David W. Moore: Gallup’s Anti-Health Care Bias

Today's post is from David W. Moore, author of The Opinion Makers: An Insider Exposes the Truth Behind the Polls (out in hardcover now, paperback with a new afterword available this fall). Moore is a senior fellow of the Carsey Institute at the University of New Hampshire. A former senior editor of the Gallup Poll, where he worked for thirteen years, Moore also served as professor of political science at UNH and is the founder and former director of the UNH Survey Center.

The Gallup Poll is without doubt one of the most influential media polls in the country, and as such one would hope that its analysis of public opinion would be objective. Usually that is the case. But on the current subject of healthcare reform, especially its most recent article that presents "key findings from Gallup surveys" on the issue, the post reads like a conservative manifesto for delaying legislation until it succumbs to a slow death.

Having worked at Gallup for 13 years until 2006, I know that everyone who writes the stories makes a valiant effort to be objective. Sometimes, however, because of a blind spot or perhaps personal preferences, an article is not as balanced as it should be. That certainly is the case with Gallup's recent post, "Americans on Healthcare Reform: Top 10 Takeaways."

The piece presents a series of public opinion findings, all of which reinforce the overall theme that "Americans may have hit the slowdown button" on healthcare reform. But there are many other public opinion findings that contradict that general conclusion. Listed below are some of the most salient assertions by Gallup, followed by examples from other polls which lead to much different interpretations of what the public is thinking. (The Gallup poll analysis is found on its website, while the other results can be found at pollingreport.com, unless otherwise noted.)

Gallup: The "bottom line" is that "while Americans apparently favor some type of healthcare reform in the long term, they are in no hurry to see healthcare reform legislation passed in the short-term on a rushed schedule…many are willing to wait until next year to see it happen."

Other polls: By contrast, a recent Time poll, conducted at the same time as the Gallup poll, reported a supermajority of 69 percent of Americans saying it was very or somewhat important "that the Congress and the President pass a major health care reform bill in the next few months" (emphasis added).

Gallup: "Most Americans do not believe that the U.S. healthcare system is in a state of crisis." This is one of Gallup's interpretations as to why the public wants to put off healthcare reform.

Other polls: The above Gallup "takeaway" apparently assumes that the public wants Congress to act only if there is a "crisis." But there is nothing in Gallup's polling data to support that conclusion.

Moreover, other polls can lead to a different conclusion about whether action needs to be taken. A recent CBS/New York Times poll reports that an astounding 82 percent of Americans feel the current health care system either needs "fundamental changes" or needs to be "completely rebuilt."

The Time poll shows that a majority of Americans give the U.S. healthcare system a low rating (fair or poor) rather than a high rating (excellent or good), by 55 percent to 42 percent. The poll also shows that by 60 percent to 35 percent, Americans give the insurance companies providing healthcare coverage a low rating.

Whether the healthcare system is in a "state of crisis" or not is a red herring. Other polls suggest the most Americans see serious problems with the healthcare situation that need to be addressed.

Gallup: "The economy outweighs healthcare as the most pressing problem facing the country and in Americans' personal lives." To support this contention, Gallup notes that "almost 7 out of 10 Americans say economic-related issues are the nation's top problem; 16% say healthcare is the top problem."

Other polls: The argument is specious. It implies that only one problem should be dealt with at any given time. But what's to prevent the Congress and President from addressing both problems at one time? Gallup presents no polling data to suggest the public wants only one problem addressed at a time.

Furthermore, the Gallup question forces respondents into a zero-sum game: to choose either the economy or healthcare as pressing problems. Back in February, when the healthcare issue was not even as salient as it is now, the CNN poll asked respondents to rate the importance of both issues (among many others). The result: 95 percent said the economy was "extremely" or "very" important," while 77 percent rated healthcare that important. Yes, the economy was more important, but over three quarters of the public also said healthcare was extremely or very important. The Gallup zero-sum comparison makes it appear as though only one in six Americans is concerned about healthcare reform.

Gallup's question (as well as CNN's) also assumes the public sees no linkage between the state of the economy and healthcare problems. But the CBS/New York Times poll found just the opposite: More than three-quarters of Americans apparently agree with supporters of healthcare reform, who argue that the rising cost of healthcare is a serious threat to the nation's economy. Only 8 percent say it is not a serious threat.

