The Health Care Generation Gap

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"The Health Care Generation Gap"

It’s certainly interesting that older Americans are disproportionately likely to be hostile to Barack Obama’s plans for health care reform and also the case that most older Americans already benefit from a Canadian-style program of universal Medicare. That said, I don’t think these facts are quite as interesting as some people are making them out to be. Consider the results of the election:

votebyage

Now consider the health care generation gap:

“Obama’s plan is most popular among younger Americans and least popular among senior citizens,” says CNN Polling Director Keating Holland. “A majority of Americans over the age of 50 oppose Obama’s plan; a majority of those under 50 support it.”

If Obama’s ex ante support had been generationally neutral, then I would say that there’s a big window here for some kind of specifically tailored messaging around Medicare or whatever. But the main issue here just seems to be that people who are inclined to like Obama are inclined to like Obama’s health plan. And for all the attention the press plays to demographic sub-samples, the tendency is for presidential politics to be dominated by pretty broad swings. If Obama were more popular in general, he’d also be more popular with seniors, and his plan would be more popular with seniors. To actually get a majority with seniors, he’d have to be wildly more popular than he currently is.

I can’t prove it, but my guess is that the main public opinion problem with Obama’s health proposals has nothing to do with health care messaging and everything to do with the fact that the economic situation has steadily deteriorated over the past six months. That’s the kind of thing that drags your numbers down.

Meanwhile, if I were a member of congress in addition to the polling I’d be thinking about how things will actually look to people when a bill passes. If you think Medicare recipients will continue to be happy with the quality of the health care services they receive, then you should assume that Medicare recipients will continue to be happy with the quality of the health care services they receive. Conversely, if you promise younger people that your bill will improve their health care, you’d better deliver something that actually improves their health care. Whether or not you sell them on it in advance seems less important than whether or not what you did looks good in retrospect.

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