Who Cares What The Public Says About Public Option?

The Washington Post has headlined a story about a poll it took with ABC News showing that the "public option" feature of the health care debate is supported by a clear majority of Americans.

But does that mean the public option will be in the final bill? Don't bet on it.

So does that mean Congress listens only to lobbyists and does not care about public opinion? Not quite.

It's all about what polls really measure and what lawmakers are really looking for in a poll. And in either case, the answer often differs from what meets the eye.

It Depends On How You Ask

Much depends on the language and framing of the questions. Supporters of the public option say it is merely an opportunity for those denied health insurance in the private market to obtain it from the government. In that guise, the public option seems to expand individual choice and freedom. That generally polls well.

The Post-ABC pollsters asked: "Would you support or oppose having the government create a new health insurance plan to compete with private health insurers?" This question was answered yes by 62 percent in June, 52 percent in August and 57 percent last week. About half the support lost over the summer appears to have been restored (an intermediate poll done in September showed this movement under way).

The Post-ABC poll found acceptance increased still further when the public option was understood to be handled by the states, not the feds, and if it would be restricted to those who had no access to affordable coverage.

But opponents of the public option, as formulated in Congress, see it as a creeping mandate. They say private insurers could not compete successfully against the government and that some employers would stop providing coverage and let the government take over.

Rasmussen Reports, a polling operation favored by many conservatives, asks the question this way: Would you support a public option "if it encouraged companies to drop private health insurance coverage for their workers?" Given that as a consequence, Rasmussen's poll shows the public opposed to the public option by 2 to 1.

Polls Can Be Poor Guides

Most surveys find two-thirds of Americans are satisfied with the health insurance they have now, so fear of being forced into the arms of Uncle Sam is palpable and potent. The public option becomes a bridge toward national health insurance.

Some say that's the best reason to have a public option, to get to a "single payer" system of Medicare for all. Others say it gives up the game, revealing the liberals' backdoor strategy to achieve "socialized medicine." Some of this sentiment was highly visible in August's town halls, becoming the focal point of the discussion and coverage.

With that backdrop, key members of Congress returned in the fall and began scaling back the health care plan. The public option was left out of the bill approved by the Senate Finance Committee, which is the only bill so far to attract even one Republican supporter (Olympia Snowe of Maine) and also the one likeliest to preserve that fragile collection of ego figurines that is the Senate Democratic majority.

Sure, there are Democratic senators insisting that they won't vote for a bill without a public option. They range in seniority and seriousness from the veteran Jay Rockefeller of West Virginia to the appointed seat holder Roland Burris of Illinois. But so far at least, no one seems to believe they will really derail the entire enterprise over this issue.

That's why the sudden appearance of fresh polling data suggesting the public option is gaining ground pours sand in the gears of conventional wisdom. Is the Senate Finance bill really the most viable vehicle for health care overhaul or not? Should we let the people decide?

Truth is, polls are a poor guide in such matters. Not that lawmakers are oblivious to public opinion — to the contrary, they are typically obsessed with it.

But the polls they care most about are not the national polls but the ones taken back in their states and districts. Polls back home can be vastly different from the national norm.

Lawmakers concerned about primaries more than general elections also cast an eye on the partisan breakdown of the polls they see. When a GOP member sees that more than 80 percent of Republicans oppose the current health care proposals in the Rasmussen Report, that lawmaker needs no further coaching.

As for Democrats hoping to do well among independents, the polling guidance can be contradictory. Polls generally show big majorities in favor of "reform," even if it means "big changes." But when people are told specifics about what is taking shape in Washington, it mostly engenders anxiety, especially given the low standing of Congress itself.

No surprise, then, that even the Post-ABC poll finds that only 45 percent of the public likes what it sees happening with health care in Congress right now. Rasmussen finds the percentage still lower at 42 percent. And that number has not changed since August.

So is that because the public option is in the mix or because it isn't in the mix enough?

Depends on whom you ask the question, and how you ask it.

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