Getting the Polling Straight on Medicare for All
Feb. 18, 2020
Contrary to misleading news reports, and despite relentless industry attacks, Medicare for All continues to win support from a majority of Americans. Poll after poll finds that Medicare for All is supported by the vast majority of Democrats, many Independents and even a substantial number of Republicans. Even when battle-tested using biased attacks on Medicare for All, support remains consistent.
However, the validity and reliability of the polling on Medicare for All and other health care reform efforts vary widely as does the accuracy of reporting on such polls. It is important for both the public and journalists to look closely at the substance of the polls, as focusing only on topline results can introduce significant bias into their interpretation. In addition, industries that profit from the broken health care system have made a concerted effort to manipulate Medicare for All polling, spending vast amounts on attack ads in swing states followed up by Koch-funded allies conducting polling in the same states.
Journalists can better represent polls by not reporting on poorly worded or biased polls, noting the increased political polarization in results and providing context about how results from an individual poll compare to results from other polls. As health care consistently tops the list of key issues for voters – particularly for Democrats and Independents – we can expect to see even more polls. It is important that they are represented accurately in the media.
Poorly Worded or Biased Polls
Many polls continue to use biased, outdated or confusing wording, which – unsurprisingly – drives down support for Medicare for All.
For example, Gallup has been using a misleading question since at least 2010, which asks, “Which of the following approaches for providing healthcare in the United States would you prefer – A government-run health care system or a system based mostly on private health insurance?” This question is a poor way to gauge support for Medicare for All, as is evidenced by the fact that support based on responses to this question has never been higher than 47% and is generally closer to 40%. Medicare for All is not directly “government run”; hospitals and doctors’ offices would remain privately owned. Instead, care would just be government funded, an important distinction. When worded differently, support is significantly higher, for example around 56% in the most recent Kaiser Family Foundation tracking poll, which uses a more neutral wording, “Do you favor or oppose having a national health plan, sometimes called Medicare-for-all, in which all Americans would get their insurance from a single government plan?”
Similarly, Quinnipiac uses misleading wording, which, unsurprisingly, leads to deflated support. They ask respondents “Do you think that removing the current health care system and replacing it with a single payer system, in which the federal government would expand Medicare to cover the medical expenses of every American citizen, is a good idea or a bad idea?” It is misleading because Medicare for All does not in any way “remove the current health care system” and such wording creates a negative impression with respondents.
Instead of asking a series of questions to clarify preferences, a recent Hill-HarrisX survey prompted respondents to choose among five potentially confusing choices. The polling firm found similar results when it ran this poll in February 2019 .
Polls also have shown that different labels for health care reforms generate very different levels of support. Even within the same poll, terms like “Medicare for All” and “universal health coverage” generally poll higher than terms like “a national health plan” or “single-payer health insurance” (with even further variation among Democrats, Independents and Republicans).
Pollsters should use consistent, accurate and neutral language when asking about Medicare for All. For example, wording such as “Do you (support or oppose) a ’Medicare for All’ health care system, where all Americans would be covered by a national health plan?” conveys the scope of Medicare for All without overly biasing respondents.
Increased Polarization in the Polls
Despite huge amounts of corporate spending on ads attacking Medicare for All, robust support among Democrats has remained consistent and even increased in recent months while Independents’ support has remained constant. A January 2020 Kaiser Family Foundation poll found that 77% of Democrats “Favor having a national health plan, sometimes called Medicare for All, in which all Americans would get their insurance from a single government plan.” A December 2019 NBC/WSJ poll found that 68% of Democrats supported “Adopting Medicare for All, a single-payer health care system in which private health insurance would be eliminated and all Americans would get their health coverage from one government plan,”—which was up from 63% in September 2019.
Polling among Independents has consistently found majority support for Medicare for All. The January 2020 Kaiser Family Foundation poll found that 61% of independents favored Medicare for All, while the December 2019 NBC/WSJ poll found that around half of Independents polled supported Medicare for All.
The primary source of actual decline in support for Medicare for All are Republicans. An August 2018 Reuters/Ipsos poll found that a majority of Republicans supported “A policy of Medicare for All when it comes to the U.S. healthcare system.” Support for Medicare for All among Republicans has declined significantly since President Donald Trump and the GOP increased their attacks on health care expansions of any kind, with particular animosity toward Medicare for All. A number of industries that profit off our broken health care system and their GOP allies have been paying for attack ads, many of which inaccurately label Medicare for All as “socialism.” Since August 2018, GOP support for Medicare for All has dropped, with only 24% supporting it in the January 2020 Kaiser Family Foundation poll and 14% of Republicans supporting it in the December 2019 NBC/WSJ poll.
The increased polarization in health care polling is shown not just in the decline in Republican support for Medicare for All, as highlighted above, but also can be seen in an uptick in Republicans reporting positive feelings about their current health care. For example, though it’s unlikely that anything has changed in their coverage (other than the typical increases in premiums and out-of-pocket expenses that Americans experience each year), a December 2019 Gallup poll found that nearly three in four Republicans were satisfied with what they pay for health care, an increase of nearly 15% compared with the previous year’s results.
Reporters should be aware of the distinction that overall drops in support are due to decreases in support only among Republicans.
Lack of Adequate Context Regarding Poll Results
Because of the momentum around Medicare for All, there have been numerous polls looking at various aspects of the health care system. This often means that authors are cherry-picking the stats that best make their case instead of presenting a more accurate picture. Any statistic must be presented clearly and should generally be situated within the larger context of the polling on health care in general and Medicare for All, in particular.
For example, even just looking at the period from June 2017 to January 2020, a Kaiser Family Foundation tracking poll found that in response to the question “Do you favor or oppose having a national health plan, sometimes called Medicare-for-all, in which all Americans would get their insurance from a single government plan?” between 51% and 59% of Americans expressed support and between 37% and 47% expressing opposition. Reporting on the results of any single month (which often happens) may present a misleading picture considering that a majority of Americans have supported Medicare for All since June 2017. And the most recent version of the survey highlighted a rise from a 51% in October 2019 to 56% of Americans in favor of Medicare for All in January 2020.
While polling is crucial for helping us understand the opinions, concerns and preferences of the American public, it is essential that results are accurally interpreted and fairly presented. To not do so plays directly into the hand of corporate profiteers who gain mightily by preserving the status quo of our broken health care system.