducted since the first of the year, are averaged together, 51.1% of respondents oppose the health reform legislation while 40.9% support it. But it isn't that simple.

Gallup finds that Americans narrowly favor passage of the bill, by a margin of 49% to 46%. The CNN/Opinion Research poll "finds that 57% generally oppose" the bill while only 40% "generally support" it. But the CNN poll shows that solid majorities favor two of the most "liberal" proposals in the House-passed version: taxing high income people (with 61% support) and the public plan option (with 55% support).

The Kaiser Family Foundation's December tracking poll (not included in the Real Clear Politics poll averages) finds that, "Overall, 54 percent say the economic challenges facing the country make it more important than ever to tackle reform, while 41 percent say we cannot afford to take on reform now." In this poll, "45 percent say the country would be better off if health care reform passes, down 9 percentage points from November, compared to 31 percent who say the country will be worse off and 17 percent who see no impact." At the same time, however, Kaiser reports that "the percentage of Americans who believe they will be personally better off if Congress passes health care reform is down seven percentage points from last month to 35 percent, making for a much more divided public on this measure, with roughly three in ten saying they think they will be worse off (27 percent) and another three in ten not expecting to see much change (32 percent)." In other words, more people believe that the bills will be better for the country than will personally benefit them.

The Washington Post/ABC poll similarly shows that most Americans are not persuaded that they will be better off if health reform passes. 53% say that it will cost them more if health reform passes than if the current system were maintained, and only 38% say the quality of care will be better if health reform passes compared to 50% who say it will be better under the current system. 56% believe that the overall cost of health care to the country will be higher if reform passes compared to 37% who say it will be higher if the current system is left as it is. The Washington Post poll, like CNN's, also shows that more Americans favor a tax on high income persons and the public option than oppose them.

In my mind, the polls show that opponents have been most effective in raising doubts among Americans on two of the core claims for health care reform: that the bills will lower their costs while improving (or at least not hurting) the quality of care they receive. But I don't think that the polls show that there has been a wholesale rejection of the need for health care reform, or that most Americans buy into the view it is too liberal and will lead to government-run health care. Instead, they don't trust that the bills being debated will deliver on the promises of better care at lower cost, and that is why a majority now oppose them. The proponents of health reform have not yet figured out how to make them feel otherwise.

Oh, and one thing about Massachusetts, no matter who wins today's election, the polls show that most of the Commonwealth's residents like their state's universal health insurance program, which consists of individually mandated insurance with subsidies to buy coverage and health exchanges to make it more affordable - just like the bills being debated in Congress.

Today's question: Who do you think is winning the battle for public opinion, and why?

2 Comments :

Blogger rcentor said...

The Democratic House and Senate, as well as Obama, have failed to develop a "sticky" message on health care reform. The current bills are unnecessarily complex and this complexity makes the bills easy to attack.

If you cannot explain the message quickly and easily, the opponents of health care reform have you vulnerable. This is a communication failure in my opinion.

January 19, 2010 at 8:35 PM  
Blogger Harrison said...

The Democrats have not managed expectations, and they have not lived up to those they have created.
The Republicans have created perceptions that have been easy to attack.

If however the Republicans succeed in defeating health care reform, they will only succeed in giving us all the future that they find most abhorrent -- a virtual takeover of health care by the government.
The system is moving quickly to being unsustainable.
The business community will be hurt by the rise in costs.
People will increasingly be left with large bills and health problems that are not covered.

If the Republicans kill the current legistlation, the Fall campaign may not look as good as they would like.
They will be killing the chance for health insurance for millions.
They will be killing the regulations on the insurance companies that keep them from disqualifying people because of pre-existing conditions.
They will be killing reforms that can slow the growth of health care costs.

The Democrats have been unable to come up with positive sticky messages, but they may not have as much trouble with negative sticky messages to pin to Republican incumbents who have not offered new ideas.

I hope that we are able to come up with solutions.

The vote in MA should instruct the Democrats to do what they should have been doing all along, which is to act as if you have 59 senators, and not 60.

Harrison

January 20, 2010 at 2:44 PM  

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About the Author

Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog

Email Bob Doherty: TheACPAdvocateblog@acponline.org.

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