The Politics of Medicare for All: The Polls
September 18, 2019
By Jill Zorn |
Note: This is Part 5 of our Medicare for All blog series. You can see all previous posts here.
Here is an important political question: Does the American public support Medicare for All?
The previous blog in our Medicare for All Series addressed one major aspect of the politics of the issue: the corporate opposition and how messaging about Medicare for All has been influenced by that opposition.
Now let’s look at the polls, and how the media narrative about the presidential election feeds off those polls.
Medicare for All is More Popular Than It Used to Be
The popularity of Medicare for All appears to have increased in the past few years. Kaiser Family Foundation has been tracking the issue since the late nineties. According to the poll, support went above 50% for the first time in 2016, when Bernie Sanders was running for the Democratic presidential nomination and Medicare for All was a focus of his candidacy. Support rose even higher in 2017 when the Affordable Care Act (ACA) was under serious threat.
Changing the branding from single-payer to Medicare for All may have also had a positive impact – see this New York Times article, How ‘Medicare for All’ Went Mainstream.
Polls Can be Deceptive
Polls can be very fickle instruments for gauging the public’s support for Medicare for All. There are many different polls out there and they don’t ask questions the same way.
And, as the Kaiser tracking poll shows, people are answering survey questions about Medicare for All without really knowing what it is. Certainly people aren’t familiar with the features of the proposed bills in Congress.
Another problem with the polls is that even when features of Medicare for All are mentioned, often the most controversial features are highlighted like:
- Most Americans will pay more taxes
- Private health insurance companies will be eliminated
The media then amplifies these concerns in their headlines and debate questions. For example, Lester Holt of NBC news asked for a show of hands from the Democratic presidential candidates in the June debate, “Many people watching at home have health insurance through their employer, who here would abolish their private health insurance in favor of a government-run plan?”
This question highlights two major negatives. It uses the messaging term government-run, that was developed by right-wing think tanks and the insurance industry. And it plays into the natural human fear about having something taken away from them.
As Ezra Klein wrote in Vox, this is a “…ridiculous question. There is exactly one reasonable response to whether you would abolish private insurance, and it isn’t ‘yes’ or ‘no.’ It’s not raising or lowering your hand. It’s: ‘It depends.’”
Meanwhile, the gains and actual tradeoffs people would experience are seldom mentioned, such as:
- While people may pay more in taxes, they will no longer pay premiums, deductibles or co-pays – in fact the average person will pay less for health care than they do now.
- While people will not be able to choose their insurer (in fact, most people have little to no choice now) choice of doctors will remain and even increase.
Is Medicare for All a Political Winner or Loser?
These far-from-perfect polls are also being used to discern whether a Democratic presidential candidate’s stand on Medicare for All will help them or hurt them in the quest to win the party’s nomination and, ultimately, the presidency.
The Kaiser Foundation poll asks this question and reports the results by party affiliation:
“Do you favor or oppose having a national health plan, sometimes called Medicare-for-all, in which all Americans would get their insurance from a single government plan?”
It would seem the Democratic base is strongly supportive, while Republicans are strongly opposed and independents are split down the middle. But, as the poll also shows, people answering these questions are not informed about what is actually in the Medicare for All proposals (see slide 11).
Yet it is poll data like this, amplified by the media, that sows seeds of concern: would support for Medicare for All hurt the Democratic candidate in the general election? Would a more “moderate” proposal be more popular and thus make a candidate more “electable”?
To attempt to answer these questions, some polls have tried to present several different alternatives to see which health reform alternatives are most preferred by the public. This is how Democrats in the Kaiser poll answered when they were asked specifically to choose between two options, “Would you prefer to vote for a candidate who wants to…?”
|Build on the existing ACA||55%|
|Replace the ACA with Medicare for All||40%|
These results are featured in the press release Kaiser Foundation used to promote the September tracking poll – feeding right into the developing media narrative that Medicare for All may not be a political winner. Here is the headline: “Poll: Most Democrats Prefer a Presidential Candidate Who Wants to Build on the Affordable Care Act.”
Is this a fair either-or question? After all, it is logical for even Medicare for All supporters to see Medicare for More or Medicare for Some plans as building blocks in the transition toward the ultimate goal of Medicare for All.
If we’re going to have a public conversation about Medicare for All, let’s have a fair discussion about the actual tradeoffs involved. Let’s have a debate with better questions, and more informed answers. Let’s not build health policy off of flawed polling instruments or use poll results to gin up controversy to generate television ratings or retweets.
As this blog has discussed, there are many ways to ask polling questions – some more leading than others. Here are two critiques from the left, that flesh out these concerns:
- Americans Actually Do Want Medicare for All
- Single-payer activists say you need to take a closer look at polls on Medicare for All
Meanwhile, the lobbying group America’s Health Care Future, that represents corporate opponents of Medicare for All, has started their own tracking poll to influence the media narrative – go here to see the results.