Do Americans Support a Public Option?

On Oct. 20, the Washington Post ran the headline "Public Option Gains Support: Clear Majority Now Backs Plan" on the front page above the fold. The perception of strong majority support may have stiffened Democratic Majority Leader Harry Reid's resolve to include a public option in the health care bill that will go to the Senate floor. But is it real?

The Post story reflected what the ABC News/Washington Post poll found: 57% in October supported the public option, up from 55% in their September poll and 52% in their August poll.

But to suggest that people have firm opinions about specific provisions of complex legislation or understand their implications is misguided. In an October Pew Research Center poll, 56% of those surveyed knew that the term "public option" referred to health care. A third, however, said they didn't know what it meant or didn't respond. The rest answered incorrectly.

Polls that suggest we are giving clear guidance risk misleading legislators and, perhaps more important, devaluing the polls themselves.

The wording of a question, or what is emphasized in it, can often sway someone's response--even if he or she knows a lot about the issue. For instance, people like competition, they like choices and they like Medicare. When questions about the public option use those words, the public option gets strong support. But questions that use phrases like "government administered" remind people that government usually doesn't run things very well, and support drops.

The same ABC/Post poll asked, "Would you support or oppose having the government create a new health insurance plan to compete with private health insurance plans?" But the new NBC News/Wall Street Journal poll asked about "creating a health care plan administered by the federal government." While both polls found four in 10 opposed, support was almost 10 points lower in the NBC/WSJ poll. Another question in the NBC/WSJ poll asked people how important it was "to give people a choice [my emphasis] of both a public plan" and "a private plan for their health insurance." Forty-five percent said it was extremely important; 27% said it was quite important. The key word here is "choice," and it is a popular one, as the results suggest.

If the public option, a centerpiece of the debate, is widely popular, one might expect that overall support for the health care bill would be stronger than it is. In the ABC/Post poll, 45% said they "supported the proposed changes to the health care system being developed by Congress and the Obama administration," but 48% were opposed. In the NBC/WSJ poll 38% said that from what they "had heard or read about Barack Obama's health care plan," his plan was a good idea; 42% said it was a bad one. In the new Gallup/USA Today poll that mentioned the White House and congressional Democrats, 25% said they would support the final health care bill and 33% oppose it, but 39% said it would depend on some decisions that have yet to be made about the bill.

Most of us are too busy to follow complex debates in Washington. We won't stay up late at night reading the 1,990-page House health care bill that was released Thursday. Sixty-six percent in the October Pew poll told interviewers that the issue of health reform was "hard to understand." In an October Kaiser poll, people split evenly about whether the word "confused" described their feelings about the reforms under consideration. In a Gallup poll from the summer, two-thirds said members of Congress probably didn't have a good understanding of the health care debate either.

Americans assert general values. We want to improve our health care system and work to insure more Americans while keeping costs down. We aren't giving specific legislative advice about the public option or other provisions of this enormously complex legislation. Polls that suggest we are giving clear guidance risk misleading legislators and, perhaps more important, devaluing the polls themselves.

Karlyn Bowman is a senior fellow at AEI.

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