Health-Care Polls Distort Support for Clinton Plan

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MANY of the founders of public-opinion research in the United States, including George Gallup and Elmo Roper, believed that polls would strengthen American democracy by clarifying the public's views on policy questions. Often they, in fact, do that. But, as their recent application on President Clinton's health-care proposals makes painfully evident, polls can also distort, rather than amplify, the public's voice.

Based on telephone interviews with 539 adults immediately following Mr. Clinton's nationally televised speech last week, ABC News Polling reported that he ``won majority support for his plan. Clinton moved the bottom line from an even division before his speech to 2-1 support afterward.''

USA Today said (Sept. 23) that the survey Gallup conducted for the newspaper and CNN right after the address showed that Americans ``support Clinton's plan by a two-to-one margin....''

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But consider the setting: With the applause of members of Congress echoing in the background, the president tells the nation that ``our health care is too uncertain and too expensive, too bureaucratic and too wasteful.''

The system must be reformed, he says, according to the principles of ``security, simplicity, savings, choice, quality, and responsibility.'' And this reform of ``the costliest and most wasteful system on the face of the earth'' can be done quite painlessly, ``without enacting new broad-based taxes.''

Polling within hours, even minutes, of the talk, it's just not possible to find out what people think about the plan. What one gets, no matter how the question is phrased, is reaction to the speech itself and the person delivering it. The polls make clear that Clinton's remarks were well received. But there is no basis whatsoever for saying that he had moved millions of people to support the substance of his proposals. In fact, there was clear polling evidence that nothing of the kind had occurred. In its own immediate post-speech survey, CBS News had the good sense to ask, ``As of now, do you think you have a good understanding of what the Clinton health care plan will mean, or is it too early to know that yet?'' Seventy-five percent of all respondents, and 69 percent of those who had watched the speech, said that they really did not know what was being proposed!

To ask (as ABC News, USA Today, CNN, and others did) a question they should have known people would not and could not in fact answer, whether they backed the president's health-care plan, implicitly compared to alternate approaches, is to invite highly misleading responses. This is by no means the only instance in recent polling on health issues when the effort has taken on a cheer-leading role. Thus, in their survey of Sept. 16-19, CBS News and the New York Times asked this terribly leading question: ``Would you be willing or not willing to pay higher taxes so that all Americans have health insurance that they can't lose, no matter what?'' The Times then reported (Sept. 22) as an important finding that 61 percent of Americans were prepared to pay higher taxes.

By linking a tax hike only to a good end, and by not specifying the amount of the hike, the question became useless as a guide to public sentiment. Other polling has shown clearly that, while the public is willing to pay a little more to improve the health insurance system, the additional amount they would support is limited.

In their survey of Sept. 17-19, ABC News and the Washington Post asked the question in a better form: ``Would you support or oppose an increase in taxes to help pay for Clinton's health care plan?'' They found only 45 percent saying they would support a tax hike, with 50 percent opposed.

For all the false starts in health-care polling, there is still an impressive body of balanced research showing that the public is deeply concerned over soaring medical bills and, as a result of the cost hikes, increasingly worried about the prospects that they might sometime lose insurance coverage. The public is also more sympathetic to persons now uninsured.

At the same time, a large majority of Americans are happy with their present coverage and with the medical care they receive. They are very skeptical about expanding government's reach in the health area. Seeing medical costs already too high, they aren't looking to ``reform,'' which winds up costing much more. They believe, by huge majorities, that the president's proposals would increase the amount they pay for medical care; and by a large plurality they fear his proposals might cost the country jobs.

Thus, public opinion on health care is full of contradictory impulses. It's just not true that, by margins of 2-to-1, the public now backs Clinton's plan.

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