Public's Views On Reform Vary Depending On Whom You Ask

Several survey results released at the end of November purportedly present the American public’s varied views of health care reform as currently debated n Congress. Of course, it depends on whom you ask and when.

Many Americans are tuned in to the health care reform debate, and the majority think that current proposals, if enacted, would have little, if any, direct effect on them. But of those Americans who do expect to be affected, most anticipate a negative effect. These are among the conclusions of a Robert Wood Johnson Foundation survey of 500 American adults. The majority of RWJF respondents (57%) think their access to health care would remain the same after reform and 61% think their financial situation would be unaffected.

Among those who do expect a change, 28% said they thought their access to care would get worse, while 15% said they thought it would improve. On finances, 27% said they thought the health care bill would make them worse off financially, while 12% expected an improvement.

When asked about changes in store for the nation as whole, fewer than 30% thought things would stay the same if Congress passes legislation. But expectations on whether or not access to medical care would improve around the country were split at 35 each. The federal budget was a major concern, with 39% saying the nation's finances would be worse off, compared with 33% saying the legislation would improve the balance sheet. However, the great majority (71%) of the RWJF respondents consider health reform necessary to address the nation's economic crisis.

At the same time, the poll found that consumers' confidence in their health insurance coverage and ability to access care rose sharply in October to 104.4 points, an 8% increase from 96.6 points in September. Researchers attributed this change to better news about the economy and progress on health care in the Senate at the time the poll was conducted.

"The majority of Americans do have health insurance, so to the extent they see the reform debate as a way to expand coverage for the uninsured, they may not see that they stand to gain as much from it," said Brian Quinn, a senior researcher with the foundation, which supports the general goals of health care reform.

The results of a Gallup Poll released on November 30 shows that Americans are nearly split between supporting and opposing the current health reform initiatives: 49 % of respondents said they would urge their Congressman vote against the bill or lean that way and 44% say they want their member of Congress to vote for the bill or lean that way. The results of the survey are similar to a Gallup poll taken earlier this month, but both are a reversal from October, when 51% of respondents said they backed the bill and 41% opposed it.

Gallup's report on the poll notes that since they started surveying people about health care reform earlier this year "there has never been a strong public mandate in favor of passing a law this year," but noted "opinion on the issue is far from settled." Still, nearly one-quarter of independents (27%) and Democrats (24%) are undecided, “which at least improves the odds that legislation could wind up getting majority public backing,” Gallup noted.

Also released on November 30, a Rasmussen Reports national telephone survey found that 41% of voters nationwide favor the health care reform plan proposed by President Obama and congressional Democrats. More than half (53%) are opposed to it. Those figures include 22% who “Strongly Favor” the plan and 40% who are “Strongly Opposed.”

Support for the legislation has risen three percentage points from the prior week. Rasmussen claims that the number of voters opposed to the plan has always exceeded the number who favor it. More than half (56%) of survey respondents say the plan will increase the cost of health care, and only 17% believe passage of the plan will lower costs. Half of respondents (50%) believe passage of the legislation will lead to a lower quality of care while just 18% believe quality will improve.

Nearly two-thirds (63%) of voters nationwide responding to the Rasmussen survey said guaranteeing that no one is forced to change their health insurance coverage is a higher priority than giving consumers the choice of a "public option" government-run health insurance company. And, pray tell, how do you offer such a guarantee? The majority (68%) of Americans younger than age 65 get their health insurance through employment and those insurance options, along with plan design and costs, can change from year to year based on employers’ decisions. Nearly half (46%) of the Rasmussen respondents favor a public option but not if it would encourage companies to drop private health insurance coverage for their workers.

Hispanic voters, on the other hand, overwhelmingly support not only health care reform, but also a public plan option. This is not surprising since the rate of uninsured is by far highest (41.3%) among Hispanics. A national survey by Latino Decisions, the Robert Wood Johnson Foundation Center for Health Policy at the University of New Mexico (UNM-RWJF Center), and impreMedia of 1,000 Hispanic registered voters found broad-based and overwhelming support (86%) for health care reform legislation, and for a plan that includes a public option to compete with private insurance programs (74% of respondents, 67% say health care should be made available regardless of citizenship or legal residency, and 61% would still like to see universal health care (61%). The results of this survey also were released on November 30.

A substantial a majority of Americans (59%) responding to the Kaiser Family Foundation’s Health Tracking Poll in November said they support having a public plan to compete with private insurers. CNN and CBS surveys in mid-November each find 56% and 61% of the Kaiser survey respondents favored inclusion of a public plan option. Furthermore, 58% favor tackling reform now compared with 36% who said that the U.S. cannot afford it. Substantial majorities among Democrats and Independents (85% and 74%, respectively) recognize the need to address health reform now, while only 43% of Republicans agree. More than half (54%) said they think the country as a whole would be better off with health reform

A new survey by the Pew Research Center for the People & the Press and the Pew Forum on Religion & Public Life also found the public split over the health care proposals in Congress, with 42% in favor and 39% opposed, but those figures represent a shift. Earlier in November, before the House voted on its bill, 38% supported the reform proposals and 47% opposed it.

Among the Pew survey respondents, supporters of reform cited the expansion of coverage to the uninsured (32%), the need for change (17%) and the need to control costs (14%) as most important to them. Opponents of reform mainly cite either the cost (27%) or the increased role that government would play (27%). Other reasons for opposition include the complexity of the legislation (8%) or skepticism that reforms won't work (8%). Very few (3%) cite abortion coverage as their reason to oppose health care reform.

So, which survey results represent the American public’s true view of health care reform? And where do you suppose these survey respondents’ get their information on reform?