(Cross-posted from Think it Through)
The debate over comprehensive health care has made pollsters and others view health care politics in the larger context of generational change and the desire to use government to help people. A look at generational attitudes suggests America is in a transitional phase in its approach to government.
Andrew Kohut of the Pew Research Center, in an analysis on the Pew website, recently argued that if Medicare was proposed for the first time this year, it would probably not pass the Congress because of public opposition to such a large government program.
Kohut has a good point. Even though most historians credit President Lyndon Johnson’s strong arm tactics as the key to having passed Medicare in 1965, Kohut tells us that, at the time, national polls showed 65% of the public trusted the government in Washington to do the right thing just about always or some of the time. By 1974, he points out, “just 36% of the public trusted the government. And from that point on, pollsters have never found anything close to a majority of Americans saying they trust Washington.”
The serious public opposition to comprehensive changes in our health care system is breathing oxygen from two vents: First, many more Americans – especially older Americans – today, compared to a half century ago hold a negative view of government. Second is the realization that when older Americans fight against government getting involved in health care, it is not because they are stupid and fail to see Medicare as a government program, but rather that elderly voters actually like their government program of Medicare so much that any talk of reform makes them afraid the government will take something away from Medicare – they worry that reform usually means “I get less.”
All of this makes the expansion of Medicare a harder sell to the older generation, mostly, I believe, because of what they have lived through. If Kohut is correct and Medicare would not pass if offered in 2009, then I think it is worth asking: how did we get to this point?
When Medicare passed in 1965, the wealthy among us paid a top tax rate of 70% on their income, compared to 35% today. Many industries – banks, airlines, telephone companies, even the stock markets – were reined in by much heavier federal regulations than they are today. Still, Americans did not feel particularly oppressed. Lyndon Johnson had just won 44 states against a sincere, articulate, if overly blunt, spokesman for smaller federal government, Senator Barry Goldwater of Arizona.
When Medicare passed the nation applauded. We had not yet experienced the collection of historic and faithless acts that would come between the American public and its government in the coming years. The nation had not yet discovered that Lyndon Johnson’s government knew Vietnam was a lost cause, even as it sent 50,000 young Americans to die there, or that President Richard Nixon would run a White House dedicated to lying about nearly everything, from the bombing of Cambodia to the bugging of the Democratic headquarters to his use of the Internal Revenue Service to punish political enemies.
Then came Ronald Reagan, a brilliant communicator who devoted all his skills to communicating one central theme – the federal government is our enemy. It was a song he could sing on any occasion and it would usually allow him to carry the room. One stanza in Reagan’s anti-government songbook was the eight years he spent telling us that Social Security was going to run dry at any moment. Like lemmings, the Democratic leaders in Congress mimicked the President’s line on social security, and the result has been that a majority of Americans have serious, but unfounded, doubts about Social Security’s stability.
In sum, when you look at the behavior and rhetoric of people in the federal government over the last 45 years, you can understand why people tell pollsters they do not trust government. Also the polls tell us that the longer you live, the less trust you have.
Gary Langer, director of the ABC News poll, questions the usefulness of the “trust in government” question because it does not tell us what aspect of government people trust or distrust. Langer believes this question usually is interpreted as asking about national security – but not always. Right now, says Langer, you could even assume that the public’s level of trust in government would track approval ratings for President Obama.
If Langer is right, and I suspect he is, the poll numbers reflect what we hear on the streets and in the town hall meetings – older Americans are unhappy with President Obama, but once you get below age 65, the terrain for Obama and health care reform becomes much firmer. And when you reach into the youngest generation, you find the most support for Obama and the most comfort with the federal government.
ABC News’ August 17th poll has President Obama’s approval rating at just 47% among Americans over age 65, then it jumps to 55% among the 50-64 age group and 54% among 40-49 year olds and 58% among those between 30 and 39. Among the youngest adults, ages 18-29, the President’s approval is at 71%.
When Pew asked recently whether the government “is becoming too involved with health care,” the public, overall, registered only slight disagreement (54% disagreed; 46% agreed). We see differences by age, however, with 18-29 year olds disagreeing by 19 points (58% disagreed; 39% agreed); 30-49 year olds disagreeing by five points (51%; 46%), 50-64 year olds disagreeing by four points (49%; 45%), and older Americans, 65+, disagreeing less (40%) than agreeing (53%).
The youngest adult age cohort – the so-called Millennials, ages 18-29 – is more wary of politicians and political spin, yet very willing to get involved in causes and political movements, if not political parties. Despite the lost potential of the Clinton presidency and the combination of government deceit and failure over the last eight years, young adults have not given up on government. Instead, these young adults have taken a sophisticated approach of making things better one issue at a time. It is why they gave Barack Obama the lion’s share of their votes in 2008.
This consideration of the attitudes and values of each generation opens a window on a new America taking shape in the future. The youngest adult cohort mirrors a commitment to the causes of Teddy Kennedy, such as voting rights, health care, better education for all, gay rights, and opposition to two unnecessary wars against Iraq.
As the oldest cohort is removed from the picture, we will have a more progressive landscape to respond to and perhaps shape our political leadership. This leaves us with two conclusions:
- Comprehensive health care, with a substantial government role, will probably become a reality sooner or later, as the majority of the nation is taken over by those less hostile to government.
- How soon this happens is a matter of political leadership. Individual leaders can indeed shape the course of human events.
The Kennedy’s did. Ronald Reagan did. Not one of these leaders succeeded by tacking to the middle. They helped to <span style="text-decoration: underline;">create the change</span> in attitudes among generations that we are observing today by making a strong and persuasive case for policies that are rooted in values held deeply by many of us. The health care issue is about security and fairness for our families. It should be a slam dunk for President Obama.
John Russonello is a partner with Belden Russonello & Stewart: Public Opinion Research and Strategic Communications in Washington, DC. He writes the blog "Think it Through."