Public Opinion and Health Care Reform for Children

Abstract

Issue Editor’s Note Public opinion will play an important role in shaping health care reform in this country. Thus polls that attempt to measure the strength and direction of public opinion have become one focus of the debate over health care reform. Until very recently, however, children were not the focus of much public opinion research. While a great deal of polling has been done to test the popularity of various approaches to health care reform, few of these polls specifically address children’s health. Despite this historic oversight of children’s issues, in this article Susan Nall Bales of the Benton Foundation reviews recent polling data from which some areas of consensus on health care reform for children can be identified. Her analysis draws on a seminar presented for U.S. congressional staff during the summer of 1992. At this seminar, four political pollsters, each involved in advising candidates during the presidential and congressional election campaigns, were asked to assess whether a children-first approach to health care reform would be able to motivate public support for health care reform. Representing the Republicans were Gary Ferguson of American Viewpoint and David Sackett of the Tarrance Group. For the Democrats were Robert Green of Penn + Schoen and Celinda Lake of Mellman-Lazarus-Lake. The analyses of the pollsters strongly suggest that children’s health care is a prime concern among a diverse public, that Americans want to see children accorded priority among competing “groups with claims on government,” and that they view political candidates’ attention to children’s health needs as a touchstone of their public responsiveness. While the public is divided regarding how to pay for children’s expanded access to health care—whether by enacting new personal or corporate taxes or by reallocating current revenues—the polls strongly suggest a new realism with respect to children and increased public support for candidates who come forward with proposals for improving children’s status, regardless of the tax liability. This emerging public mandate to do more for children is tempered, however, by an ambivalence regarding the private nature of family concerns. The public still holds parents primarily accountable for their children’s condition; at the same time, the public wants more help from government for families with children, and not just poor families. But children’s health is often overlooked by the public and, therefore, by pollsters and policymakers because the public does not automatically link these issues to the political arena. This suggests that these issues are just emerging in the minds of American voters as legitimate political concerns. An important issue revealed in the polls is that the public is often unable to speak out in support of children’s services because it lacks understanding of the specific programs—from Medicaid to the Special Supplemental Food Program for Women,