Americans Cool to Sanders\' Single-Payer Proposal

Americans are divided about the idea of creating a single-payer government health insurance system, as Democratic presidential candidate Bernie Sanders has proposed, but support shrinks when negative arguments are highlighted and alternatives are presented, according to a poll released last week.

In his insurgent primary campaign against Hillary Clinton, Sanders has been championing a Medicare-like single-payer plan for all citizens. The idea has been a popular proposal in the liberal wing of the party for decades. Clinton views it as politically infeasible and has been arguing that it is better to build on the Affordable Care Act than raze it in favor of an entirely new system. Republican candidates are all strongly opposed to the idea and would prefer to overturn the ACA.

The poll from the Kaiser Family Foundation found that 50% of Americans favored the single-payer idea, but support was highly partisan: seven of 10 Democrats and two in 10 Republicans liked it. (KHN is an editorially independent program of the foundation.) However, only 24% of people would like to establish such a plan if given other options, including expanding the existing Affordable Care Act, according to the poll. A majority of Democrats favor the incremental approach rather than creating a universal government plan.

Campaign-style attacks on a plan like the one proposed by Sanders could wither its general popularity, the poll found. Support was reduced by nearly half when people were told that a single-payer plan would increase taxes or “give the government too much control over healthcare.” Support also dropped substantially after people were told a government plan would require eliminating or replacing the existing health care law.

Some of those opposed to a single government plan could be swayed by positive arguments, such as it would guarantee all Americans have insurance as a basic right or that the plan would eliminate premiums, copays and other costs borne by employers or individuals. At most, 13% were converted to favoring the idea, leaving 30% still opposed.

The words used to describe a single-payer plan also affected opinions, the poll found. “Medicare-for-all” was the most popular, with 64% of Americans responding positively. “Guaranteed universal health coverage” appealed to 57% of people. Only 44% liked “single-payer health insurance system” and 38% liked “socialized medicine.”

“Most Americans think that if guaranteed universal coverage through a single government plan was put into place, uninsured and low-income people would be better off, but there is little consensus among the public about how it would impact their care personally,” the pollsters wrote.

On a separate issue, the poll reported that the majority of the public was well informed about how the Zika virus spread, amid reports of birth defects in babies born to infected mothers in South and Central America. Three-quarters of people knew the virus spreads through mosquito bites and more than half were aware that it can spread through sex. Seven in 10 people knew Zika cannot spread through handshakes.

The discovery of high levels of lead in the water supply of Flint, Michigan, has fueled broad concerns about the safety of public water supplies, according to the poll. Seventy-seven percent of people said they were worried about water for low-income areas and 47 percent were concerned about their own water supply.

The poll was conducted from Feb. 10 through Feb. 18 among 1,202 people. The margin of error for the full sample was +/- 3 percentage points.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.