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THE TIMES POLL : Americans Sending Mixed Messages on Health Reform


WASHINGTON — For members of Congress confronted with difficult choices over health care and hoping for guidance, the polls have an answer: You're on your own.

The near-gridlock in Congress over health care reflects the reality in the nation. On almost every major issue involved in the yearlong debate over health reform--from universal coverage to cost-control efforts--Americans remain closely divided, according to The Times Poll.

On the one hand, health care has risen once again on the scale of public concerns, after being partly eclipsed earlier this year by public worries over crime. Asked to name the nation's most important problem, 22% said it was health care, up from 18% in the last Times Poll in April and only 12% in January. In comparison, 38% named crime or related issues such as violence in society and drug use--down from 51% in April and 43% in January.

An overwhelming majority of Americans would like to see Congress pass some kind of health reform plan. Despite the recent remark by Senate Minority Leader Bob Dole (R-Kan.) that "there might be a big sigh of relief around the country" if Congress passed nothing, only 14% of those polled said that Congress should "pass no health reform plan."

A sizable minority, 35%, said that they will be "angry" if Congress "cannot get a health care plan passed by the end of this year." That sentiment was strongest among Democrats--44% of whom said they would be angry--but exists among 23% of Republicans and 28% of conservatives as well. Moreover, asked if Republicans were "offering constructive criticism" or "being obstructionist for mostly political reasons," 57% overall, and even 37% of Republicans, said that GOP members of Congress were obstructionist. Only 28% overall said that they were being constructive.

On the other hand, concern about health care and a desire to see some plan pass does not translate into a consensus. To make matters more complicated, core constituencies of the two parties have staked out strongly opposing positions--weakening the ground under members of Congress from either party searching for a middle position.

Unusually large numbers of registered Democrats, 45%, and liberals, 49%, said that they would be inclined to oppose their representative in Congress if he or she voted against universal coverage. On the other side, while only 14% of all those polled said that Congress should pass no health bill, 25% of self-identified Republicans said that is what they think.

The net result for members of Congress is political peril in almost every direction. Democrats who move too far away from coverage for everyone risk alienating their core supporters--something that could cost the seats of members from closely divided districts. Republicans who vote for any health reform plan may anger supporters who have decided that no bill would be best. But with the public so divided about what reform should mean, compromise would appear necessary to produce any bill that would garner majority support.

The poll, supervised by Times Poll director John Brennan, was conducted nationally among 1,515 adults from Saturday through Tuesday. The results have a sampling margin of error of plus or minus 3 percentage points.

The poll confirms the sense in Congress that abortion coverage probably will have to be dropped or severely watered down for a health reform bill to pass. Asked if companies should be required to "make abortion coverage available to any worker who desires it," only 33% said that they favored the idea, while 60% opposed it--with 46% strongly opposed.

But the poll contradicts several other beliefs that have gained strong currency in the health reform debate.

First, support for universal coverage, although large in the abstract, is far shakier than many Democrats assert.

By 58% to 31%, poll respondents said they favor a bill that would guarantee insurance for all by requiring companies to cover all their workers rather than "more limited reform that would . . . leave some people without coverage." But asked if they would still go along if the coverage requirement "would cause job losses," almost half the supporters defected. Overall, 28% of those polled supported the mandate even if it would cause job losses, 31% supported it, but not at the cost of jobs, and 31% said that they wanted Congress to pass a more limited bill regardless.

Analysts generally agree that requiring all companies to provide insurance would cost jobs in some industries while creating them elsewhere, but they disagree on the net effect.

Two other central elements of most reform plans are also highly controversial.

On efforts to control health costs, the poll found that 47% favor some government price limits even "at the risk of limiting the availability and quality of health care," while 40% would leave prices to the free market "even if that might mean higher health care costs for the average person."

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