Updated at 9:21 a.m. on June 22.
Let the deluge begin.
As the president and the Congress begin to take up health care reform in earnest, media pollsters are already deploying their analytical firepower on this highly charged and complex issue. In the last two weeks we have seen new surveys from NBC News/Wall Street Journal, the Pew Research Center, Diageo/Hotline and CBS News/New York Times that asked more than 60 questions total about health care reform. And that does not count a June tracking survey all about health care from the Kaiser Family Foundation.
So how do we make sense of it all?
First, where to look.
As a resource on public opinion and health care, it is hard to beat the high-quality surveys of the nonpartisan Kaiser Family Foundation. No one else has tracked public opinion on health care reform as much or as often since the early 1990s.
Also, with so many questions being asked by so many pollsters, it is worth bookmarking the extensive compilation of health care survey results maintained by the Polling Report. The site provides the full text of survey questions asked by reputable, nonpartisan media organizations so you can easily compare the way different pollsters ask about similar issues.
The complex attitudes on health care reform do not easily reduce to a single question.
Second, what to look for.
As should be obvious from all the questions asked in recent weeks, public opinion on health care reform is highly complex and multifaceted. And, since Americans have direct contact with their health care providers, it is also deeply personal. "We are talking about the health and well being of your loved ones," said Mollyann Brodie, Kaiser's director of public opinion and media research.
So polling questions on health care reform tend to sort out into two categories. As Brodie points out, those that measure core beliefs and values -- including general attitudes about the need for reform or change -- tend to be more stable and relatively consistent from poll to poll. Yet when the surveys turn to questions about more complex policy options, the results can vary widely.
For example, the recent surveys show overwhelming sentiment in favor of "change" or "reform" when asked in general terms. The Diageo/Hotline poll found 62 percent of Americans in favor of "enacting a major overhaul of the health care system." The June tracking poll from Kaiser found 60 percent agreeing that it "is more important than ever to reform health care right now."
Many of these attitudes have remained constant over time. Democratic pollster Stanley Greenberg recently compared the results of surveys he conducted in 1993 and 1994 during the last major push for health reform, by President Clinton. He found "eerily parallel numbers" in assessing the public's general readiness for reform, their satisfaction with their own health insurance and their "anxieties about government's ability to improve the system."
That's where unfamiliar details about pending legislation can wreak some polling havoc. As Kaiser's Brodie points out, between the personal nature of health care and Americans' general satisfaction with their care and coverage (except for its cost), "it is really easy to scare people into thinking that reform will make their own situations worse off than the current status quo."
Arguments matter. On their June tracking survey, the Kaiser researchers found that a majority of Americans (54 percent) oppose "changing the law so that workers with the most generous health care benefits would pay taxes on the money their employer puts toward their coverage" (40 percent favor). Yet they found these attitudes were "quite malleable." After presenting arguments for or against the change, they were able to move opposition as high as 73 percent or reduce it to as low as 36 percent.
The generally negative reaction to payment options worries Democrats who support reform. "The public supports 'health care reform,'" said Democratic pollster Allan Rivlin, who worked as an adviser to Health and Human Services Secretary Donna E. Shalala during the 1993-1994 reform effort and writes about health care at CenteredPolitics.com. "But paying for it is still an open question." Voters know that more coverage at lower costs will mean sacrifices, he said, "but they want the sacrifices to fall on someone else, not them."
Finally, while the complex attitudes on health care reform do not easily reduce to a single question, the analysts at the Kaiser Foundation have one they are watching closely: whether Americans think their own families will be better off if major health reform legislation is enacted.
In September 1993, according to Kaiser President and CEO Drew Altman, a CNN/Time/Yankelovich poll in September 1993 found Americans divided on whether the Clinton plan would make them or their families better (20 percent) or worse off (21 percent), with the majority (57 percent) believing they would be unaffected. A year later, the percentage who thought they would be worse off had increased to 37 percent. Altman attributes the rise to a fear that "the Clinton proposal might force them out of their current health care arrangements."
The most recent Kaiser tracking survey finds 39 percent of Americans saying they would be better off "if the president and Congress passed health care reform," while 16 percent say they would be worse off. "The number to watch, then," say the Kaiser analysts, "may be the 36 percent who currently say health care reform wouldn't affect them at all."