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The Home Front on the Public Option

The 13 senators who yesterday voted against both government-sponsored health insurance plans represent populations whose support for health reform improves significantly when the plan does not include just such an option.

Among those living in states represented by the 13* Senate Finance Committee members opposing both amendments, a majority in the latest Washington Post-ABC News poll gave a thumbs down to the health reform proposals being developed by the Congress and Obama administration. But when asked about a package that excluded a public option, the results flipped and most stood in favor of the reform effort.

The opposite was true among those living in states represented by the 8** members of the committee who voted for both amendments, as support in those states held steady regardless of the inclusion of a public option.

Just over half (51 percent) in states represented by a senator who opposed the two amendments said the proposals as they understood them would create too much government involvement in health care, about four in 10 (41 percent) said it would be the right amount and fewer than one in 10 (7 percent) said it was not enough government action. Among those whose senator backed both amendments, 48 percent considered it the right amount, 16 percent said it wasn't enough government action and 34 percent felt it went too far.

The politics of the vote are also notably different between the two sets of constituencies. Majorities in both (53 percent among opposing states, 55 percent among supporting) said a congressional candidate's views on the reform effort would not impact their vote next November, but among those who said the vote would be crucial, the divide is clear. Among those in states represented by opponents of the amendments, 28 percent said support for reform would make them less apt to back a candidate while just 18 percent in the supporting set of states said the same.

Among both sets of constituencies, about seven in 10 said Democrats in Congress should modify their bill to win some GOP support.

Q. Overall, given what you know about them, would you say you support or oppose the proposed changes to the health care system being developed by Congress and the Obama administration?

                ------- Support -------  -------- Oppose -------
                NET  Strongly  Somewhat  NET  Somewhat  Strongly
All             46      30        16     48      12        36

Support states  54      35        20     39      14        25
Oppose states   40      30         9     54      11        43

Q. Say health care reform does NOT include the option of a government-sponsored health plan - in that case would you support or oppose the rest of the proposed changes to the health care system being developed by Congress and the Obama administration?

               Support   Oppose
All              50        42

Support states   55        38
Oppose states    53        38

*Arkansas, Arizona, Idaho, Iowa, Kansas, Kentucky, Maine, Montana, Nevada, North Dakota, Texas, Utah and Wyoming

**Massachusetts, Michigan, New Jersey, New Mexico, New York, Oregon, Washington and West Virginia

By Jennifer Agiesta  |  September 30, 2009; 12:40 PM ET
Categories:  Health care , Post Polls  
Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   StumbleUpon   Technorati   Google Buzz   Previous: Virginia's Regional Divide on the Issues
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What so many in favor of the "public option" fail to understand is that it is not universal coverage, it's not free public health care. If a public option was available, people would STILL HAVE TO PAY a premium for it, granted in theory that premium would be less than what the private insurers charge.

Secondly, a public option wouldn't itself cover every American. A public mandate would have to be part of the legislation (similar to that of Massachusetts). So the poor (and healthy) may be forced to purchase insurance from the government, which may or may not be less expensive than private insurance.

And I never seem to hear these points brought up by Rachel Maddow or anyone else on the "left".

It seems to me that those who keep crying "public option now!" need to give this a bit more thought.

Posted by: RambleOn | September 30, 2009 1:16 PM | Report abuse

Public Opinion is not the proper way to drive governance. Democracy is not viable using the current method of advertising numbers approving and disapproving. CNN and others no longer even post, let alone refer to the statistical accuracy of their polls. 40% think this and 70% think that. What we need are statesmen who are willing to risk their political future by doing the right thing for the American people.

Posted by: buddecj | September 30, 2009 1:38 PM | Report abuse

Everyone should have to purchase health insurance. Just as everyone has a right to be taken to an emergency room in an emergency, everyone should have to pay into the system that pays for the emergency rooms. No one on the left thinks that healthcare is free. We just resent those on the right that don't want to pay for it "because it's not in the constitution."

Posted by: tropunlim | September 30, 2009 1:44 PM | Report abuse

I'm reading this in California, and I'm in favor of Universal coverage, or failing that the "public option".

I'm unclear about the reasons for being against the public option, assuming the survey questions are not biased. It does not replace private medicine. Just as in the UK and Canada, for example, we would remain free to choose our own insurance policies and private physicians. But it would compete with private insurance and possibly be better and cheaper.

