Indiana Survey Finds Little Edge for 'Public Option' Over Single Payer

Indiana University's Center for Health Policy and Professionalism Research (CHPPR) recently completed a survey that found "support for government-sponsored health insurance for individuals under age 65 remains virtually the same regardless of how the plan is described or how involved the government would be."

43% considered a "public health insurance plan" appealing, with 30% finding it unappealing; a "Medicare-like" plan enjoyed a 44-26% edge; and a "single-payer" option had 39-36% support. The pollsters characterized the support numbers for the three as falling within the "margin of sampling error for results based on the total sample" of 609 adults surveyed, which was plus or minus 4 percentage points.

The CHPPR poll described the public health insurance plan as competing with private health insurance plans for the business of "everyone under the age of 65" who "would decide whether or not they want to purchase private health insurance through a private company or public health insurance offered by the United States government" under a plan that "would compete with private health insurance plans ... and would be available to anyone regardless of employment." The "Medicare-like" plan was described in virtually identical terms.

The "Single-Payer Scenario" was a system "changed in the following way...Similar to other countries, everyone under the age of 65 would automatically be enrolled in a health insurance program provided by the United States government. In addition to receiving government funded health care, you would have the option of purchasing additional coverage from private health insurers."

But perhaps of equal interest was the partisan breakdown. Republicans strongly opposed all three options - "public health insurance" by a 45-29% margin, the "Medicare-like" plan by 37-30%, and single-payer by 56-12%. Unaffiliated voters narrowly supported all three: "public health insurance" by 41-31%; "Medicare-like" by 41-30%; and single-payer by 40-37%. In contrast, Democrats went for all three in a big way - "public health insurance" by 63-11%; and the "Medicare like" plan by 64-8%. But the single most remarkable outcome of the Indiana poll has to Democrats' 69-10% margin of support for single-payer.

Certainly a poll is just a poll. There'll be many more and none of them can compare with the impact of the type of financial and propaganda blitz the health insurance industry can afford to put on if and when it needs to. Nonetheless, this one does suggest several conclusions. The first, and most important, is that not only is single payer actually viable among real life, unbought voters, but a plurality of them actually support it. Another is that association with Medicare is modestly helpful, which is no news to congressional single payer advocates who already call their vehicle, HR 676, the Single Payer Medicare for All Bill.

And after reading this poll, it's hard not to be impressed with the work that the single payer advocates have done over the past decade in garnering the support of nearly 70% of Democrats. Work that was largely done with the mainstream media either ignoring their issue or declaring it a non-starter because it fell outside the bounds of the national corporate consensus. Which leads us to the elephant in the poll - the degree to which the Democratic Party is not serving its own base in this debate, a charge that clearly cannot be leveled against the Republicans.

Certainly it's hard for a single payer backer to look at these poll results and not muse wistfully what might have been, had either the White House or the Democratic Congressional Leadership been willing to provide any small "l" leadership. Even the Employee Free Choice Act, whose supporters have their own hard row to hoe, has had the benefit of a labor movement that has closed ranks around a plan they determined to be the best option and not publicly whittled down its own position before debate had even begun. But then serious leadership was never in the cards on health care and we might perhaps better ask, "What now?"

Well, the Indiana poll does suggest that, despite all that has not happened, the single payer banner remains the one that makes the most sense to carry through the current congressional town meeting tumult and on into the fall. And the principal reason for doing so is not necessarily either the fact that it has broad support or that the President himself acknowledges that it is a legitimate route to universal coverage while the plans floating around Congress are not.

It's a matter of coherence. The opponents of health care reform have the advantage of clarity - they are simply against mucking around with the system that the Republicans and the medical industrial complex claim works so well. And the other side is for - what exactly? A general concept of reform that holds harmless the insurance industry that is the cause of so much of the waste? And, oh, yes, maybe a little public plan as a sop to the single payer people - if they're good and go along with the program.

Anti-government activist Grover Norquist once famously said, "My goal is to cut government in half in twenty-five years to get it down to the size where we can drown it in the bathtub." From the look of things, any "public option" likely to come out of Congress these days probably wouldn't require a whole lot of shrinking before drowning. Nor is it likely to be improved by people agreeing to take whatever it is they are given.

It's simple really - you want the best possible health plan? Demand the best possible health plan.