Thursday, July 30, 2009

Have the Stars Aligned for Health Care?

Throughout his full court press strategy to sell the American public on health care reform, President Obama has repeatedly used the phrase the "stars have aligned" implying health care reform is inevitable due to some cosmic glitch beyond our control. The last time the stars were aligned was coincidentally when the last Democratic President had a Democratic Congress, namely Clinton. We all know how that turned out. Have the stars aligned even more perfectly this time for the "One" Barack Obama or is his health care effort every bit as vulnerable as Clinton's?

Certainly things have not been going very smoothly for the President given that cosmic alignment and all. He has made several pretty disastrous mistakes while trying to maneuver legislation through the Congress. Recent polls show the public appetite for reform souring. The question remains, though, whether there was a greater appetite for reform now compared to the mood in the Clinton era.

To answer this question Robert Y. Shapiro and Sara A Arrow of Columbia University compared polling data from 1994 and 2009 and tested the hypothesis there would be greater support for Obama's reform. The results showed the public mood or climate to be roughly the same if not even slightly less favorable than during the Clinton presidency. While several questions showed a more favorable mood those that showed less favorable mood related to increased taxes required to finance the reform:
The questions that yielded less favorable responses concerning health care reform during 2008-2009 than 1993-1994 were ones that asked about paying taxes: to finance national health insurance, to enable everyone to have health insurance, or to guarantee health insurance coverage

There was also a less favorable environment with respect to the belief the country as a whole spent too much on health care and there was a 6 point increase in opposition to guaranteeing health care for all Americans.

The current mood was also compared to that of the Johnson Administration where the most sweeping reforms were passed through Congress with the creation of Medicaid and Medicare. There was one significant difference between the Johnson era and the current political environment:
But what has changed in American politics since that time is that partisan and ideological differences, both in Congress and other leadership arenas and consequently in mass public opinion itself, have widened across the full range of
economic, racial, social values, and foreign policy issues (cf. Bafumi and Shapiro, 2009; Page and Shapiro, 1992, Chapter 7)

The authors' conclude that despite a relatively stable mood over time for change in the health care system, the perils of the Clinton Administration's efforts suggest that President Obama has his work cut out for him.

Hat Tip to Andrew Gelman who provides a thorough review of this study at FiveThirtyEight.

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