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What parts of the US support healthcare reform and why

Dante Chinni

Posted: 11.23.2009 / 8:29 AM PST

The big news out of the weekend is that healthcare reform efforts will move forward in the Senate following a Saturday night vote.

Judging from poll numbers and contacts we have had with our Patchwork Nation communities, voters appear to be becoming more supportive of the idea but are still unclear about what the bills would actually do.

A poll from the Pew Research Center for the People and the Press and filtered through our community types finds that four of the 12 approve of the way President Obama is handling the issue. That’s not a ringing endorsement, of course, but compared with some earlier numbers, it is an improvement.

Previous polls showed only two community types supporting the “the bills currently in Congress.” This time, the question was different – it was about Obama’s handling of the issue. But those two areas of the debate, “Obama’s handling” and “the bills in Congress,” are about to come together as a noisy month of Senate debate is about to begin.

At some point, whatever comes out of Congress will become “the president’s bill,” and this round of numbers should at least offer some comfort to the White House that Mr. Obama’s touch could help legislation through. But that will be only the beginning.

Who’s supportive?

Three of the groups that support Obama’s handling of healthcare reform voted for him in 2008: the wealthy “Monied ’Burbs,” collegiate “Campus and Careers,” and big city “Industrial Metropolis” communities. The fourth, the “Military Bastion” located near military bases, did not.

It should be noted that the sample size for two community types, rural, agricultural “Tractor Country” and Church of Latter-Day Saint adherent-heavy “Mormon Outposts,” is not big enough to be considered. Both, however, tend to be opposed.

The “’Burbs” and the “Industrial Metros” would be key to any reform effort. They hold a lot of people and are located where the big media outlets are based.

Many of this summer’s healthcare reform “town halls,” for instance, were held in smaller towns and Republican areas – places like “Tractor Country” and aging “Emptying Nests” counties. So they created a negative image about the public’s attitude.

What do people support/oppose?

Of course, “supporting” or “opposing” doesn’t necessarily mean understanding. As we talk to people in our communities, it seems that many of the attitudes toward reform are based on rough ideas of what may or may not be in them. In fact, in some of our communities it seems people still have not engaged on the issue.

“People are not talking about the healthcare bills here, and I don’t think they understand what’s in them,” e-mails Dan Kemp, mayor of Hopkinsville, Ky., a Military Bastion near Fort Campbell. “People are focused on local and state issues. D.C. is a long way from Hopkinsville.”

In Sioux Center, Iowa, a “Tractor Country” community, local newspaper editor Steve Hoogland says there is a lot of interest in the bills. Understanding? That’s something else, he writes in an e-mail. “[T]here are so many changes and even so much contradictions in what information is coming out, it’s hard to see how specifically anyone grasps all of what’s been talked about.”

The same can be said in Clermont, Fla., an “Emptying Nest” community. There, writes local businesswoman Susy Gibson, older voters in particular are concerned regardless of what anyone says is in the bill. “[T]hey seem to think it will affect their Medicare no matter what the government is saying,” she writes in an e-mail. “Yes, they are talking about it. And I’m not sure they, nor anyone else, understands what’s actually in the bills.”

Add it all up and what do you have? A very confusing picture. Even now, as the healthcare reform debate enters the homestretch, many seem to have little understanding of a bill that would dramatically affect a sector that makes up about 17 percent of US gross domestic product.

That means, whatever polls say, if Congress passes a bill, most people probably won’t have informed opinions on it until they have lived with it for a while. That suggests the real “healthcare debate” hasn’t even begun yet.