Wednesday, March 10, 2010

Why Obama can't move the health care numbers

Scott Rasmussen and Doug Schoen have analyzed polling data on health care reform and offer a cogent explanation of why President Obama has been unable to move the health care numbers.  They make three main points.  First, while the President focuses on the details of his plan, Americans are convinced and afraid that it will hurt the economy.  Second, people simply do not believe the cost projections.  Third, most Americans are satisfied with their current health care, and believe the congressional bill, if passed, would force them to change insurance.  Wall Street Journal:
Why can't the president move the numbers? One reason may be that he keeps talking about details of the proposal while voters are looking at the issue in a broader context. Polling conducted earlier this week shows that 57% of voters believe that passage of the legislation would hurt the economy, while only 25% believe it would help. That makes sense in a nation where most voters believe that increases in government spending are bad for the economy.

When the president responds that the plan is deficit neutral, he runs into a pair of basic problems. The first is that voters think reducing spending is more important than reducing the deficit. So a plan that is deficit neutral with a big spending hike is not going to be well received.

But the bigger problem is that people simply don't trust the official projections. People in Washington may live and die by the pronouncements of the Congressional Budget Office, but 81% of voters say it's likely the plan will end up costing more than projected. Only 10% say the official numbers are likely to be on target. [snip]

The final piece of the puzzle is that the overwhelming majority of voters have insurance coverage, and 76% rate their own coverage as good or excellent. Half of these voters say it's likely that if the congressional health bill becomes law, they would be forced to switch insurance coverage—a prospect hardly anyone ever relishes. These numbers have barely moved for months: Nothing the president has said has reassured people on this point.

The reason President Obama can't move the numbers and build public support is because the fundamentals are stacked against him. Most voters believe the current plan will harm the economy, cost more than projected, raise the cost of care, and lead to higher middle-class taxes.
It is surprising to me that even 10% of people believe that the CBO cost projections will be on target.  In the February issue of Hillsdale College's publication Imprimis, Representative Paul Ryan (R-WI) provides staggering historical evidence of the unreliability of such projections:
If there is any doubt that control of health care services should not have been placed in the federal government, we need only look at the history of Medicare and Medicaid—a history in which fraud has proliferated despite all efforts to stop it and failure to control costs has become a national nightmare. In 1966 the cost of Medicare to the taxpayers was about $3 billion. The House Ways and Means Committee estimated that it would cost $12 billion (adjusted for inflation) by 1990. The actual cost in 1990 was nearly nine times that—$107 billion. By 2009 Medicare costs reached $427 billion, with Medicaid boosting that by an additional $255 billion. And this doesn't take into account the Medicaid expansion in last year's “stimulus.”
The legislative epilogue of this year's health care debate will be written by those wavering Democrats in the House of Representatives.  Speaker Nancy Pelosi has stated that Democratic lawmakers should be willing to sacrifice their jobs to get health care reform passed.   It remains to be seen how many of them will heed her call.

At this late hour in the debate it's up to the American voters to let their representatives know in clear terms that a yes vote on the Democratic health care bill is a portent of their early retirement from the Congress.

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