WASHINGTON — Americans are divided over how they want health care fixed and whom they trust most to do it, refusing to forge a consensus for or against President Barack Obama as he and Congress march toward a historic overhaul.
A new McClatchy-Ipsos poll released Wednesday found people torn over several key questions that are likely to dominate debate in Congress in coming weeks, including:
- How a federal government insurance plan would affect their own health care and their pocketbooks.
- Whether the government should stress cost controls or expanded insurance coverage.
- Whom they trust most to expand coverage.
Obama still has the most prominent pulpit in the debate, leading the list of voices Americans trust most on health care. However, he doesn't dominate the debate — only one in four named him the most trusted voice on health care — perhaps because rising unemployment appears to be taking a toll on his overall standing.
The lack of a popular consensus underscores the risks and stakes as Congress rushes toward proposals to provide coverage to the uninsured and rein in soaring costs for those who do have coverage.
Obama and the Democrats who control Congress are pressing toward a vast overhaul of the health care system that could include tax increases to pay for expanded coverage and a federal government-run insurance plan to compete with private insurers as one way to try to rein in insurance costs. Most Republican lawmakers say that a public plan would drive private insurers out of business.
On one key question, the poll found Americans split over the benefits of being able to buy insurance from a new government program. While 40 percent said they thought it would lower the quality of their care, 21 percent said it would improve the quality and 36 percent said it wouldn't make any difference. The rest had no opinion.
The survey also found 38 percent saying that the availability of government insurance would bring down their family's costs, 27 percent said it would raise their costs and 31 percent said it wouldn't make any difference.
The poll found Americans almost evenly divided when they were asked to choose the primary goal for health care legislation, with 46 percent saying it should expand coverage and 44 percent saying it should control costs.
Just as there's no broad agreement on how to overhaul health care, there's also no dominant voice in the debate.
Obama has the edge, as 26 percent said they trusted him most to expand care to the uninsured. The second most trusted voice, however, was doctors and other health care practitioners, named by 20 percent of Americans.
The rest: 14 percent trusted Democrats in Congress the most, 10 percent trusted Republicans in Congress, 9 percent trusted health insurance companies and 3 percent trusted pharmaceutical companies. Thirteen percent trusted none of them, and 5 percent had no opinion.
One possible reason Obama doesn't have a more commanding position is that he's lost support in recent weeks, as Americans have grown more skeptical about the state of the country.
The survey found the ranks of people who think the country is on the right track dropping to 40 percent, down 12 points since early June and the lowest since Obama took office in January.
As unemployment continues to rise, Americans who say the country' s on the wrong track jumped to 54 percent, a 12-point rise and the highest since Obama took office.
The number of Americans who approve of the way Obama is doing his job also dropped, to 57 percent, a 7-point decline from early June and the lowest of his presidency that McClatchy-Ipsos has recorded.
His biggest loss of support was among independents, whose approval decreased from 58 percent to 50 percent. However, he also lost ground among Democrats, down 5 points, and Republicans, down 3 points.
Notably, the total of Americans who "strongly" approve of Obama's job performance dropped 11 points in a month, to 29 percent, his lowest ever. Conversely, 22 percent said they strongly disapprove, up 6 points and the highest of his six months in office.
On other health care questions, the poll found that Americans:
- Support tax breaks to small businesses to help provide insurance, by 91-8 percent.
- Want the government to have the power to negotiate drug prices, by 71-25.
- Want to order businesses to offer insurance to employees, by 70-28.
- Support mandating individuals to have insurance, by 69-26.
- Want limits on malpractice awards against health care providers, by 62-31.
- Support higher taxes on alcoholic beverages to help pay for health care, by 59-39.
- Oppose higher taxes on soft drinks, by 51-42.
- Oppose a national sales tax or value added tax, by 61-32.
- Oppose taxing people on the value of their employer-provided health insurance, by 64-32.
The survey, which was taken last Thursday through Monday, has an error margin of 3.09 percentage points.
These are some of the findings of a McClatchy-Ipsos poll conducted from last Thursday through Monday. For the survey, Ipsos interviewed a nationally representative, randomly selected sample of 1,007 adults. With a sample of this size, the results are considered accurate within 3.09 percentage points, 19 times out of 20, of what they would have been had the entire adult population in the U.S. been polled. All sample surveys and polls may be subject to other sources of error, including coverage error and measurement error. These data were weighted to ensure that the sample's composition reflects that of the U.S. population according to U.S. Census figures. Respondents had the option to be interviewed in English or Spanish
MORE FROM MCCLATCHY
For more McClatchy politics coverage visit Planet Washington
McClatchy Newspapers 2009