Everyday Politics Blog

Making Sense of Public Opinion on Health Care Reform

Michael Xenos

While there are many issues facing the government right now, health care reform is undoubtedly an item near the top of the policy agenda. As Scott’s recent post points out, major reform efforts such as those surrounding health care right now are especially difficult in a political system such as ours.  Nevertheless, as the discussion on this morning’s Meet the Press shows, supporters of reform like White House Senior Advisor Valerie Jarrett believe there is strong momentum on health care reform and we seem to be nearing what host David Gregory calls “brass tacks time” on the issue.

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In news coverage of the health care debate, which according to one estimate is about 10% of all news stories right now, we hear a lot about public opinion on health care reform. Opponents are quick to tout polls that paint a picture of rising opposition to the reform packages being considered in Congress, while supporters point to majority approval of various key provisions of the plans under discussion.

Informed consumers of public opinion polls typically make sense of individual results by looking to factors such as whether the poll is based on a scientifically sound random sampling technique, what population is being sampled (for example, the general public or “likely voters,” which may be defined in a number of ways), the specifics of question wordings, and other factors known to have a strong influence on the numbers and their implications. For complicated issues such as health care reform, it is also helpful to seek more in-depth analysis provided by public opinion experts. In the past, this kind of analysis was difficult to find.  Now, however, there are a variety of resources available online, such as pollster.com and others I’ll mention below, that offer valuable insights for understanding the flood of sometimes conflicting and confusing poll numbers we are seeing in the media.

On the health care issue, for example, the non-partisan Pew Research Center for the People and the Press recently issued an informative report on health care opinion. (Readers of one of my previous posts will be relieved to know that these researchers are keenly aware of the contemporary difficulties surrounding telephone polling, and regularly integrate cell-phone users into their surveys.) Their report provides a detailed account of the mixed picture created by support for specific provisions alongside opposition to broader packages.  By way of explanation, they suggest that “[t]he disconnect between support for specific elements of health care legislation and overall opposition to the proposals in Congress appears to be driven by a lack of understanding about what is being proposed, the complexity of the topic and declining trust in Congress.” Indeed, in a separate survey probing what the public knows about various issues in politics, the Pew researchers found that only 56% of their respondents recognized “the public option” as a part of the current health care reform debate (as opposed to pertaining to Energy and the environment, Banking reform, or Unemployment), with 33% confessing that they didn’t know what issue it was related to and 11% incorrectly guessing one of the other options.  Polling expert David Moore further emphasizes this aspect of public opinion on health care in a post on his blog, SkepticalPollster.com.  In discussing some of CNN’s polling on the issue, Moore suggests that “the dysfunctional results can be found in a question that was not reported on CNN’s website, politicalticker, but was posted in its archive. When asked how much they knew about the details of Obama’s health care proposals, almost six in ten respondents admitted that they knew little to nothing – after having just opined about them during the previous twenty-minute survey. Only 11 percent said they knew “a good deal.””

Hopefully, as the policy process moves forward, more Americans will become more informed about this major policy issue.  Conventional wisdom tells us that when that happens we will see opinion become more stable and less confusing. In the meantime, we should be aware of this important facet of opinion on health care and take this as a good opportunity to think and talk about key aspects of public opinion in American Government courses.

Are Opinion Polls an Endangered Species?

Michael Xenos

You wouldn’t think so based on paying casual attention to the major news stories of the day. Just yesterday, while interviewing Chairman of the Joint Chiefs of Staff Admiral Mike Mullin on Meet the Press, David Gregory referred to findings from a recent Washington Post-ABC News poll suggesting that 51% of Americans do not think that the war in Afghanistan is worth fighting. Coverage of the current battle over health care reform commonly includes references to President Obama’s approval ratings and a variety of policy-specific opinion figures. Incidentally, a useful source of relatively raw versions of these kinds of poll results is Polling Report.com.
 
And why shouldn’t there be a lot of discussion about what the public thinks in a representative democracy such as ours? Most would agree that having information on what the public thinks about various issues is important in a democracy, and although they have their problems, traditional public opinion polls conducted by telephone are the most sophisticated and scientifically refined means we have of gathering such information. However, as one of my colleagues recently reminded me, even those who make a living from telephone surveys are wondering how much longer they will be able to provide useful information about the American public’s attitudes and opinions.
 
My colleague pointed me to a story in which Jay Leve, the CEO of SurveyUSA (the country’s largest polling firm) is quoted making a number of comments suggesting that the telephone-based public opinion poll as we know it, is likely a creature that is not long for this world. Some of the reasons are probably obvious to readers of this blog. Most notably there is the difficulty most pollsters have in reaching young people and others who rely exclusively on their cellular phones and are not connected to any kind of landline. Moreover, due to the nature of cellular phones, even if a pollster manages to get someone to answer their call, it is no longer to tell things like where they live based on the number. Perhaps most interesting is Leve’s analysis of a much less technical issue, the fact that we simply lead much more complicated and different lives than we did when these techniques were perfected. In his words: “Ringing someone’s phone without warning and asking if they have 20 minutes to spend with you flies in the face of everything that’s going on in the world today. I barely have 20 minutes to spend with my daughter.”
 
On a more positive note, Leve also suggested ways that polling might adapt to the realities of our contemporary lifestyles, such as making the whole process more interesting and even enjoyable for the respondents. If effective, such adaptations might point to the evolution of polling more than its extinction.  
 
What do you think?  Are opinion polls valuable? Are they obsolete? What role should they play in our political system?

