Thursday, November 19, 2009

Support for US Health Care Reform in Three Dimensions

A nice map repetition from a New York Times op-ed shows support for health care reform along axes of income and age:

health care reform support map

The accompanying opinion piece is by Nate Silver, Andrew Gelman, and Daniel Lee. Say the authors:
Using a statistical method called multilevel regression and post-stratification, we ... mapped opinion on health care, breaking down voters by age, family income and state. We’re used to thinking about red states and blue states, but the geographic variation is dwarfed by the demographic patterns: younger, lower-income Americans strongly support increased government spending on health care, while elderly and well-off Americans are much less supportive of the idea. But in general, senators seems to be less interested in what their constituents, old and young, rich and poor, might think about health care, and more interested in how they feel about President Obama.

This may actually be good news for the Democrats. Although the Annenberg surveys had shown health care subsidies to be quite popular — they had 67 percent support nationally in 2000 and 73 percent support in 2004 — that was back when they were a mere abstraction, and before voters might have been considering how to pay for them. Nowadays, President Obama enjoys higher approval ratings — in the low to mid-50s, according to most polls — than do the Democrats’ health care reform plans, which are mired in the mid-40s in most surveys. Conditions being what they are, Democrats would rather have a referendum on the president than one on the health care bill itself.
Support for Obama seems to be driving attitudes about health care reform to some extent, and not the other way around. Of course, a lot of what this has to do with is trust. As Machiavelli said, reform is hard: vested interests who benefit from the status quo will oppose it at every turn, and they tend to be well-organized, while support for reform tends to be diffuse and shallow. Whether you're going to support a large intervention in a system that, for all its shortcomings, is our system - the one most of us have grown accustomed to - will depend in large part on whether you trust the folks who are doing the reforming. And of course, if you're already a beneficiary of guaranteed government-provided health care, like everyone in the US over the age of 65, you really don't have much incentive to support reform; unless, that is, you aren't entirely self-interested, and actually care about, for instance, the ability of young people to acquire health care when they're in their 20s and don't have access to the kind of job stability that's necessary to acquire employer-based health insurance; or who can't get health care in the free market because of a pre-existing condition like asthma; or are just too poor to afford quality health care.

But of course the maps show a geographical dimension too. Support tends to be lower in Republicaan-leaning regions like the Plains and the Utah-Idaho-Wyoming triad of conservative Western states; it tends to be higher in the Northeast and Great Lakes states. (By the way, when and why did Wisconsin become more liberal than Minnesota?) What will be interesting to me is to see how support shifts once a bill is actually passed. My guess is that support will increase across the board, once there are a bunch of headlines about Obama signing "historic leegislation" and all that. On the other hand, I wouldn't put it past Congress to end up with such a watered-down bill, with so many sops to the health insurance and health care industries, that it just pisses everyone off.


Gus Snarp said...

So basically we're being held back by grumpy old rich people? Ironic given that one of the key arguments of those opposed to health insurance reform is that young healthy people shouldn't be forced to pay for the care of less healthy people.

Gus Snarp said...

OK, this thing is interesting, but hard to read. Those healthy young people are less supportive than a lot of older folks, especially as they get richer, they're just more supportive than the really old folks.

I do love how the people who have government health care don't support anyone else having it.

Andrew B said...

Minnesota has been trending Republican for years, driven by huge Republican strength in the Twin Cities suburbs (think Michelle Bachman). If a Republican wins nationally in 2012 or 2016, they will probably win Minnesota.

This is why Al Franken could barely "beat" (after the comical vote "counting" and "recounting" process) a Republican stiff like Norm Coleman in a three way race in the best Democrat year in 64 years.

Here's the trend with US and Minnesota Republican percentages, and the arithmetic difference:

2008: 45.6%, 43.8% (-1.8%)
2004: 50.7%, 47.6% (-3.1%)
2000: 47.9%, 45.5% (-2.4%)
1996: 40.7%, 35.0% (-5.7%)
1992: 37.5%, 31.9% (-5.6%)
1988: 53.4%, 43.9% (-9.5%)
1984: 58.8%, 49.5% (-9.3%)
1980: 50.8%, 42.6% (-8.2%)
1976: 48.0%, 42.0% (-6.0%)
1972: 60.7%, 51.6% (-9.1%)

The Democrats in Minnesota rely on big margins in Hennepin (Minneapolis), Ramsey (St. Paul), and St. Louis (Duluth + Iron Country). The Republican southern and western suburbs are growing, while the Democrat core of those areas shrink. Simple math tells you the end result.