Gallup: "Americans agree that healthcare costs are a major problem for the country. Americans do not, however, believe that healthcare reform would lessen costs -- neither for the system as a whole nor for individuals."

Other polls: This is a classic case of question wording determining the answer. Gallup asked respondents whether healthcare reform would lessen costs. Gallup did not ask what would happen without reform. The CBS/New York Times poll asked both questions, and the newspaper reported that the public seemed conflicted and confused:

In one finding, 75 percent of respondents said they were concerned that the cost of their own health care would eventually go up if the government did not create a system of providing health care for all Americans. But in another finding, 77 percent said they were concerned that the cost of health care would go up if the government did create such a system (emphasis added).

The fact is most people simply don't know what effect the current proposals would have on costs. Or perhaps they think healthcare costs will go up regardless of whether reform is adopted.

Gallup: "The push for healthcare reform is occurring in an environment characterized by high levels of concern about fiscal responsibility, government spending, and the growing federal deficit." Gallup goes on to note that "Americans are worried about their country's budget deficit."

Other polls: Yes, the public is concerned about the deficit. But which issue concerns the public more? Oddly, Gallup does not address this issue. Gallup does cite a Pew poll that shows people who are worried about healthcare reform are most likely to mention the cost and the deficit as reasons. But what Gallup somehow forgot to mention is that the same Pew poll asked respondents to indicate their priorities: reducing the deficit, or spending more to make healthcare more accessible and affordable? The public favored healthcare reform over reducing the deficit by 55 percent to 40 percent.

Gallup: "Americans have relatively little confidence in Congress and thus, by inference, little confidence that Congress can effectively and efficiently reform the country's massive healthcare system."

Common Sense: Is this truly a reason to say the public is tepid on healthcare reform?! Look at Gallup's own 35-year chart on Congressional approval. Except for the economic boom years at the end of Clinton's presidency, and the rally-around-the-flag support given to Congress and President Bush after 9/11, Congress has typically received low marks from the public. But that hasn't prevented the public from wanting Congress to act on a myriad of issues.

By selectively pointing to some poll results and not others, Gallup has presented a highly negative case for public opinion about healthcare reform this year. But there are many other polls, with different question wordings and different interpretations, which present a more positive case.

Indeed, using the selective approach, one can make the case that the vast majority of Americans believe the current health system needs major revisions that should be adopted in the next few months, and that the failure to do so would have serious consequences for the country.

Bottom line: Pick the polls that support your position. There are plenty for whatever views you might have.

Comments

[Steve]

Wow. Polling around health care has seemed especially messy, and not only for Gallup, for reasons you give (not only here but in your book): this particular Gallup poll seems like a especially ugly example of opinion making (as you put it) rather than opinion finding. I've noticed that the "upstart" polling companies, most of which use IRV and most of which did well in last year's election polling (PPP and SUSA in particular) have stayed away from national healthcare questions, the kind where you are polling an uninformed public about complex policy matters, and the kind (as you show) where question choice and question wording can create "opinion" and determine the answer. I've been following, instead, approve/ disapprove and trial-heat election matchups, which people like PPP keep running (though I know those are flawed too, for reasons you give in your book): those polls seem to suggest that Americans want problems fixed and disapprove of leaders (state governors, for example) who seem unable to fix them. It's an "opinion" the President probably shares.

[Irene hernandez]

Gallup's poll stating that only 50 per cent of Americans favored Health Care Reform was biased in that no Americans of Hispanic or Spanish heritage were included in the study. That is a slap in the face to many Americans, including those whose parents, grandparents and grandparents were born in the United States!

[James]

I would have to agree. Another stupid poll they drug out was how much Americans thought their current health care would be affected.

A majority (about 30-40%) usually said that their plan would be worse off. While everyone else (30ish% won't change, 30ish%improve) said it would stay the same or improve.

But he kept stating that the 30-40 percent with health care was the majority. The most idiotic thing about the poll is that it didn't include people without health care insurance - which I thought was the whole reason for the bill.

Sadly, I think the point was lost...