It's an OPTION, not a mandate.

Posted by: shadowmagician | September 30, 2009 1:46 PM | Report abuse

It appears that states with large populations favor the public option and states with small populations do not. Given that we are a democracy where the majority rules, except in the senate, it seems clear that merits are with those who favor the public option.

Posted by: cdierd1944 | September 30, 2009 1:47 PM | Report abuse

How do you tame a lion such as private health insurance whose has little regulations even at the state level since states are afraid to uphold what laws there are because of their threats of "pulling" out of that state?? Provide a Public Option that is in every state so there is less likelihood of this type of blackmail!

Posted by: bonnieblue12 | September 30, 2009 1:54 PM | Report abuse

I'll take CBS/NYT poll over WAPO/ABC poll any giving Sunday....

Haitt works here at WaPo so that's a conflict of interest right there!!!

But I know one thing



Posted by: danders5000 | September 30, 2009 1:58 PM | Report abuse

Notice that a lot of these nay sayers are from small population states. If the Senate rules didn't include the supposed need for 60 votes (well over fifty percent) the public option would have been long-since passed.

Not to do the public option will be to do Medicare D on a grand scale. After Medicare D, drug and insurance prices skyrocketed. And people paid too. Remember the donut hole? Many just quit buying drugs because they couldn't negotiate the donut hole.

It is a simple issue. Is health care reform being done for the billion-dollar corporations and their bonus-rich CEOs, or for the ordinary people? The only way to reign in skyrocketing costs and terrible abuses (rescission, pre-existing illnesses as reason for exclusion, high deductibles and low caps on coverage for high premium insurance) is to give ordinary people the option of choosing a public plan.

Reputable polls show that people favor the public option. Democrats, get off your duffs and pass a public option.

Posted by: tinyjab40 | September 30, 2009 2:04 PM | Report abuse

The American people do not want the system of fascism that underlies Obama's veneer, simply put. Ironically, many liberals go along with this non-right system, not even realizing that they are advocating a system that will eventually eliminate any/all criticism of government...their penchant. Do your homework!

Posted by: nosam32 | September 30, 2009 2:14 PM | Report abuse

I am a 58 year old diabetic. I would like to be able to purchase health insurance, but insurance companies will not insure people like me. The public option allows me the opportunity to purchase health insurance. Why are conservatives against me purchasing health insurance?

Posted by: gmason2 | September 30, 2009 2:36 PM | Report abuse

It appears that states with large populations favor the public option and states with small populations do not. Given that we are a democracy where the majority rules, except in the senate, it seems clear that merits are with those who favor the public option.

Posted by: cdierd1944 | September 30, 2009 1:47 PM

WOW I know those like you don't think very highly of our Constitution especially when it gets in the way of what you want. Or maybe its a function of our education system. Either way we are not a Democracy, we are a Republic. See our Founding Father's (You know those Old Guy) they foresaw a situation where the people's house (House of Representatives or) with numbers allocated by population could become overtly Partisan and they could try and completely reshape the Nation so they set-up a State House (Senate) with 2 from each State who were originally appointed by each State so as not to be subject to the politics of the day and be a deliberative body (later changed by the 17th Amendment). This is why states like Wyoming and Rhode Island have 1 representative but 2 Senators. Hope that clears it up for you.

Posted by: skatman104 | September 30, 2009 2:39 PM | Report abuse

thought i would make it through one comment section without the word facism,socialism. wrong.

Posted by: donaldtucker | September 30, 2009 2:45 PM | Report abuse

If you would like to take a stand against open corruption in Washington please join our Reform voting bloc at:

If you would like to take a stand in support of real health care reform please join our Health bloc here:

Posted by: letsgobuffalo | September 30, 2009 2:51 PM | Report abuse

How do you tame a lion such as private health insurance whose has little regulations even at the state level since states are afraid to uphold what laws there are because of their threats of "pulling" out of that state?? Provide a Public Option that is in every state so there is less likelihood of this type of blackmail!