Richard said...

Agewise, the big demarcation line is at 65. Below 65, support is about the same for each income level & state (slightly more support amongst the youngest, though the the upper-income, upper-middle aged folks in a few big northern states (Illinois & NY) support reform more than anyone else in their income bracket & state.

The biggest determining factor is income level, which makes sense when you consider people to be naturally self-interested.

Gus Snarp said...

@Andrew - Wow, you've managed to turn a simple post about an interesting way of displaying information into a rant about the vote count in Minnesota. I'll agree with you that it was comical, but probably for different reasons. It does (along with the 2000 election, and now the NY23 election) point out one thing - we need to establish a nationwide standard for elections for national office. There should be one standard nationwide for what triggers a recount and what kind of recount is done. The courts wouldn't have to go through such hoops if they had clear laws to work with.

Chachy said...

For what it's worth I didn't take Andrew's comment as a "rant," and he makes good points about suburban growth in Minnesota. (So does this phenomenon not extend to Wisconsin? Not as much growth in Milwaukee's exurbs? That wouldn't surprise me. Furthermore, I do have the impression that such growth as there is in WI is focused on the liberal college town of Madison.)

But as for elections, I'm not sure why the MN recount struck people as comical or mis-managed. It seemed to be they managed it extremely well and fairly, and had a much clearer, non-partisan procedure in place for resolving the dispute than most states would have. It's just that any election that has a result within a few hundred votes is going to be a real hassle to resolve.As for the 2000 election, the problem was less the counting of the vote (though the Florida process was far from ideal, and clearly worse than, e.g., the MN-Sen recount), and more the fact that we have an antiquated system of choosing our president (and Senate). After all, there was no disputing the fact that one of the 2 main candidates in 2000 received more votes than the other - about half a million more, in fact. The problem was that our 18th-Century method for allocating weight to those votes (!) led us into a legal gray zone and a disputed election outcome - and, arguably, to some enormously bad consequences for the country. Meanwhile, I don't even know what you're referring to regarding NY-23. That election result isn't seriously disputed or controversial.

Andrew B said...

Gus, Chachy:

Minnesota was a classic example of "lets recount all the votes until I'M ahead, then declare victory and decry any further attempt to recount the votes".

It was right up there with Florida 2000, Landslide Lyndy, Christie Gregoire 2004, Maria Cantwell 2000, Tim Johnson 2002, and many other "magical" elections with tight margins, mysteriously appearing ballot boxes stuffed with uncounted ballots, and recounts where the vote trend mysteriously and inexoribly and against all odds heads only in the direction of one candidate - the one demanding the recount be held and continued until he/she is in the lead (at which point it can always be stopped).

The whole nation got a view of this process up close and personal in Florida 2000 (thankfully, the Bush campaign did not spread the fiasco to thin Gore margin states like Oregon, Wisconsin, Iowa, and New Mexico) and sees what a farce the vote counting process is in a close race, thanks to the undue power, money, and influence now tied to elective office.

The only elections I have any confidence in a reasonably accurate outcome having actually occurred are those where the margin of victory is over several thousand votes. Anything less, and the ability and will for mischief is clearly there, worked through the legal system and the farcical manipulation of unclear votes, unverifiable electronic and mechanical voting machines, and a partisan influenced legal system.

The tried and true solution - paper ballots - is of course avoided like the plague.

Chachy said...

There, now - that's a rant.

But yeah, paper ballots. All for 'em. And I think they proved themselves in the Minnesota recount, which again, seemed to me to be pulled off quite well.

income tax calculator said...

Hi. Well, the fact is that a reform is really needed as the figures indicate that the situation today is critical: More than 15% of the American population has no insurance coverage and the costs are extremely high. However, I not very sure whether Mr. Obama's reform is the right way either. Anyway, I still believe that it's better to do something than nothing.
Take care,

Healthcaregate said...

Thankfully, I did not see this when it was posted.

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