Tuesday, January 12, 2010

At this stage, with the U.S. House and Senate each having passed its respective version of health care reform in late 2009, we're waiting to see what kind of merged, compromise bill emerges so the House and Senate can vote on final passage. We're also waiting on a January 19 special U.S. Senate election in Massachusetts to fill the late Ted Kennedy's seat, which will determine whether the Democrats still have 60 seats (including two Independents who caucus with the Democrats) to ward off Republican filibusters.

With the House-passed public option seemingly dead due to Senate resistance and relatively few major issues still being negotiated between the two chambers, most of the current polling appears to be on general preferences.

Gallup, which for several months has been asking respondents if they would advise their members of Congress to vote for or against health care reform, now (Jan. 8-10) shows "for" edging ahead of "against," 49 to 46 percent, the first time the "for" side has led since last October.

A more pessimistic tone comes from a new CBS poll (Jan. 6-10), however, as "Just 36 percent of Americans approve of Mr. Obama's handling of health care... In December of last year, 42 percent of Americans approved of the president’s handling of health care, and 47 percent approved in October."

The CBS poll asked its questions in a way that, in my view, provides greater context than most polls about what seems to be going on. First, the poll asked about three main objectives of reform: expanding health-insurance coverage, cost-control, and regulation of the insurance industry. Second, the poll asked respondents whether they felt congressional proposals went too far, got it about right, or did not go far enough, with regard to each of the three aforementioned objectives.

Questions that ask respondents if they think health care reform in general does or doesn't go too far are open to multiple interpretations. To liberals, "not going far enough" could mean not expanding coverage to enough people, whereas to conservatives it could mean not doing enough to roll back government involvement in health care. By asking respondents whether they think the current legislative proposals go too far or not far enough, specifically and separately with regard to coverage, cost-control, and regulation, CBS appears to have removed much of the ambiguity in interpreting the results.

On the question, "Do you think the changes to the health care system under consideration in Congress go too far in trying to provide health insurance to as many Americans as possible, don't go far enough, or are the changes about right?," the 35% saying not far enough would seem to be responding in a liberal direction, with another 22% saying about right (detailed results).

On the question, "Do you think the changes to the health care system under consideration in Congress go too far in trying to control costs, don't go far enough, or are the changes about right?," 39% say not far enough. I'd argue there is some ambiguity here, as liberals could be referring to cost control by reining in the industry whereas conservatives might mean cutting government spending.

The third question -- "Do you think the changes to the health care system under consideration in Congress go too far in trying to regulate the health insurance industry, don't go far enough, or are the changes about right?" -- seems to go a long way in clarifying things. Here, a "not far enough" response would seem to be liberal. Indeed, self-identified Democrats (50%) were more likely to say the plan didn't go far enough than Republicans (26%); Independents said not enough at a 48% rate. For the total sample, 43% said the plan didn't go far enough.

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