Posted by: bonnieblue12

Again that old crumply piece of paper gets in your way. Even Stenny Hoyer,(D.Md) Majority Leader recognized this when asked why not allow insurance to be sold across State lines he said that would be a violation of the 10th Amendment. Therefore if insurance across State Lines is a violation how could force States to allow in a public option (federal government insurance). It would be good if more people were made to learn about the foundation and function of Government so we would not hear the whining about what can't be done. Before you say Medicare and Medicaid are Government Options I would just ask you to call your State Office of Medicare/Medicaid and ask who administers the programs. You would find that bills have been filed 18 States protecting their citizens from this Federal over-reach.

Posted by: skatman104 | September 30, 2009 2:53 PM | Report abuse

The goverment has NO right to force me to buy health insurance, and i for one will leave this country before being forced to pay for something i dont need. You want to live in a country were they tell you what to do and how to live go to china, i for one wont have any part of it though. You people that think the goverement has the right to tell us what to do, do not understand the basic princible of freedom, you want a fascist country just so you can get a handout and continue on being a burden on hard working people like me.

I will admit that we need health care reform but doing the wrong thing just to get something done is only going to make our problems worse, a goverment option is not the way to go, and lazy stupid bastards (that think it is the goverments job to take care of them) are the only people supporting it. This is a free country and i for one will not be told what to do by some commy bastards.

Posted by: Joe62 | September 30, 2009 2:54 PM | Report abuse

As a self-employed health insurance agent, because of pre-existing conditions, I am uninsurable. My wife is a self-employed CPA, also uninsurable. It would be nice to be able to purchase an insurance plan that would cover us. The public option would make that available to us.

I previously lived as a teenager in Northern Ireland, and received health care in that country, which was very good, both quality and service.

At 60 years old, I have thought of moving to another country just to get health coverage, which is really sad. There are many more people in my situation, and I guess we don't count in this matter. Well, only 5 more years and I'm on Medicare. Public option will finally be available, pre-existing conditions or not. Pathetic.

Posted by: COLEBRACKETT | September 30, 2009 3:01 PM | Report abuse

Why the mandate plans won’t work, and why
single-payer “Medicare for All” is what we need

By Len Rodberg, PhD
reposted from

A majority of physicians (59 percent) and an even higher proportion of Americans (62 percent or more) support single-payer national health insurance or "Medicare for All."

In spite of this, all we are hearing about today are mandate plans that would require everyone to buy the same private insurance that is already failing us.

These proposals don’t regulate insurance premiums, they don’t keep the insurance companies from refusing to pay many of our
bills, and they don’t improve the insurance we now have.

Some offer a “public option,” but this will
quickly become too expensive as the sick flee to the public sector as private insurers avoid them, abandon them, or make it too difficult for them to get their bills paid.

Posted by: ryan_heart | September 30, 2009 3:06 PM | Report abuse


You know the only reason these clowns are trying to push this down our throats is so they can create another 2 milling GoVmt/union, tax-payer funded, Jobs. If these people took sometime to get educated they would know that the GoVmt doesn't have any money other than what it can cohearse for those of us who were and pay taxes. They could also look at DOL records and would find that the split is 60/40 private/public right now and if this heath care and cap and tax both pass it will be public would exceed 50/50. Maybe they would wake-up and stop drinking the kool-ail knowing that everyone (not just their favored enemy the rich) will have to give $.5 of every $1 they earn for another person to have a job and then whatever additional % to keep the GoVmt running. This is called Indentured Servitude, so they don't have to look it up SLAVERY!!

Posted by: skatman104 | September 30, 2009 3:10 PM | Report abuse

Everyone please don't think that I am not in support of providing health care for all, its more of an issue of how you do it that does give one person a right without infringing on another's right. Reading the drafts of the house bills and the summary posted by the Senate don't even come close. In fact if others read the bills "instead of listening to pundants on both sides) they would also be question what if anything do they have to do with providing health care for all.

Posted by: skatman104 | September 30, 2009 3:20 PM | Report abuse

Just for the record, Skatman104, the densely populated state of Rhode Island has two reps, not one, as you suggested. Unfortunately, this is the least of the misconceptions riddling your posts.

Posted by: DCRI | September 30, 2009 3:24 PM | Report abuse

This column completely misses the KEY number from yesterday's vote. The 13 senators who voted against both public options represent a grand total of 55 million Americans -- about one-sixth of the population. Take away John Cornyn's Texas, and the number is well under 30 million. Take away the rest of the Republican votes -- which wouldn't matter if the Democrats could enforce the slightest bit of party unity -- and Conrad, Baucus and Lincoln represent just 4.5 million people.

