Support for National Health Insurance: Intercohort Differentials

Past research has demonstrated that the majority of the American public favor some form of national health insurance (NHI), but the sources of this support have not been clearly identified. This paper shows that support for NHI follows party lines, with Democrats most favoring it, followed by Independents and Republicans. The young, women, blacks, the less educated (among others) also favor NHI more than others, but it is apparently not a "personal need" for the insurance that prompts this support. Lack of adequate insurance coverage, dissatisfaction with current care, or poor access to health care are not associated with support for NHI. Instead, cognizance of the larger socioeconomic issues (particularly rising society-wide health care costs), in addition to political identification, generates support for NHI. Steven R. Steiber is a Research Associate with the Center for Health Services Research and Development of the American Medical Association. Leonard A. Ferber is a former Research Assistant with the AMA's Center for Health Services Research and Development and is currently enrolled in the University of Pennsylvania Law School. The authors wish to thank colleagues for comments on an earlier draft of this paper and Andrea Powell for typing assistance. The views expressed here are those of the authors and do not necessarily represent the official position or policy of the American Medical Association. Public Opinion Quarterly Vol. 45:179-198 ? 1981 by The Trustees of Columbia University Published by Elsevier North-Holland, Inc. 0033-362X/81/0045-179/$2.50 This content downloaded from 207.46.13.124 on Wed, 22 Jun 2016 05:39:46 UTC All use subject to http://about.jstor.org/terms 180 STEIBER AND FERBER a reaction to the inflated cost of health care, and a perception that national health insurance (NHI) would improve the quality of available health care. Moreover, the vast majority (76.1 percent) of those favoring NHI identified the necessary components of such a plan to be the same as those embodied in the current Kennedy insurance plan under debate. The Kennedy, or comprehensive NHI, plan has as its fundamental goal the provision of first dollar coverage for all medical and hospital costs to all individuals according to need. The sources for support, however, have yet to be satisfactorily identified. NHI is certainly a political issue, but to what extent do personal health needs or perception of the larger society's health needs generate additional support for NHI? This paper analyzes data from the Gallup (1978) poll of the American population which show those sectors from which NHI currently receives its strongest support as well as its opposition, and compares these two groups with respondents who have no formalized opinion-the "Don't Knows." Inasmuch as these "Don't Knows" account for fully 17 percent of the total and this response has been demonstrated to be substantively meaningful, especially on politically charged issues (e.g., Converse, 1977; Faulkenberry and Mason, 1978), it is included in these analyses. With three response categories, these three contrasts exhaust the empirical possibilities.