Health Care Fight About Politics, Not Policy?

Most Americans think the fight over health care reform was primarily motivated by politics rather than policy, a new CBS News poll shows.


Americans believe that both Republicans and Democrats were fighting about health care reform because of politics, not policy, a new CBS News poll finds.

Asked why Democrats worked to pass a health care bill, 57 percent said “mostly political reasons.” Just 35 percent said it was because Democrats think the bill is good policy.

Americans had an even more cynical view of Republican motivations: Sixty-one percent said Republicans were acting on the basis of political concerns, while 29 percent said Republicans truly believed the bill was bad policy.

While partisans on both sides tended to think their party was acting out of policy concerns, independents were overwhelmingly likely to say that both parties were simply playing politics.

I’m not sure what to make of this.  Asking people to dissect the motivations of people they’ve never met — indeed, mostly couldn’t name — seems rather silly.

By the end of the process, few Democrats, indeed, thought that the bill they were voting for/against was “good policy.”   Most of the supporters did so holding their nose.   But that doesn’t mean they were motivated primarily by politics, merely that their options were constrained by political realities.

For Republicans, the initial opposition was certainly about policy but the strategy was almost purely political.  That is, the party line enforcement to ensure that ZERO Republicans voted for the bill and the attempt to defeat it outright rather than achieve some sort of bipartisan compromise that they would have nonetheless hated was calculated with an eye towards November.  But that doesn’t mean that they secretly thought the bill was a good one.

FILED UNDER: Healthcare Policy, Public Opinion Polls, US Politics, , , ,
James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College and a nonresident senior fellow at the Scowcroft Center for Strategy and Security at the Atlantic Council. He's a former Army officer and Desert Storm vet. Views expressed here are his own. Follow James on Twitter @DrJJoyner.


  1. john personna says:

    It sounds like people are pretty smart. Democrats like the bill because (while it does some good things) it moves the healthcare ball down the field. You can call that politics.

  2. Most of the supporters did so holding their nose.

    That is simply not true, James, and you should know better. Democrats have been trying for 20 years to increase coverage. They have been talking for a decade about the problems of preexisting conditions and rescissions.

    The bill is not perfect. NO BILL IS. But the idea that Democrats, on the whole, are unenthusiastic about the substance of the bill is simply untrue.

    Your posts on this topic are consistently misleading and wrongheaded. I don’t know what in the world has gotten into you on this issue, but I can’t recall the last time you’ve even managed to be in the ballpark on the facts on HCR.

    At its core, this bill makes is easier for millions to get health insurance and removes the stress of millions more about losing their coverage when they might need it most. The price of accomplishing that is that everyone needs to buy insurance. But the mitigation factor on that is the provision of subsidies for the working families unable to qualify for medicaid. That’s it. The only provision that is genuinely unpopular in this bill is in the individual mandate – -but even there, for $750 a year you can simply ignore that as well. And $750 a year is quite a nice deal given that you can now buy insurance ever after you get sick.

    If you want to address cost issues. Great. It does not need to be either/or. Let’s all push for another bill to deal with costs. But dealing with costs does not need to be at odds with providing additional access.

    Anyway, long story short. I know A LOT of Democrats, and let me assure you, we are all giddy about the passage of this bill. It is a tremendous step forward, and will be regarded as such by future generations as well.

  3. James Joyner says:

    But the idea that Democrats, on the whole, are unenthusiastic about the substance of the bill is simply untrue.

    Despite an overwhelming majority in the House, Pelosi had to fight kicking and screaming to get this thing through. Most of the Progressive wing hated large parts of this thing. That was true on the blogs as well as in Congress.

    It’s likely true that mainstream Democrats will see this as a step forward but even they polled lukewarm or worse on the bill.

  4. Herb says:

    That is simply not true, James, and you should know better.

    Okay, okay…let’s revise it a bit:

    Most Many of the supporters did so holding their nose.

    That, my friend, is true.

  5. James, no, you are misreading the issue.

    First of all, Fire Dog Lake does not speak for most progressives. The bill accomplishes long-standing Democratic objectives. Would many of us liked something more robust? Sure. But are we happier with this than nothing? Absolutely.

    Pelosi got the progressives on board. What she lost was the Dems in R-leaning districts — the guys who won in 2006 and 2008, but who were going to be vulnerable anyway because of their conservative constituents.

    Democrats liked the substance, on the whole. The reason 35 Dems voted against it was precisely because of the politics.

    You’ve completely reversed the causality on this, and if you will look at the empirical data on which Dems voted against, you’ll see that is the case.

    The Progressives were holding out because they were trying to maximize their bargaining position, not because they disliked expanding coverage!

    But, hey, I shouldn’t be trying to convince you of this. Please, please, please make repeal the rallying cry in 2010. To quote a great American, “Bring ’em on.”

  6. Stan says:

    By the end of the process, few Democrats, indeed, thought that the bill they were voting for/against was “good policy.”

