A pollster asks: "Do you think the government should stay out of Medicare?"

How to fix health policy.
Sept. 28 2009 6:28 PM

The Medicare-Isn't-Government Meme, Part 4

A pollster asks: "Do you think the government should stay out of Medicare?"

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One of this column's many responsibilities is to track the Medicare-isn't-government meme. Medicare, of course, is government—it's a federal program supported by taxpayers like you and me—but in various ways, sometimes subtle and sometimes not, Republican enemies of health reform have been encouraging the public to think of Medicare as some sort of private-sector enterprise that those scoundrels in Washington can't wait to get their mitts on. (See "The Medicare-Isn't-Government Meme," "The Medicare-Isn't-Government Meme, Part 2," and "The Medicare-Isn't Government Meme, Part 3.")

Has the effort been successful? Hard to say, since we don't have a base line. But in August a firm called Public Policy Polling decided to toss out a few nut-bar questions in a nationwide survey of about 900 voters conducted over three days. One of these questions was, "Do you think the government should stay out of Medicare?" (The others touched on the urban myth that Barack Obama was not born in the United States.) The findings were sobering.

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One occasionally hears it alleged that the Medicare-isn't-government meme is merely a give-private-insurers-a-larger-role-in-administering-Medicare meme that's been misunderstood. Far from displaying ignorance, it merely demonstrates support for Medicare Advantage, the privately managed Medicare program that was meant to prove the private sector could manage Medicare more efficiently (but, conservatives are loath to admit, ended up proving the opposite). Are respondents to the Public Policy Polling survey misunderstood in this way? I think not. To endorse the view that government should "stay" out of Medicare pretty clearly indicates a (mistaken) belief that government has hitherto avoided meddling with it.

It is therefore with a heavy heart that I report that no fewer than 39 percent of my fellow Americans agree that "the government should stay out of Medicare." Another 15 percent aren't sure. This means that a majority of Americans (margin of error: 3 percent) is at best unsure as to whether Medicare is a government program. The left appears to have a firmer grip on reality, at least within this circumscribed realm, than the right. Sixty-two percent of McCain voters, 59 percent of self-described conservatives, and 62 percent of self-described Republicans think government should stay out of Medicare as against (a still distressingly high) 20 percent of Obama voters, 25 percent of self-described liberals, and 24 percent of self-described Democrats. Among independents, 31 percent agreed that government should stay out of Medicare.

There's an income disparity among respondents, but it isn't as consistent or as dramatic as you'd think; 48 percent of those earning less than $25,000 think government should stay out of Medicare compared with 35 percent earning between $25,000 and $50,000; 39 percent earning between $50,000 and $75,000; 33 percent earning between $75,000 and $100,000; and 35 percent earning more than $100,000. Similarly, "government should stay out of Medicare" won support from 42 percent of high-school dropouts; 45 percent of high-school graduates; 44 percent of those with "some college"; 35 percent of those with bachelor's degrees; and 36 percent of those who went to grad school(!). No significant differences were found between men and women. Only 30 percent of blacks said they wanted government to stay out of Medicare, compared with 41 percent of whites and 41 percent of Hispanics. Forty percent of those age 18 to 29 and 40 percent of those age 30 to 45 endorsed the proposition, compared with 36 percent age 46 to 65 and 45 percent older than 65.

That's right: The people who actually use Medicare appear to understand it the least.

E-mail Timothy Noah at chatterbox@slate.com.

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