Thus, 13 senators from backward, podunk states -- representing (again, apart from Texas, which wants to secede anyway) a far smaller number of Americans than the ranks of the uninsured -- get to force the status quo on the rest of us. Thus is progress thwarted in the U.S. of A.

Posted by: jonfromcali | September 30, 2009 3:28 PM | Report abuse

i have watched the hearings on health care.

cuts in medicare should not be on the table.

our government has known for 50 years it would run out of money. it took the money the baby boomers paid in and misued it.

we paid for our parents and grandparents.

it is the governments fault for bad management of money.

the seniors are the majority, vote them out and change all of this back.

people who worked all their lives, paid their taxes, voted, should not be treated as people who are asking for a handout and the word entitlement is used the way it is.

Posted by: s-tharp | September 30, 2009 5:50 PM | Report abuse

seniors may be the majority,but seniors of today are not the seniors of yesterday.people use the term seniors like we are all feeble in nursing care pooping our diapers.seniors are much more active today than ever,remember age 62 is considered a senior and aarp membership is less than that so look around you see [seniors in their late 70s and 80s very active not every 80 yr old is arnold palmer but there are more of them playing golf and enjoying other activities than are in nursing homes.i myself am 65+16 days,and i weigh within 5 lbs of what i weighed after 28 yrs of active military service.everyday on my walk and jog i pass guys and gals 20-30yrs younger and 20-30lbs heavier than the politicans should not equate age with weakness or not sure but i would bet that half of the us senate are seniors and are kept alive by drugs .in office by drug the seniors of today are much different from yesterday.and most of us object to the term senior citizen.

Posted by: donaldtucker | September 30, 2009 7:23 PM | Report abuse

How We Can Come Together
...Right Now

We must endeavor not to antagonize each other from the exclusive vantage of our own personal perspectives. This is how they that perpetuate these injustices continue to win.
Joe-62 and Len Rodberg PhD aren't so far apart. Joe doesn't want people who are already struggling financially to be FORCED to pay for insurance. As a healthy organic eating UberLiberal/tarian I feel exactly the same way.
Although Dr. Rodberg is ultimately correct about Medicare-for-All being the most rational and humane route (See Norway's clear success as atested by their #1 world ranking) a Public OPTION may be the proverbial foot in the door, the toehold we need. Provided that there is absolutely NO mandate to purchase ANY plan-including the public one.
If Joe wants it-it's there for him (provided he pay a minimal deductable that is assumedly a fraction of what a private plan is). If he doesn't want it...F--K it and he'll take his chances.
Many of us on both sides have no use for the Western Medical Establishment for our own reasons (particularly those that actually respect and care for their bodies)-and may opt out even if it were free. But there must be a safety net to care for those that cannot care for themselves. Now...Are we truly so far apart?

Posted by: flyingtrees | October 1, 2009 12:59 AM | Report abuse

First, I really hate when people start to destroy conversation with rants about fascism and other such manure (nosam). It's not 'debate' when the equivalent of a drunk in a bar is calling you names. I keep hearing Fox and the right talking about the August 'debates'. There were no debates, just angry people spewing out mostly nonsense and shouting down anyone who wanted to ask reasonable questions. I went to our town hall and listened to long rambling ranting speeches from ill- informed but hard headed attendees that kept most of us from getting to ask questions. Our rep did a good job of explaining aspects of what was going on in Washington re health care, but some just wanted to play Rush/Beck wannabe games. I watched some of the meetings on C-span and saw people get shouted down just for asking how they were going to get health care since they lost their jobs. These people were shaking as they stood up and I could see why. You cannot have a decent conversation with someone scowling and shaking their fists.

Posted by: livefromNY2 | October 3, 2009 4:32 PM | Report abuse

Another separate point. I agree with the earlier poster who said we need representatives who work for us without being tied into hourly polls. Am I the only one who is tired of being told minute by minute that some poll (of which I wasn't part of)agrees/disagrees with me. I've noticed how some talking heads and some politicians will use poll numbers that at times are totally different than another poll. the only poll that should matter to these guys is the election. Then they should do their job. I also realize that,sadly,they are tied to the polls because they spend most of their time in office raising funds for their next election. That's another item for reform for another time.

Posted by: livefromNY2 | October 3, 2009 4:39 PM | Report abuse

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