Tuesday, August 26, 2014
August 25, 2014
Loving and Hating Obamacare With One Muddled Mind
By Jonathan Bernstein
E.J. Dionne has a nice column pointing out that while "Obamacare"
remains unpopular, most of the provisions are well-liked, and thus
Democrats should run on the issue. As regular readers know, I certainly
agree that the individual components of reform are far more popular than
reform overall. Actually, support for key provisions of the law,
including coverage of pre-existing conditions, health-insurance
exchanges offering subsidies to middle-income policy holders and
Obamacare's Medicaid expansion, have always polled well.
Moreover caution is always in order with issue polling. When these kinds
of polls show public opinion fractured, it's tempting to believe that
one side or the other represents voters' "true" support. That's the
wrong way to interpret such polls. Yes, the ACA polls badly while most
of its components poll well. But that doesn't mean that the ACA is
genuinely unpopular (as most opponents suggest) or that it's genuinely
popular (as most supporters contend). There is no underlying truth to be
excavated from the results; the best we can do is say that public
opinion is inconsistent.
Well, that's the best we observers can do. Campaign operatives, in
contrast, can counsel their candidates to stress whatever is popular.
What those operatives shouldn't do is to fall for their own spin, or let
their candidates fall for it.
The broader point: We can measure public opinion, but sometimes –
actually, quite often – public opinion is an incoherent mess. Voters
have plenty of things other than politics going on in their lives; it's
not surprising that they should find the strongest selling points from
both sides quite appealing and let it go at that. For those of us who
pay close attention, it may seem weird that someone could hate Obamacare
while loving almost every part of it. There must be one overriding
opinion hidden in there -- pro or con -- that good research can isolate,
no? Well, no. Sometimes, incoherence in the polls simply reflects
incoherence among voters. We just have to live with that.
Comment by Don McCanne
The public reaction to the Affordable Care Act (ACA) is very instructive
as far as understanding public attitudes toward single payer reform.
Most of the specific policies in ACA have been supported for many years
by those who are relatively well informed on the issues - a minority of
our population. The negative views of the public have been formed in the
hollow echo chamber filled with empty political rhetoric devoid of
illuminating explanations - a message chamber that reaches most of our
people. The political attack has been aimed at President Obama and the
Democratic Party, but not at ACA's beneficial policies. Thus many in the
media have correctly reported that "Obamacare" continues to poll poorly
- as a political construct - whereas the specific improvements in health
care coverage - the health policies - have support of the majority.
Although the situation with the public attitude towards single payer is
similar, it has not had nearly the same intensity of exposure has had
ACA. More Americans have now heard the term "single payer," but the
majority still have a poor understanding of what a tremendous
improvement it would be over our highly dysfunctional, wasteful,
inefficient, and inequitable multi-payer system. That is, the public at
large is still very poorly informed on single payer policies.
The hollow echo chamber of empty political rhetoric targeting single
payer has been around much longer but has been maintaining a lower
profile. As long as single payer reform does not seem to be imminent,
the effort of opponents has been directed to building anti-government
memes that can be rapidly brought to the front should a single payer
reform effort gain traction.
Examples of this latter phenomenon include Proposition 186 in California
and Measure 23 in Oregon. Both of these single payer measures polled
favorably until close to the elections. In both instances, it took only
a couple of weeks of mindless trashing of the measures to result in a
tidal wave of opposition. They were defeated by empty rhetoric and not
by opposition to beneficial health policies.
In today's article, Jonathan Bernstein makes the important point that
"quite often public opinion is an incoherent mess." Look how much
difficulty the supporters of ACA are having in getting the message out
about the genuine benefits of ACA when the listeners are exposed to a
background of meaningless cacophony generated in the hollow echo chamber.
When single payer is ready for its day, the cacophony will be almost
unbearable. That is why it is so important now to pull all stops in
educating the public on single payer benefits. They will need a much
better understanding of the concept so that they can sort out the facts
from the noise.
Bernstein says, "Sometimes, incoherence in the polls simply reflects
incoherence among voters. We just have to live with that." No, we don't
have to live with that. We simply need to build our own colossal echo
chamber spewing out the facts. Education. Education. Education.
at 2:23 PM