Why the Public Supports a Public Plan

Polls show that concerns about cost are driving support for a public health care plan option, writes Ruy Teixeira.

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Debate is really heating up on health care reform and at the center of that debate is Obama’s proposal to create a public plan option to compete with private insurance companies.

Right now support is running high for the public option. A recent CBS/New York Times poll showed 72 percent favoring “the government offering everyone a government administered health insurance plan—something like the Medicare coverage that people 65 and older get—that would compete with private health insurance plans,” compared to just 20 percent who were opposed.

Why is support for a public plan running so high? The chief reason is the public’s overriding concern with health care costs. Polls consistently show that people are most dissatisfied about health care costs, both for themselves and for the country as a whole.

This pattern is nicely illustrated by data from a March CNN poll showing 17 percent dissatisfied with the quality of the health care they receive, 26 percent dissatisfied with their health care coverage, 48 percent dissatisfied with their total health care costs, and 77 percent dissatisfied with the country’s total health care costs.

So people are hugely concerned with health care costs—and they have little faith that private insurance companies, left to their own devices, can deal with this problem. In fact, they believe by a wide 59-26 margin that the government—and not private insurance companies—can do a better job holding down health care costs.

That’s why the public sees a public plan as critical to ensuring effective competition to lower prices in the health care marketplace. In an April Kaiser Family Foundation survey, the public, by 57-39, said the “better way to encourage health insurance companies to provide the best product for the lowest price” is to have private insurance companies and a public plan compete with one another instead of private insurance companies competing amongst themselves.


Thus the public is centrally concerned with high health care costs and sees a public plan as central to dealing effectively with that problem. Including a public plan option as part of health care reform is therefore both good policy and good politics.

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Ruy Teixeira

Former Senior Fellow

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