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THE TIMES POLL : By 2-1 Margin, Public Backs Health Care Plan

September 30, 1993|RONALD BROWNSTEIN | TIMES POLITICAL WRITER

WASHINGTON — With his all-points sales pitch, President Clinton has won broad initial support from the public for his sweeping health care plan, a Times Poll has found.

In their preliminary reaction, the survey shows, Americans support Clinton's health care plan by a greater than 2 to 1 margin. They overwhelmingly endorse his argument that maintaining the status quo would be more risky than dramatic change. And they decisively reject the contention by critics that the Administration proposal constitutes "excessive government intrusion" into the private marketplace.

But public opinion about the numbingly complex proposal remains extremely tentative.

Clinton has not yet convinced most Americans that it will improve the quality of care they receive. Nor are they convinced that the plan will reduce their medical costs--the concern those polled cited most often about their own health care. Public fears about potential job losses also loom as a potential vulnerability as the debate over the plan sharpens.

Heading into the long congressional struggle over health care, Clinton's overall political position is strengthening. Americans now approve of his job performance by 53% to 38%, a significant increase from June, when a plurality of those polled gave him failing marks. Similarly, nearly 7 in 10 Americans now say that Clinton is "working hard to bring fundamental change to the way government is run."

The Times Poll, supervised by John Brennan, surveyed 1,491 adults from Sept. 25 to 28. It has a margin of error of plus or minus three percentage points.

At the most basic level, Americans are not yet convinced that the sweeping changes Clinton has proposed would improve their own health care situation. Just 24% of those polled said that the plan is likely to improve their family's health care coverage, while 17% said that it is likely to weaken their coverage and 46% said they expect no change.

On costs, assessments of the plan's likely impact are even less optimistic. Only 10% of those surveyed said that they expect to spend less for health care under the plan; 30% said that they do not expect their bills to change. And fully half said they expect their costs to rise.

But such personal calculations appear to be less important in guiding reaction to the proposals than broader considerations like partisanship, ideological views about government's role in the economy and the degree of urgency Americans feel about reforming the health care system. So far, the poll suggests, Americans seem to be asking not what the plan will do for them but what it will do for the country--and, largely, if tentatively, answering that it will do more than the status quo.

"Here's the issue: As they fill in details on how it will affect them personally will that become a larger determination for people or will they continue to judge it on how it affects the nation?" Brennan said.

On other issues, the poll found Americans still divided over--and uncertain about--the North American Free Trade Agreement that Clinton is urging Congress to approve this fall. In the survey, 31% of those polled said they oppose the plan, 26% expressed support for it and 37% said they were unaware of it. Despite intensifying public debate in the last several weeks, those numbers are little changed since June--or, for that matter, last fall.

Some demographic divides are emerging in consideration of the agreement, though. While whites generally oppose the agreement and blacks split evenly on it, Latinos now support it by more than 3 to 1. Among college graduates, support is twice as great as among those Americans with a high school education or less. Union members oppose it by 2 to 1. Non-union members essentially split over the question.

Perhaps more tellingly, almost half of those surveyed said that they expect the treaty to cost American jobs, while just 1 in 7 respondents accepted Clinton's contention that it will produce net employment gains. Those sentiments vary little by partisan or ideological affiliation--which suggests that the Administration still has an uphill struggle ahead to build a base of public support for the agreement.

On health care, those who think that the plan will diminish their own care now overwhelmingly oppose it, while those who expect it to improve their personal coverage support it by lopsided numbers. But the large group that expects to pay more actually supports the plan by 45% to 36%. And those uncertain whether their coverage will improve or their costs will rise are now inclined to give Clinton the benefit of the doubt: at least three-fifths of both groups support the plan.

Likewise, opinion on the plan varies little between those who said that their health care coverage has changed substantially in the last five years and those who reported little change, among those who consider their finances shaky and secure, those who work for large employers and small employers and among those who consider their own health good or poor.

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