Jayne O'Donnell USA TODAY
Health
care is one of the most divisive issues of the 2020 presidential campaign, with
candidates disparaging insurers and polarizing
labels creating deep divisions even among Democrats.
But remove the buzzwords from the policies, and voters who will decide the
election aren't so far apart in their own positions, new research
shows.
Regardless
of party affiliation, nearly everyone wants to see the nation's health
care system improved, and a majority want big changes. That includes people for
whom the system is working well, and those who may be political
opposites.
That's
the big picture finding of a new Public Agenda/USA TODAY/Ipsos
survey of Americans' attitudes on health care. The survey
is part of the Hidden Common Ground 2020 Initiative, which seeks to
explore areas of agreement on major issues facing the nation.
The
nationally representative survey of 1,020 adult Americans 18 years and older was
conducted December 19-26, 2019. It has a margin of error of plus or minus 3.3
percentage points.
The
survey removed politically charged language such as "Medicare for
All" and "Obamacare" and simply explained the basics of health
care approaches in an effort to capture voters' true opinions.
"There’s
the making of a public conversation about this and it does not need to be
around ideology," said Will Friedman, president of Public Agenda, a
nonpartisan, nonprofit research and public engagement organization.
"People just aren't so set on what they want."
The
sharpest divides were on the size of government and taxes.
In
general, Democrats were more comfortable with a larger role for the federal
government, such as the single-payer government insurance program also called
Medicare for All, or a public option.
Instead
of saying "public option" though, pollsters asked respondents how
strongly they agreed with the concept of a new federal health insurance program
that gives people a new choice beyond the current private insurance market.
Any
adult could buy into the program on a sliding scale, they were told, and 48%
were in favor. A survey released last week by the nonpartisan Kaiser
Family Foundation found similar support, with the same percentage of
Americans favoring such an option.
When
described in general terms, 46% of respondents said they would support
market-based plans and 45% could back Medicare for All-type plans.
Five
goals were rated by more than 90% of those surveyed as
very or somewhat important: making health care more affordable for ordinary Americans;
lowering the cost of prescription drugs; making sure people with
preexisting medical conditions can get affordable health insurance; covering
long-term care for the elderly and disabled; and making sure all
communities have access to enough doctors and hospitals.
So why
the gridlock?
"There
are these sort of flashpoints with politicized terminology that send
people to their partisan corners," said former Vermont Gov. Jim Douglas, a
Republican who is on the board of the bipartisan, nonprofit United States of
Care. "If we avoid them, we're going to be more successful."
John
Greifzu, a survey respondent and school janitor in Fulton, Illinois, used to be
a Democrat and "almost middle of the road." Now, after being a single
father of three children until his recent marriage, health insurance costs
have made him distrust his party.
His
wife is "paying an arm and a leg" — up to a third of a paycheck — for
"bottom of the barrel" insurance that comes with a $2,000 deductible
through her retail job. And even on the Medicaid plans that cover his children,
there are things that aren't covered, he said.
Greifzu
watched his insurance costs rise as it became offered to the unemployed.
"I
work hard for what I've got," said Greifzu. "I'm not going to give up
more money for people who don’t do anything."
Emily
Barson, United States of Care's executive director, said the survey
"validates our worldview ... that people agree more than the current
political rhetoric would have you believe."
It also
shows success at the state level is particularly promising, Barson added.
Before
the midterm congressional elections, some Republican members of Congress
avoided unscripted town halls with voters as concerns rose about the fate of
the Affordable Care Act and protections for people with
preexisting conditions. In states, Douglas said governors and state
officials can't avoid voters — or each other.
State
officials need to get elected too, but "more importantly, we (states) have
to balance our budgets every year," said Douglas, now a political
science professor at Middlebury College.
Friedman
noted, however, that voters made it clear in their responses that they don't
want policymakers to leave health care issues to the states. When queried
on the specifics, respondents said they didn't want moving from state to state
to make health care any more complicated.
"In
terms of the overarching solution, the public would like to see it
solved nationally," he said.
Larry
Levitt, senior vice president at the Kaiser Family Foundation, said most of all
it's clear voters want something done about the prices they pay.
"Americans
across the political spectrum desperately want relief from health care
costs," Levitt said, "and at some point they’re going to hold
political leaders to account for not delivering."
The
findings from the Public Agenda/USA TODAY/Ipsos poll are part of an
election-year project by USA TODAY and Public Agenda. The Hidden Common Ground
initiative explores areas of agreement on major issues facing the nation.
The
survey of 1,020 adult Americans 18 years and older was taken December 19-26,
2019. It has a margin of error of plus or minus 5.7 percentage points
for Democrats, plus or minus 6.2 percentage points for Republicans and
plus or minus 5.7 percentage points for independents.
The
Hidden Common Ground project is supported by the John S. and James L. Knight
Foundation, the Charles Koch Foundation and the Rockefeller Brothers Fund. The
Kettering Foundation serves as a research partner to the Hidden Common Ground
initiative.
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