Class War? What Americans Really think about Economic Inequality

by David Watkins

Over the Summer, I'll offer brief reviews of recent books of interest to students of American Politics. I begin with a short but important book about public opinion regarding economic inequality in the United States. Class War? What Americans Really think about Economic Inequality by Ben Page and Lawrence Jacobs, provides an overview of 'the data' on public opinion. They review existing polls on the subject over the last several decades, and commissioned a major poll of their own (conducted in 2007; interestingly, the public opinion they measure is prior to the current economic crisis).The central finding is one that many who’ve followed public opinion closely have long known—that substantial majorities of American have favored a number of policies that reduce economic inequalities and threaten opportunities, and they express a willingness to pay for these policies as well. In addition to this startling and direct finding, their analysis of the data reveals three other significant features about American public opinion on economic inequality:

Agreement. For those of us who follow politics closely, the fact that Republicans and Democrats largely agree on most issues regarding economic inequality will probably come as something of a surprise. Certainly, this fact often seems to have little effect on the behavior of Republican politicians, and would seem foreign to those who interact primarily with Republican Party activists and movement conservatives. But on question after question, over time, Republicans are generally only slightly less likely than Americans overall to support measures to reduce economic inequality and increase economic opportunity. A few examples: 72% of Americans affirmed the statement that “Differences in income in America are too large”—as did 56% of Republicans (pg. 44). 64% of Americans said they were willing to pay more taxes to support funding for early childhood education in kindergarten and pre-school, as did 57% of Republicans (pg. 59). Should the federal government see to it that everyone who wants to work can find a job? 67% of all Americans and 60% of Republicans say yes (pg. 62). Is it the task of government to see to it that no one is without food, clothing, or shelter? 68% of Americans and 61% of Republicans say yes (pg. 72). This pattern repeats itself with High-income Americans, who respond in a similar fashion to Republicans. There is little widespread disagreement amongst American voters on these issues, at least along the traditional cleavages where we’d expect to find it. 

Knowledge. A number of survey questions in chapter two indicate that Americans are actually quite knowledgeable about economic inequality. Many might find it inconsistent that a solid majority of American agree with the statement “In order to get people to work hard, large differences in pay are necessary” (pg. 33) while at the same time supporting measures to reduce inequality. But it’s not necessarily inconsistent at all. One can support inequality—even large amounts of it—and still recognize that we currently have too much, and more than is necessary for any socially beneficial consequences of inequality. On inequality issues, American public opinion is more knowledgeable than is often assumed. 

Complexity. What I’ve presented here is fairly straightforward, but Page and Jacobs introduce an important twist in understanding American public opinion on inequality. We are, in an important sense, philosophically conservative. Americans want work, effort and talent to be well-rewarded. They want actions and choices to have consequences, positive and negative. They remain suspicious that governments will spend our money well. But when our questioning moves from the realm of abstractions to specifics—health care, education, taxation, and the like, they seemingly abandon this conservatism and support action to reduce inequality. Page and Jacobs call this operational liberalism, which combined with philosophical conservatism yields a result they call ‘conservative egalitarianism.’  

These three features—agreement, knowledge and complexity, suggest a very different picture of American public opinion than we are often presented with in contemporary political discourse. But this analysis raises an obvious question—if there is so much agreement on these matters, why is there such tepid support for substantial inequality-reducing reforms? Page and Jacobs don’t tackle this difficult question until the end of the book. There are many possible answers, I think, and the ones they prefer—inaction due to the structure of American politics and, more importantly, interest group politics resulting in the overrepresentation of elite interests and perspectives in government, seem as plausible as any. Nevertheless, the book, while succeeding admirably at presenting a more accurate picture of American politics than is typically presented, left me wanting a more thorough discussion and investigation of the gap between political preferences and policy. This book is an excellent beginning to this discussion. 

Abortion and Public Opinion

By Scott Lemieux

People interested in subjects like the effects of question wording and selection on public opinion surveys should definitely read John Sides and Nate Silver on recent abortion surveys.   Their analysis brings up a couple important puzzles:

• When is there enough evidence to determine that there has, in fact, been a substantial change in public opinion, in a way which might affect the political calculus of public officials, the outcomes of initiative votes, etc.?   When public opinion has been as stable as it's been on the abortion issue in the United States, it's prudent to be skeptical about the results of individual polls representing a shift, but of course it's also important to be open-minded.    The next round of surveys will be interesting, and I'll try to follow up.
• Even on some fairly straightforward issues, measuring public opinion can be difficult, with subtle changes in question wording producing different results.     Abortion is even trickier, particularly given what appears to be a rough public consensus in favor of legal-but-regulated abortion.   Should questions ask general or specific?   Should they ask about the morality of abortion or about specific legal regulations of abortion?    Because of this, it's probably especially useful to have multiple polling groups asking their own particular set of questions, even if it makes long-range comparisons more difficult.      

The bottom line is that any conclusions in any direction have to be tentative.   It will be interesting to follow this issue in the coming months.  

Election Day

By Scott Lemieux

It's the big day in American politics!   If you want to get a sense of what public opinion surveys are saying about the election, you can check out aggregations of polls at FiveThirtyEight, Pollster, RealClearPolitics, and ElectoralVote.com.   There are differences among the polls, not because some major pollsters are incompetent, but because election polls require making assumptions about things that are unknowable.   In particular, we can quite accurately determine how a population as a whole will vote, but a great deal depends on who turns out to vote.   Pollsters see the election outcome differently because they make different assumptions about who will vote, but there's no way to know this for sure in advance.   In addition, the Presidential election is determined not by the national popular vote, but by the electoral college. State polls are generally more volatile and less reliable than national polls, so figuring out who will win a close state is more difficult. 

At any rate, it will be interesting to see what happens, as always!   We will be back to analyze the results.