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Have Americans Accepted the Idea of Big-Government Health Care?



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Today’s Washington Post contains a story that assesses the political prospects for the most brazen attempt ever to insert the government into the day-to-day micro-management of our $2 trillion health care system.

“The great unknown of the health-care debate,” Post reporter Shailagh Murray writes, “is whether the current political landscape will prove more hospitable to mandates, cost controls and tax increases — all measures now on the table that helped doom the Clinton plan.”

As part of her assessment, Murray dismissed Senate Republican opposition to the “big government” elements of the recently released Democratric proposal as nothing more than a throwback to a bygone era, a veritable “Back to the Future” political moment. She writes:

But Republicans are betting that the specter of “big government” can still unsettle voters. When Senate Minority Leader Mitch McConnell (Ky.) spoke on the chamber floor Thursday morning, his remarks sounded as if they had been pulled from an early-1990s focus group.

Advocates of the big government approach, she reports, believe things have changed enough since 1994 to allow the reform effort to succeed. Senate Finance Committee Chairman Max Baucus (Mont.) insists that a successful health-reform effort this time is “a given” and, indeed, “inevitable.” Democratic pollster Geoff Garin believes the odds of a reform measure passing are greater because we’re in a moment of “greater realism.”

Are Senate Republicans and their colleagues in the House stuck in some sort of time warp? Are Americans more open to a government takeover of our health system today than 16 years ago?

Well, let’s go to the videotape. 

This March, pollsters Sheri Rivlin and Allan Rivlin compared polling data on health-care reform from 1993 with the most recent available data available to answer a very relevant question: “has enough changed in public opinion to offer hope that the outcome will be different this time around?”

Bottom line: They concluded that “the basic contours of public opinion that undercut the previous effort continue to be true today — perhaps even more so.”

They warned the 2009 class of big government health reformers to cool their jets:

Just as in 1993, it would be easy to read current polls as highly encouraging. Many of these measures appear quite strong; it is just that they are not as strong as comparable numbers in surveys taken before the start of the 1993 effort when many pollsters, including those advising the White House, were fooled into believing they had a clear mandate for major change.

Some examples of the public’s sentiment on health reform then and now include:

·    In March 1993 66% of Americans said they would be willing to “pay higher taxes so that everyone can have health insurance.” Only 30% disagreed. Fast forward to March 2009. The same question asked by the same pollster (NBC News/Wall Street Journal) found much greater resistance to higher taxes. Only a plurality (49%) is now willing to pay more taxes, versus 45% who are not.

·    Americans are marginally more satisfied with “the total cost of healthcare in this country” now than they were in May 1993. Back then, Gallup found overwhelming dissatisfaction (90%) with costs. Only 8% registered their satisfaction. By November 2008, the percent saying they were satisfied had more than doubled (to 19%) and the level of dissatisfaction had tempered slightly to 79%.

·    Another Gallup poll periodically asks respondents to characterize the state of America’s health system — in a state of crisis, having major problems, minor problems, or no problems at all. Between September 1994 and November 2008 Gallup found only slight variations in the answers.

Finally, though I was unable to find a comparable question from the Clinton era, it is nevertheless significant that the percentage of Americans who believe it is the government’s “responsibility” to make sure all Americans have health coverage fell to 54% last November. While alarmingly high, this is still 10 points lower than in November 2007 and 15 points below the 69% who felt this way in November 2006. And the 41% who dissented from the big government view last November represents the high point in ten Gallup surveys that asked this question going back to January 2000.

So, compared to the national mood in the early 1990s, the overall level of angst with respect to the health system is the same, fewer Americans are apoplectic over the cost of their health care, more are opposed to tax increases to finance health reform, and fewer see health care as the government’s responsibility.

Hmmmm.

Here’s an idea for the current crop of liberal health reformers. Scrounge around for those old dusty focus group reports from 1994. Re-read them. Maybe even adjust the findings a bit to fit the slightly more conservative views of Americans today. Then you will have an accurate picture of how Americans view health reform in 2009.

Then we can discuss all that supposedly outdated rhetoric about “big government” health care.



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