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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

Finding Consensus on Health Care Reform

Doug Usher, sr, v.p.and director of research and polling at D.C.-based Widmeyer Communications, has a keeper for Dems interested in forging a consensus for health care reform. Usher’s article in The Politico, Are voters ready for health care reform?, explores the the latest opinion data on health care reform and finds it complex and and somewhat paradoxical:

On its face, revamping our health care system should be a political winner. Voters see two fundamental problems with health care. First, it costs too much: 74 percent in a recent Democracy Corps poll say they are dissatisfied with the cost of health care, a number matched in a Kaiser Family Foundation poll from 2006 (80 percent). Second, 70 percent of voters believe the number of uninsured people is a very serious problem, according to a recent New York Times poll.
A strong majority believes health care is a top domestic priority — 55 percent, according to the Times poll — and 64 percent believe the federal government should guarantee health care for all Americans.
All of this appears to create an environment for sweeping reform; indeed, 90 percent of Americans say the health care system as a whole needs change — 54 percent say “fundamental change” is necessary, and 36 percent say the system should be “completely (rebuilt).” Just 8 percent believe the system needs “minor changes.”

Sounds like a mandate for far-reaching reforms. But not so fast, argues Usher:

But the picture changes dramatically when questions shift from the systemic to the personal. Despite concern about the broader health system, Americans are generally satisfied with the care they currently receive. In the Times poll, 77 percent of Americans are satisfied with the quality of their care; 82 percent say the same in the Democracy Corps poll, compared with 89 percent in the Kaiser poll. Indeed, the Kaiser poll finds high satisfaction across a broad range of health care dimensions: communication with the doctor (87 percent), availability of emergency care (83 percent), availability of appointments (82 percent), specialists (79 percent), getting the latest treatments (78 percent) and getting treatment without waiting (73 percent).

Usher notes further:

The 64 percent majority in the Times poll that believes the government should guarantee health insurance for all shrinks to 48 percent when asked their support if a universal program were to raise their own health insurance cost. The 60 percent in the same poll who say that they would be willing to pay higher taxes to insure everybody shrinks to 49 percent when a $500 price tag is attached to it.

If health care reform advocates fail to adequately take such satisfaction levels of currently insured voters into account, Usher believes it could backfire on election day. He concedes that “the hypotheticals posed by these questions may be misleading.” An important point. Indeed, most advocates of both fundamental and incremental health care reforms argue, often convincingly, that their reform plans would actually save taxpayers money, compared to the plans that most insured Americans have. Certainly, no political candidate is saying “My plan will only take an extra $500 per year out of your pocket.”
Usher sees hope in the reform plans being pioneered at the state level, and notes that Canada’s much-praised health care system emanated from the provincial, not federal, level of government. No doubt there is much more the states could do, such as the reforms being explored by Massachusetts and California. But most Americans would surely agree that a nation as prosperous as the U.S. can find a way to provide a health care plan that covers every illness and every person.

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