Why Progressives Have to get Serious about Health Care Reform

Overview

We are convinced that the country will support comprehensive health care reform — if progressives respect how voters will assess our plans, provide key information about how reform will work (particularly to reduce costs) and if the president carries forward with his educative role. This conclusion is based on our most current survey, which shows a plurality for the Obama plan, but short of a majority — which gets larger after a robust debate. The survey replicates questions we asked in 1993 when President Clinton launched his health care reform plans, and I write about those findings in the latest New Republic. I hate the subtitle, “Why health care reform could fail again” — which I did not write. It should have read, “Why progressives have to get serious about health care reform.”

When we got these results, Democracy Corps launched into intensive focus groups and a new survey that will be released next week. But we want to underscore some of our key findings now.

• As in 1993, a large majority wants change. Almost 60 percent of likely voters are dissatisfied with the current health care system, and three-quarters say health care should be either completely rebuilt or reformed in major ways.
• The president’s plan is strongly favored. A good majority of those under age 65 — those impacted by reform — favor the Obama plan, and do so strongly, after a descriptive debate of the issue. Still, we begin this battle with only a small majority here, which leaves little cushion once you factor in conservative attacks against a “government takeover,” the not inconsiderable minority among this population who believe government could create more problems, and a rising concern about deficit spending.
• Messages of security play strongly. That no one would ever again lose coverage and no insurance company could drop a consumer or raise rates for pre-existing conditions, health, gender or age are the strongest messages and most emotional factors in the current support. But we cannot expand the majority supporting health care reform without showing how we reduce costs for individuals and how we expand choice.
• Still, people are satisfied with their own insurance. The main reason we have trouble expanding the majority is the three-quarters who say they are “satisfied” with their own insurance plans. Understand, our focus groups are showing they are not satisfied — they have traded off wage increases, stayed in a job rather than leave, paid into a high-deductible plan, and made other compromises so they can have insurance and their choice of doctor when they need it. But that makes those voters who want reform risk averse — they want to confirm key elements in the plan.
• Voters need solid answers to their questions. People really need to know how they will pay less, how the plan will be paid for and how they will have choice. Their presumption is that reform costs more, not less — and so, we have to be doubly diligent, respecting how personal a choice this is for people in very tough times.
• There is little support among seniors. Voters over the age of 65 clearly need to see that there is something in health care reform for them as well.
• Voters are desperate for change — if it is done right. The public is following the debate very closely and are desperate for the changes being discussed, but only if done right and for the right reasons. The president has the ability to explain reform but also to tell the larger story about what this plan means for middle class families and America.