From some of the rhetoric surrounding health care policy, you’d think Americans by and large dislike government involvement in health care.
Nothing could be further from the truth.
While the requirement for a portion of uninsured Americans to purchase insurance (the mandate) is not popular — particularly in polls that do not mention that subsidies are available to those covered by this requirement — this does not mean that people dislike government involvement in health care.
In fact, citizens strongly support government in health care.
Most Americans want strong regulations on insurance companies, such as a requirement that the companies provide insurance to people with pre-existing conditions. Moreover, they don’t want to see Medicare and Medicaid privatized.
In a recent poll,
Asked what Medicare should look like in the future, just 26 percent said it “should be changed to a system where the government provides seniors with a fixed sum of money they could use either to purchase private health insurance or to pay the cost of remaining in the current Medicare program.”
Fully 64 percent said “Medicare should continue as it is today, with the government … paying doctors and hospitals directly for the services they provide to seniors.”
Even a solid 56 percent to 30 percent majority of Republicans preferred the current system.
During the debates on the Affordable Care Act, majorities supported a public option and expanding Medicare. Those options, which were discarded because moderate Senate Democrats were trying to build compromises with Republicans, would have been clearly constitutional. Instead they adopted (along with many other provisions) mandates with subsidies and insurance exchanges, a plan developed by the conservative Heritage Foundation and adopted by Republican Governor Mitt Romney.
Then and now, schemes involving private insurance companies — whether the mandate or privatization of Medicare and Medicaid — generally have not been liked.
Americans much prefer government paying medical bills out of tax revenues — just as they strongly prefer public pensions (Social Security) to privatization of this much-used and loved government program.