The Cato Institute’s Michael Cannon has replied to Part 1 of my response to Cato’s report on the Patient Protection and Affordable Care Act (ACA) .You’ll find his reply here. Unfortunately, the Cato Institute website doesn’t have a space for comments, so I decided to respond here, on HealthBeat.
First, let say that Cannon’s reply is both civil and gracious. Thank you, Michael Cannon. I’m hoping that this debate will move forward as I continue to write about the rest of the Institute’s recent white paper, “Bad Medicine: A Guide to the Real Costs and Consequences of the New Health Care Law.” This seems to me a good opportunity to have an intelligent, rational dialogue about reform, comparing facts, while laying out two very different points of view, calmly and clearly.
In my original post, I had pointed out that in order to support his argument that the legislation “remains deeply unpopular,” Michael Tanner, the author of the July 12 Cato report, used an old number, dating back to May 22. As it happens, the May poll, which showed 63% of respondents favoring repeal of the legislation, stands as the high-water mark for repeal during the seventeen weeks that Rasmussen has been asking the question on a weekly basis. This led me to suggest that Tanner “cherry-picked” a poll that squared with his thesis.
Cannon explains: “I’m not sure why Tanner didn’t include more recent numbers, but it may have been because it often takes 6 weeks for a paper to emerge from Cato’s publishing process.”
Fair enough. I can imagine it might well take 6 weeks for a think tank to come out with a print version of a white paper. But Tanner’s report appeared online July 12. It would seem that the online version would have been updated to acknowledge that in the weeks that followed May 22, support for repeal fell, first to 60%, then to 58% (two weeks running), before tumbling to 55%, and finally hitting a low of 52% the week of June 25-26.
At that point, Rasmussen’s pollsters observed: “This is the second lowest level of support for repeal in 17 weeks of surveying since the health care bill was passed by Congress. It marks what appears to be a continuing downward trend in support for repeal since June.” As I put it in my post: “in the five weeks following May 22, support for repeal consistently dropped, while opposition to killing the bill rose” from 32% to 40%.
Here, Cannon objects: “this is not quite accurate.” After all he notes, the table I included with my post indicates that six weeks after the May 22 poll (on July 1) support for repeal bounced, rising to 60%. This is true, but the table also shows that the very next week, the number of respondents favoring reform plummeted, once again, to 53%, while opposition to repeal climbed to 42%. (After I wrote my post Rasmussen released July 15 numbers, showing 56% favoring repeal and 38% opposed.)
Granted, the numbers do not form a straight line. Weekly poll numbers never do. But a trend line seems clear. Since May 22, the percent of respondents who want repeal has dropped from 63% to 56%, while the share who wants to keep the bill has risen from 32% in May to 38% today. (You’ll find a table showing poll results each week from March 23 to July 16 here.)
The problem with the Cato Institute report is that it gives us just one dramatic chart (see below) showing the results of that single May 22 poll which , it turns out, was an outlier. In the 17 weeks since Rasmussen has been asking about repeal, support has reached 63% only once, and opposition has never fallen lower that it did on May 22, when 32% objected to killing the bill.
Rasmussen Poll –May 22-23
Rasmussen Reports, poll of 1,000 likely voters, May 22–23, 2010, margin
of error +/- 3 percentage points, with a 95% level of confidence.
In my critique of the Cato report, I go on to cite other polls which confirm that as time passes, the more voters learn more about the reform legislation, the more they seem to like it. A Gallup poll also suggests that opposition is largely confined to the one group that already has universal coverage–seniors. Here I quote Ezra Klein: “seniors, of course, aren't opposed to government-run health care. They love their Medicare, and insofar as they have a policy concern here, it's that the Affordable Care Act will interfere with the single-payer system they rely on.”
Cannon ignores the fact that the ACA is popular among the people it will actually affect, and suggests that I have picked polls that support “the Left’s theme.” (Here, he seems to imply that I’m cherry-picking. I’m surprised; this is the first time I’ve heard anyone suggest that the folks at Gallup are Lefties.)
He goes on to declare that he prefers consulting “Pollster.com,” which takes all available polls into account. When you do that, he argues, “you see that . . . the trend line is not moving in the direction Mahar says it is.” This, I’m afraid, is simply not true. But I understand where Cannon got the idea. Pollster.com itself says: “The trend lines don’t look so good for supporters of the law.”
Indeed, if you stand back and look at the chart below from a distance, that red line showing disapproval does rise sharply over time. But take a closer look, and you will discover that the chart begins in February of 2009, more than a year before the bill made its way through Congress.
Back then, in February of 2009, very few pollsters were asking the public whether they liked the health reform legislation. (Those little colored squares on the chart above represent individual polls.) That is because it is very hard to ask people whether or not they like legislation that doesn’t yet exist. It was only after the final bill was passed, that people could begin to offer an opinion.
So if you’re looking for a trend, it’s only sensible to begin the day the bill was signed, March 23. (This is also when Rasmussen began polling). You can see the trend from March to mid-July clearly if you go to pollster.com’s website click on “tools” at the bottom of the chart, then click on “date range,” and change the beginning date to March 23 2010. (Make sure you change the year from 2009 to 2010). Finally, click on “set range.” You’ll get a new chart which reveals that on March 23 about 51% of respondents disapproved of the legislation. Today, that number has fallen to 46.8%.You also will notice that, since March the red line has been moving down quite smoothly.
The black line (indicating approval) has been wriggling around. This indicates that great many people still don’t know whether they like the bill: they won’t know what effect it will have on them and their families until it is implemented. But as I indicated in my original post, if you move beyond the “approve/disapprove” formula and ask more probing questions, polls from NBC/Wall Street Journal and Kaiser show that the majority of respondents either support the ACA or prefer that it “be given a chance to work with Congress making revisions as needed.” They don’t favor repeal. A Bloomberg News poll released last week confirms “that a full 61 percent of respondents don’t have an interest in repealing the health care legislation…(47 percent want to see how it works, 14 percent say it should be left alone). Just 37 percent want the bill repealed (as is the wish of the Republican leadership). (Let me add, I don’t think anyone sees Bloomberg News as a tool of “the Left.” )
Many Americans just are not sure how the legislation will play out. But they are certain of one thing: they do not want to see their legislators to return to vitriolic debate over health care reform. They want them to move forward, to discuss jobs and the economy. If conservatives and libertarians push repeal theme in the fall elections, I believe that they will lose votes.