    Unadulterated bullshit. Gung-ho liberals are a minority of the party, and most of them (including my own family) supported the bill as a good first step. I think you’re associating too much with people who agree with you, and when you have to learn something about liberal opinion you’re reduced to reading FireDogLake.

  7. yetanotherjohn says:

    Real clear politics had a pre-passage survey of GOP and dem insiders assesment of the obamacare on next november. I forget the exact number, but no one on the GOP side thought passing obamacare would hurt the GOP, a small percentage said it would have no impact and about 80%+ thought it would hurt the dems a little or a lot.

    On the dem side, a significant percentage thought it would help, but a large percentage thought it would hurt.

    Assuming the survey matches the congress critter mindset, that says the GOP was motivated by policy. Letting it pass made for good political tactics (at least in their view).

    The dems were mixed with some supporting passage as part of making political points (again in their view) and some supporting passage for policy, despite the bad politics.

    On another note, I read some of the above “liberals weren’t holding their noise” posts with a grin. Their argument boils down to half a loaf is better than none and we will get the rest later. There will be lawsuits over this. While the upshot of the lawsuits is unclear, imagine the distinct possibility that the supremes decide against obamacare under the enumerated powers doctrine. Not only would that cost the half loaf, but it would endanger every progressive expansion of government going forward.

  8. While the upshot of the lawsuits is unclear, imagine the distinct possibility that the supremes decide against obamacare under the enumerated powers doctrine. Not only would that cost the half loaf, but it would endanger every progressive expansion of government going forward.

    Well, sure. An activist Supreme Court determined to undue the expansion of the federal government would be a major development. This has little to do with Affordable Care Act, however. If Roberts has 5 votes to roll back the New Deal, he’ll do it, regardless of health care.

    But on the more basic issue, why bother inferring from indirect evidence like RCP? Look, the single best predictor of dem votes on HCR was how large Obama’s margin was in 2008 in that district. Basically, every Dem in districts where Obama got 70% voted for the bill, but only half the Dems McCain districts voted for the bill. Dems liked the bill, but voted against it because of political pressures.

    Look, I know I can’t convince the conservatives here. You all just see this as part of a liberal plot to take away your freedoms… because ya know, we’re just the terrorists, we hate freedom. Except, freedom to smoke pot and have gay marriages, I guess. But whatever.

    But we really like health care reform. We think it makes America a better country. We want our neighbors and children to have access to health insurance and be able to keep coverage even when they switch jobs or get sick. We tend to believe that illness is largely one of those unavoidable facts of life, not an issue to be turned into a object lesson in personal responsibility simply because we believe that even if you do everything in your power to remain healthy, you can still be stricken with cancer or some other costly illness. And having that happen should not mean you lose your home, or the ability to send your kids to college.

  9. Zelsdorf Ragshaft III says:

    Bernard, I think I understand your problem. You may have been educated beyond your ability to understand. Get someone of above average intelligence to read the U.S. Constitution to you as you seem to read in things not written into it. Get a dictionary because there are phrases and words written into that document which most liberals do not understand. The Constitution is not written in legalese or is in anyway difficult to understand except for those who insist words like “shall not” does not mean what most people think it means. The common welfare clause does not mean the Government has the power or authority to tell me what products I can buy or that my car must carry around an extra ton of steel for my supposed safety. If I desired that level of governance I would move my ass to Cuba or North Korea. Anyhow, Bernard, when you are done with this exercise, read the God damned health care bill and explain to me how the federal government has the authority to require me to purchase a product or for that matter be involved in my life to the level it already is. I think we are on the verge of a new civil war. It may be the only way to restore the Republic. Your side will lose the fight, and if you continue down this path, I promise a fight. Could be the best thing, that would be to put the sword to the liberal progressives. That is what they plan for us.

  10. ggr says:

    I suspect so many people think its about politics rather than policy because both parties so often change their positions (most recently the deficit, the importance of public opinion) based on whether they’re in power or not.

    There’s actually very little reason to believe anything either party says, so to save time people assume everything they do is about politics.

  11. wr says:

    ZR — It’s kind of sad that conservatives have so completely lost every intellectual argument in this time that all they have left is threats of violence. “A new civil war” is the rallying cry of the loser and the whiner who can’t convince a majority of the people that his argument is right, so now he wants to start shooting those on the other side.

    Maybe you should try to think through your ideology and find a way to reframe it so it appeals to some who don’t hate minorities, don’t want to see poor people dying in the street, and think that providing health care to the populace isn’t a violation of the constitution while torture is. Because you guys are a small, ugly, and (fortunately) shrinking group. You can make a lot of noise, and if you decide to follow through on your threats of violence, I’m sure you can hurt or kill many people and cause the rest great pain. But that just makes you the same as the losers who join Al Qaeda in hopes that blowing themselves up will somehow give their lives meaning.

  12. The Q says:

    Mr. Ragshaft,

    Thank you for personifying the right wing idiocy that Mr. Finel was pointing out.

    Gee, nowhere in the Constitution does it mention “corporations are people” either, but I will bet a year’s salary you have no problem with the SC rulings on that issue.

