Poll suggests public opinion movement in the right direction

In U.S., 51% Say Government Should Ensure Healthcare Coverage

By Justin McCarthy
Gallup, November 23, 2015

U.S. adults are slightly more likely to say it is the responsibility of the federal government to ensure all Americans have health insurance coverage (51%) than to say it is not the government's responsibility (47%). The percentage who believe the government has that obligation is up six percentage points from 2014. This year marks the first time since 2008 that a majority of Americans say the government is responsible for making sure all citizens have health insurance.

From 2000 to 2008, between 54% and 69% of Americans said ensuring healthcare coverage for all citizens was the responsibility of the federal government. But the issue grew more divisive in 2009, as President Barack Obama worked to enact the Affordable Care Act, which Congress passed in 2010. Between 2009 and 2011, Americans were split nearly evenly on the matter. Then from 2012 to 2014, public opinion shifted, with slight majorities saying healthcare coverage was not the government's responsibility.

Do you think it is the responsibility of the federal government to make sure all Americans have healthcare coverage, or is that not the responsibility of the federal government?

Percent saying, Yes, government responsibility:

2005  58
2006  69
2007  64
2008  54
2009  47
2010  47
2011  50
2012  44
2013  42
2014  45
2015  51

Which of the following approaches for providing healthcare in the United States would you prefer - a government-run healthcare system, or a system based mostly on private health insurance?

Percent saying, System based on private insurance:

2010  61
2011  56
2012  57
2013  61
2014  61
2015  55



By Don McCanne, M.D.

Regarding views toward health care reform, there is a suggestion in these polling results from Gallup that the American public may be influenced more by politics than by policy, but that might be changing.

After experiencing unsustainable rises in health care costs along with the abuses inflicted upon us by the managed care industry, there was considerable support for having the government assume responsibility for health care coverage, peaking in 2006 at 69%.

The support persisted as a majority of the nation gathered around the candidacy of the man offering us HOPE - Barack Obama. Although a few Republicans were ready to work with President Obama and the Democrats on health reform, the Republican leadership decided that it was more important to make Obama a one-term president. Thus began one of the most politically polarized times in the history of the United States.

Although initially distracted by the financial crisis, the battle over health care reform quickly commanded the nation’s attention. Without regard to a consideration of beneficial health care policies, the Republicans demonized Obamacare, and their constituents joined in with a vengeance. Much of the bashing included intense anti-government rhetoric. By 2013, when reform was largely implemented, support for a government role had dropped to 42%. At the same time, support for private insurance plans, which formed the basis not only of Obamacare but also of the models proposed by the Republicans, was at 61%.

It is important to note that the Republican versions of private insurance were much less comprehensive than plans available today, but there was never a serious discussion of the policy implications of these plans which would leave patients with fewer benefits and exposed to even greater out-of-pocket costs than we have with today’s high-deductible plans.

Now that Obamacare has been implemented and patients are experiencing high premium costs, intolerable cost sharing, skyrocketing drug costs, and loss of choice of their health care providers, people are beginning to realize that private plans are failing on their promise to bring us higher quality at lower costs. There is a suggestion in the polls that people are beginning to lose faith in private insurance.

A bare majority - 51% - now say that it is the responsibility of the federal government to make sure that we all have health care coverage. A majority - 55% - say that the system should be based on private insurance, but that is declining from last year’s high of 61%. It is possible that support for private insurance may plummet as more individuals discover that they gave up their choices of physicians and hospitals in exchange for an insurance program that failed to protect them against financial hardship - what most believe to be the primary function of insurance.

As others make the some discovery, we may finally reach the critical threshold of support that we need to convince Congress to enact a single payer national health program - an improved Medicare for all. Can hardly wait.