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?
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.Follow @BobDohertyACP
- Why do red states gain the most under health refor...
- What do the health reform bills do ... to increase...
- Keep government out of health care? It's already ...
- Government spending on health outpaces private sou...
- Meet the New Year, same as the old year
- How the Grinch Stole Health Care
- Liberals Attack "Government-Takeover" of Health Ca...
- Pushing drugs to doctors and patients
- Waiting for Godot (a.k.a. Senator Joe)
- Should federal spending and taxes be taken away fr...
The Wall Street Journal's blog on health and the business of health.
Health Affairs Magazine Blog
The Policy Journal of the Health Sphere.
The Health Care Blog
Everything you always wanted to know about the Health Care system. But were afraid to ask.
Vignettes and commentaries on the medical profession.
The New Health Dialogue Blog
From the New America Foundation.
DB's Medical Rants
Contemplating medicine and the health care system
Notes From The Road
Bloggers post from medical meetings, press conferences, and policy gatherings from the U.S. and around the world, providing readers with a tasty analysis of the buzz, the people, and the stories that don't get told.
A blog dedicated to medical education, news, and policy as well as career advising.
Disease Management Care Blog
An ongoing resource for information, insights, peer-review literature and musings from the world of disease management, the medical home, the chronic care model, the patient centered medical home, informatics, pay for performance, primary care, chronic illness and health insurance.
Medical Professionalism Blog
The Medical Professionalism Blog was created by the ABIM Foundation to stimulate conversation and highlight best practices related to professionalism in medicine.