    BTW, the constitution does say women, property-less white males, people under 21 or blacks could not vote.

    And I bet you are fine with those restrictions.

    Of course, you and your crazed cohort of idiotic right wingers have to bring in the de rigueur references to Cuba and North Korea.

    This hyperbolic bloviating from your side is tiresome and ignorant.

    Your side had 20 years of congressional and/or presidential influence to rectify even one small wrong of the healthcare system (lets say rescission for example) and refused.

    I think as more of the details of the bill come out, the more voters will like it.

    I suppose you also are against the ban on child labor as being unconstitutional as well? I mean no where in the constitution does it say that 8 year olds couldn’t work 16 hour days, 6 days a week in sweatshops now does it?

    You probably hated U.S. v. Darby in 1941 which effectively prohibited most child labor in the U.S.

    Mr. Ragshaft…A sad day for you and the constitution right? since we all know how badly those coal mine owners needed 8 year old fingers in the shafts to access those hard to get at nooks and crannies, kinda like the grey matter in your brain?

  13. gVOR08 says:

    ggr – false symmetry. I think all politicians pretty much think public opinion is important all the time. Sometimes they may be willing to take a longer view or a risk or take a more nuanced interpretation of the polling. On deficits Republicans believe they’re good when they’re in power and evil when they’re out. Democrats pretty much always believe that deficits are bad in good times and good in bad times. This is that “nuance” thing again.

    There’s also the thing about inheriting two wars, tax cuts, a recession, and a banking crisis.

  14. TangoMan says:

    There’s also the thing about inheriting two wars, tax cuts, a recession, and a banking crisis.

    This “inheriting problems” excuse is the lamest defense that can be uttered. Every single President inherits the problems that have accumulated from previous administrations. Bush inherited an unresolved Iraq situation, an unresolved Al Queda situation, an unresolved Ponzi Scheme social welfare system, an immigration crisis, a demographic crisis, a health sector growing faster than inflation, etc. Clinton also inherited many problems. Bush I also inherited many problems. Each President was aware of these problems before they committed to run for office.

    Obama and his defenders crying baby tears about the inherited problems is pathetic. Man up, you losers.

  15. Herb says:

    Man up, you losers.

    Says the guy whose side just suffered a legislative defeat.

    Although I will admit that I do like that phrase. “Man up, you losers.” Indeed, it’s a message I think the Tea Party folks should hear. Keep spreading it, Tangoman.

  16. steve says:

    James- The health care system, including Medicare and Medicaid, is the single biggest problem with our economy. Regardless of how this polled, it would have been irresponsible to not address the problem. I am not sure that is just “politics”.


  17. john personna says:

    Very funny Tango, but don’t forget the flip side. If the Dems fix the economy and get everyone jobs, everyone will feel prosperous and vote Republican again.

  18. TangoMan says:

    If the Dems fix the economy and get everyone jobs

    Huge “IF” in that scenario. Keep in mind that taxes and regulations put brakes on economic development and job creation. We’re moving in the direction of Eurosclerosis with a) this health care bill, b.) Cap and Tax and c.) Amnesty.

    Efficiency and Equality are two vectors moving in opposite directions. Democratic hot-buttons are not known to have positive effects on economic growth and job creation.

  19. steve says:

    “Keep in mind that taxes and regulations put brakes on economic development and job creation”

    See Reagan, Ronald. Tax increases circa 1983.

    See Clinton, Bill. Tax increases circa 1994.


  20. TangoMan says:

    See France, 1980-2010.
    See Belgium, 1980-2010.

  21. TangoMan says:


    Are you seriously staking out the position that increasing tax obligations and imposing more regulations on business will spur economic and job growth? Really, is that the position that you want to advance?

  22. An Interested Party says:

    Man up, you losers.

    Terribly ironic coming from someone who is, perhaps, hiding behind an alias rather than admitting to being a person who founded a racist, xenophobic website, if the theory of Michael Reynolds is correct….man up, indeed…

  23. UlyssesUnbound says:

    Whenever Zels or G.A. (or any of that type of conservative) start talking about the constitution, I’m always reminded of this article.,2849/

    Its perfect.

  24. TangoMan says:

    An Interested Party,

    Are you trying to leave a hint that you’re actually David Duke? I don’t get what you’re saying. I’m not a liberal therefore I must be kind of slow, so your subtlety is lost on me.

    Can’t you guys actually attack arguments? If you really believe that blaming past administrations for present-day difficulties and believing that this dynamic of inherited problems is unique to Obama, are both solid arguments, then make your case, otherwise agree with me that it is a feeble crutch which indicates that the commenter has no other rhetorical arrows left in his quiver.

    Look, if you guys want to attack the person, rather than arguments, I have a store of writings at my blog and Google will lead you to my arguments on other sites. There should be plenty of material that I’ve written that will get your panties tied into knots, no need to attribute someone else’s writing to me. Grow up, David.

  25. An Interested Party says:

    Weak, Peter, er, TangoMan, weak…