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:



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.

Where the Uninsured Are

NPR has a map of the uninsured by congressional district and by state.



On the face of it, it looks like the usual, albeit paradoxical, story: areas that vote more Democratic, and which support a broader social safety net, have less need of one, since fewer people are uninsured in those areas; whereas Republican-leaning areas, where support is presumably greater for the status quo (the maintaining of which seems to be the Republican approach to health care), tend to have more uninsured. Unfortunately, this map doesn't do a good job of letting you see urban congressional districts, so the appearance of the map could be rather unrepresentative of the country as a whole, and especially of Democratic-leaning areas (many of which are in cities).

However, you can also see uninsured numbers by state, which reveals that of the 26 states (counting DC as a state for wishful thinking purposes) where the uninsured are less than 15%, 21 were won by Obama in 2008. And of the 13 states where the uninsured are more than 20%, 10 were won by McCain. (McCain won 7 of the 12 15-20% states.) That's a rather striking correlation, no?

Meanwhile, Nate Silver uses math n' stuff to create a map that projects support for the public option for every congressional district:



Based on a few polls in certain states and districts, Nate created a regression analysis to project what support across every district in the US would likely be, based on a few variables, including poverty rate and Obama's vote share in the district. He found that:

-- The public option is estimated to have plurality support in 291 of the 435 Congressional Districts nationwide, or almost exactly two-thirds.
-- The public option is estimated to have plurality support in 235 of 257 Democratic-held districts.
-- The public option is estimated to have plurality support in 34 of 52 Blue Dog - held districts, and has overall popularity of 51 percent in these districts versus 39 percent opposed.

By implication, the public option was favored in 56 of the 178 Republican-held districts. Nate breaks out the projected support numbers for every district in his post.

Thanks to Matt Osborne for that one.