The Problem with a Plan.

At the upcoming health-care summit, and in the days following, Republicans will be talking a lot about how the American public has rejected the Democrats' health-reform plan, and therefore we ought to toss it out and "start with a blank piece of paper," which in practice means abandoning health reform altogether. But has the public actually rejected the Democrats' plan? The answer is, yes and no. A Newsweek poll contains some interesting data. When they asked people whether they favored or opposed the Obama plan, 40 percent said they favored it, and 48 percent said they opposed it -- not great, but not a disaster for the Democrats. Then they listed a bunch of the plan's provisions, and asked them whether they favored or opposed each. They got pretty much what you'd expect: Most of the provisions are extremely popular:

Health care table.JPG

The ones that aren't popular are the things you wish you didn't have to do, but you have to in order to make the system work: having an enforcement mechanism for the individual mandate and having an excise tax on high-cost plans to nudge people into more affordable plans. In the poll's language, these involve "imposing fines" and "imposing a tax" respectively -- very distasteful to voters, as the data show. Nevertheless, all the other provisions are extremely popular (even the public option, which isn't actually in the president's plan).

But here's another interesting part. After getting people's opinions on all these (mostly) popular provisions, the poll asked, "Now please think about the proposals I just described to you. ALL of these proposals are included in Barack Obama's health-care reform plan. Having heard these details, what is your OVERALL opinion of Obama’s plan – do you favor it or oppose it?" You might think support would explode, but it didn't. After all that, you have 48 percent supporting it and 43 percent opposed. Better, but not overwhelming.

This can be partly attributed to the particular context of a phone survey. When I just told you I opposed the plan, telling you now that I support it means admitting both that I didn't know much about it, and that I'm kind of fickle. And once you take a position, you're unlikely to be persuaded by contradictory evidence. Instead, we tend to look for ways to justify the place we've already put ourselves in.

But this kind of data should still offer Democrats some needed spine-stiffening. The thing people are opposed to is something abstract: It's a "plan" that is being debated in Washington, which they probably don't know much about. An actual program, once implemented, will have a very different place in people's consciousness. There will be no more "Obama health plan"; there will only be a series of things having to do with health insurance, most of which people will be very happy about (and the ones that seem less popular now, like enforcing the individual mandate, will actually affect relatively few people). When, for instance, you can actually put your 25-year-old kid on your health insurance, that'll feel good. When the exchanges actually start operating, you'll probably like the way they work. Those things will be "my health insurance," not a "plan" being debated in Congress.

It's easy to convince people that a plan is dangerous; it will be much harder to tell them that their own health insurance is part of a socialist plot.

--Paul Waldman

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