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    What America Thinks
    Healthcare: Round Two

    By Richard Morin
    Washington Post Polling Director
    Monday, July 5, 1999

    Suddenly, everybody's talking health care – again. One reason, of course, is that the presidential campaign is upon us. Democrats in general and Al Gore in particular see clear advantage in making health care reform a showcase issue next year.

    Recent surveys suggest that Democrats continue to be seen as the party of choice for Medicare and health-related issues. And Washington Post political reporter Ceci Connolly reports that Gore gets his biggest applause on the campaign trail when he mentions health care reform.

    But beware. Democratic partisans and particularly liberal Democrats may still go knock-kneed at the mere mention of reform, polls consistently show. Remember the lessons of 1993, when top-heavy public support for the image of health care reform morphed into hard opposition when confronted with the reality of the Clinton health care plan.

    In fact, public attitudes toward health care remain deeply ambivalent. The latest poll from Louis Harris & Associates underscores some problems politicians face when making health care an issue. While reform remains popular with the Democratic faithful, most Americans remain skeptical of broad changes in the system. In fact, the climate for reform may be growing chillier, not warmer, the survey found.

    "There is no consensus on whether the nation's health care system is getting better or worse or on whether the trend toward more managed care is a good thing or a bad thing," writes Humphrey Taylor, chairman of Louis Harris. "Public expectations for the system are more positive than they were; furthermore, the public backlash against managed care has diminished somewhat in the last year and does not represent the opinions of a majority of adult Americans."

    According to the survey, 47 percent of those interviewed said the nation's health care system is getting better while 43 percent said it is getting worse. This is significant: Two years ago 57 percent said the system was getting worse. The same is true for attitudes toward managed care plans: 42 percent said the trend toward managed care is a good thing, while 44 percent said it is bad. "A year ago, the public was slightly more hostile with a 47 percent to 40 percent plurality thinking it was bad," Taylor writes.

    A 55 percent majority still believes, however, that managed care will harm the quality of care they receive, and 56 percent agreed that more managed care will not make health plans more responsive to their medical needs. Taylor and his colleagues have detected a puzzling trend: "When we started asking these questions three years ago, public attitudes to managed care were substantially more positive, but more people believe the system was getting worse." In each successive year, Harris polls found people more critical of managed care but less pessimistic about the system.

    In their latest survey, says Taylor, "attitudes toward managed care have, if anything, improved slightly and optimism about the system has continued to increase." He adds: "The backlash against managed care has bottomed out and may have started to turn."

    The American Century

    America is going to hell – but in style and comfort, according to a national survey by the Pew Research Center for the People & the Press.

    "Americans see the 20th century as a time of great economic, social and technological progress," says Andrew Kohut, director of the center. "As individuals, as families, as members of various social and demographic groups, nearly two-thirds of Americans say they have improved their circumstances since the 1950s, and even larger numbers see economic and social gains for many segments of society over the past half-century."

    At the same time, a majority of Americans say the quality of life in the United States isn't necessarily better than it was in the 1950s, and three in 10 say it's worse. "Misgivings about America focused on the moral climate, with people form all walks of life looking skeptically on the ways in which the country has changed both culturally and spiritually," says Kohut.

    This best of times/worst of times view is reflected in answers to questions rating inventions and trends of this century.

    On the list of America's top trends: Civil rights, women in the workplace and mutual funds. Best inventions include the radio, automobile, computer and the highway system. Among the worst features of modern life: Credit card use, rap music, divorce and telemarketing. Topping the list of inventions we could live without are nuclear weapons, cloning sheep, fertility drugs and nuclear energy.

    The End of the World

    A majority of Americans – 56 percent – said it's at least "somewhat likely" that the Y2K computer bug will produce widespread economic disruptions "along with lengthy shut-downs of electricity supplies and major industries. . . [and] widespread dislocation and possibly chaos, even a collapse of law and order at all levels of government that could last for many years," according to a new national survey conducted by the Americans Talk Issues foundation.

    Richard Morin is director of polling for The Washington Post. "What Americans Think" appears Mondays in The Washington Post National Weekly Edition. Morin can be reached at .

    © Copyright 1999 The Washington Post Company

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