Guest Contribution by Jan Werner

By Jan Werner

(With Jan's permission, I am reprinting a commentary originally distributed to the American Association for Public Opinion Research's listserv discussion group.)

Today's NY Times Week In Review section fills some unsold space with yet another rehash about poll results differing because of question wording, this time in the context of opinions on health care reform.

At the same time, the front page of that same section has an article on the expected costs of failure to enact some kind of health care reform.

This brings up the issue of why the media polls keep asking the same questions with slight variations of wording, instead of doing serious digging into just what people know about health care reform and what they want, or fear, from it.

Even the Kaiser Family Foundation tracking polls, while far superior on health care topics to anything one gets from the usual media suspects (NYT, ABC, Pew, etc.), mainly focus on the political affiliation of respondents rather than whether they have health care coverage and, if so, where it comes from and what it costs them.

Why don't we see questions about the source of respondents' health care coverage, the percentage of their income it consumes, how that amount has changed over time and how they expect it to change in the future, how much they know about rising health care costs and why they are rising? And why don't we see crosstabs by that kind of information rather than just by the same Dem/Ind/Rep political breakdowns?

One answer comes from Bob Blendon of the Harvard School of Public Health, via Trudy Lieberman, who writes on health care reporting in the Columbia Journalism Review.

Obviously, if only insurance companies are willing to sponsor serious research into what drives opinions on health care reform, then they are going to be the main beneficiaries of what that research reveals.

[Editor's Note: Quinnipiac has sporadically used respondents' type of health insurance -- none, Medicare/Medicaid, or private -- as a grouping factor in crosstabs, as seen here. Other pollsters may have done similarly, but I can't locate other examples right off the top of my head.]

Cohen, Newport, and Klein on Health Care Public Opinion

Jon Cohen and Frank Newport offer synopses of where public opinion currently stands on health care reform (via Pollster.com).

UPDATE: And so does Ezra Klein.

Pre-Summit Round-Up

With President Obama preparing to release a new version of the health care reform plan in advance of Thursday's bipartisan summit on the matter, and Senate Majority Leader Harry Reid (D-NV) getting on board with the idea to use budget reconciliation to make changes to the Senate's December-passed bill, here are some recent developments in public opinion.

Newsweek revisits the issue of support for health care reform, as a general proposition, versus support for specific provisions (via Political Wire).

In terms of political calculus for this November's congressional elections, Public Policy Polling notes that a great deal of the opposition to the Democrats' health care reform legislation comes from people who would never vote Democratic anyway. Hence, any attempt by the Dems to trim back the legislation to attract these voters would be futile.

Comprehensiveness and Complexity (ABC/Post Poll)

In the aftermath of Republican Scott Brown's win in the Massachusetts special election for U.S. Senate and with support in national public-opinion polls for health care reform (as a general proposition) clocking in around 40%, there have been calls for the Democrats to scale back their aspirations for reform. In particular, many Republicans (and some, shall we say, "cautious" Democrats) have suggested the Congress move away from comprehensive health care legislation such as what passed the U.S. House last November (including various mechanisms to cover roughly 30 million uninsured Americans and regulate the insurance industry) and instead aim for something more limited.

As one example, Republican Representative Bill Cassidy advocates a number of narrow provisions that seem unlikely to increase the number of insured persons by anything near the extent proposed by the Democrats. House Speaker Nancy Pelosi (D-CA), in constrast, has argued that health policy changes cannot be effective in isolation, thus necessitating a more comprehensive approach.

A new ABC/Washington Post poll (in the field February 4-8) contained the following item, which has received considerable publicity:

Do you think lawmakers in Washington should (keep trying to pass) a comprehensive health care reform plan, or should (give up on) comprehensive health care reform?

Keep trying to pass 63%
Give up on 34
No opinion 4

The public, knowlingly or not, thus appears to side with Pelosi on this matter. Another item, which appears to have received much less attention, to some extent gets at Pelosi's idea that effective reform requires the coordination of many "moving parts." It reads:

Do you think the proposed changes to the health care system are too complicated, or do you think the changes have to be this complex to accomplish what they're trying to do?

Too complicated 60
Have to be this complex 35
No opinion 5

Whether the 35% who claimed the Democratic plans' complexity is unavoidable truly were exhibiting systems-oriented thinking or were just rationalizing in defense of a plan they support, we don't know. Peter Muhlberger, a colleague of mine at Texas Tech, has written about political-science theories claiming "that many people have simplistic understandings of human agency. These understandings result in an inability to conceptualize complex
systems of governance and an inability to take alternative political perspectives" (p. 54).

Whatever else one can say about the pending health care reform legislation, it certainly exemplifies the operation of "complex systems of governance."

UPDATE: A Zogby poll that was in the field from January 29-February 1 obtained findings opposite to the ABC/Post poll summarized above, regarding the public's desire for comprehensive legislation.

Silver Analyzes Open-Ended Survey Data

Nate Silver takes a look at open-ended responses from a Gallup survey to assess the degree to which opposition to health care reform might be based on faulty information. As Silver discusses, much of the information is ambiguous. Take, for example, respondents' statements that they oppose reform because it would hurt the elderly (with no further elaboration). If a respondent were referring to "death panels," that would be an erroneous reason. However, if someone were referring to Medicare Advantage cuts, that would be grounded in reality.

PolitiFact on Boehner's ACA Claim

PolitiFact reviews polling data to gauge the accuracy of U.S. House Minority Leader John Boehner's (R-OH) claim that a "majority" of Americans oppose the health care legislation before Congress (via Pollster.com). I think the PolitiFact piece is sound, as far as it goes. However, it does not delve into opposition from the left (a topic covered extensively here in the November and December 2009 archives). To the extent people would interpret Boehner's comments as implying that a majority oppose the bill because it's too liberal -- which Boehner never actually says -- I think it helps contextualize things to know that some of the opposition is because the bill is perceived by some as not liberal enough. Also, Pollster's Mark Blumenthal offers his assessment on where things currently stand with the health care reform legislation.