The July survey of voters by Civiqs puts polling on health care and healthcare reform in a new light. It turns out, people aren't afraid of getting guaranteed coverage for everyone from the government. They're worried about change if private insurance goes away.
When asked, "Would you support or oppose eliminating private health insurance, and replacing it
with a government-run healthcare program?" the panel was strongly opposed, 52-31%. It still received 53% support from self-identified Democrats, but just 33% from Independents. Republicans are Republicans, and 86% oppose—88% of frequent Fox viewers included.
But flip it around, and you get a much better sense of the public's level of comfort with a single-payer kind of system. People were asked, "Would you support or oppose a government-run healthcare program that covered every American, but had the option to purchase additional health insurance from private insurance companies?" That gets 51% support to 38% opposition. That includes a whopping 82% of Democrats and 50% of independents. The lowest level of support is in the near-Medicare age group, 50-64, which still gives it plurality support at 48% to 43% opposed. Even 37% of occasional Fox viewers support the idea.
How this is framed makes a significant difference, demonstrating that it's not the "socialism" that scares people when they look at a Medicare for All kind of system. It's the change they fear. Even with Democrats, who overall support a government-run system by 30 points, support grows 75 points when you tack on the possibility of supplemental private coverage (which is how most other OECD nations have done it). It's the familiar—there are private Medicare supplemental plans that everyone sees advertised on the TV all the time. It's something we know and we know works.
Here's the most important takeaway: The premise of everyone getting basic coverage run by the government, truly universal coverage, gets majority support if there's an option to purchase some form of additional private health insurance. As long as part of this remains the same. Given the turmoil of the past decade, with Republicans threatening every day to upend the whole thing, that's understandable.
Thus, you could flip the whole idea of just adding a public option to the Affordable Care Act into having the main thing be Medicare for All with the padding of a private option for the nonessentials. The fight over whether or not the private insurance system is eliminated or not is right now working as a distraction from the right. Fundamentally, the next healthcare reform effort is centered on a much larger role for the federal government in guaranteeing universal access. The American public has come around since the fight for the Affordable Care Act began in earnest in 2010 to accept that vision. It's not a terrifying idea for the non-Fox-viewing public.
And if Trump and the Republicans succeed in the courts in overthrowing the ACA, you can expect those numbers supporting single-payer to start ticking up.