ASHINGTON — Americans are not clamoring for single-payer health care, as Sen. Bernie Sanders has suggested they are, in proposing a plan that would have the government foot most medical bills.

He’s right that support for the idea has grown and in some polls tops 50 percent. But polls suggest that the prevailing sentiment is ambivalence.

Saving money on health insurance holds lots of appeal. Seeing taxes rise to cover those costs may dull the appetite.


Sanders’ plan, released Wednesday, would have the government finance coverage now paid for by a mix of employers, their workers, public plans and people in the individual insurance market. He’s not given details of the likely cost or how, exactly, he’d pay for it.

A look at the independent Vermont senator’s claims about the popularity of a government-financed system and how they compare with surveys of public opinion:

The claims:

—”You mean because the people in this country want to move toward a Medicare-for-all system, that is divisive? I think in a democracy, we should be doing what the American people want.” — AP interview Tuesday, when asked about divisions in the Democratic Party over his idea.

—”Guaranteeing health care as a right is important to the American people not just from a moral and financial perspective; it also happens to be what the majority of the American people want.” — Opinion piece in The New York Times on Wednesday.

The facts:

It takes a selective use of polling to make that case. Overall, public opinion research delivers decidedly mixed results.

The Kaiser Family Foundation reports a “modest increase” in support for single-payer coverage in recent years, with “substantial” opposition. Perhaps most notably, public opinion is “malleable,” with support dropping when people are presented with arguments against it that are certain to emerge in the debate.

Kaiser’s tracking poll in July found 53 percent in favor of having all Americans get their health insurance from the government; 43 percent were against that. Opposition climbed to 60 percent when people were asked to consider that such a plan would call for higher taxes for many. A slight majority also swung against a single-payer plan when respondents were told that former President Barack Obama’s health care law would be replaced as a result.

Public opinion research also helps to explain why Sanders calls his plan “Medicare for all.” Labels matter. People tend to react more favorably to the notion of expanding the popular Medicare program to cover everyone than to the idea of “single-payer” even if they amount to the same thing.

In other polling:

—People were about evenly divided in an AP-NORC Center survey in January, 39 percent against having everyone get their health insurance from one government plan and 38 percent in favor. Support dropped substantially when the prospect of a large increase in federal spending was introduced.

—Respondents favored a Medicare-for-all plan 51-38 in a Quinnipiac poll in August that did not raise the question of potential costs.

—In his Times article, Sanders cited an Economist/YouGov poll in April that found a clear preference for expanding Medicare to provide health insurance to all — 60-23. The survey did not address the cost or tax implications of taking that course. That survey was conducted using an opt-in online panel recruited with internet advertising, a methodology criticized by some because of concerns that it does not reach a random sample of Americans.

—The Pew Research Center in June found 60 percent who believe the federal government is responsible for ensuring health care coverage for all Americans, with 39 percent disagreeing. That supports Sanders’ contention that people want health care as a right. But ensuring coverage is not the same as paying for it. Support for a single-payer system registered at only 33 percent in that poll. Many of those who felt the government has a responsibility for making sure people have coverage instead supported a mix of public and private programs.

— By Calvin Woodward and Emily Swanson

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  • the primary problem with health care is this: We have allowed the entire sector (nearly 20% of our overall economy) to function completely free of the two mechanism we use to control price and protect consumers – real market competition on price, or in the absence of competition as with utilities, price regulation. the mostly for-profit providers, hospitals, labs. pharma all are legally allowed to collude and set prices based on what they would LIKE to earn or collect as a profit margin. They do this with total disregard for the ability of their customers to be able to afford the goods and services they sell. This is unprecedented and destructive. It has predictably led the current situation, where the prices and incomes have risen so astronomically that the federal government now pends close to $600B of taxpayer money annually via Medicare, Medicaid and Obamacare insurance subsidies to cover the shortfall between what the participants in the industry demand and the customer can pay. The inherent dynamics of this situation dictate that the trend will continue relentlessly. Single payer is one of the only options to correct the madness. The federal government can insist on TRUE competition between the players, or institute real price controls based on cost and reasonable returns, as they do in the case of utilities. The other key to affordability is to eliminate the insurance company layer, and just process the payments. The savings we will all see due to the loss of premiums, copays and deductibles will more than make up for the increase in our tax bill.

  • Americans may not seem to support single-payer, but extremely wealthy and powerful forces in the medical/pharma industry complex skew any honest news coverage of the topic. With all the skimming multi-millionaires/billionaires in this industry, how could a single payer not be cheaper?

  • As a Canadian the most of us just can’t understand why you oppose universal health. It’s not more expensive it’s cheaper. Americans spend about 17 % of GDP on health care. Canada spends about 11%. We live longer and this idea of going to the US because we have waiting lists is garbage. If your situation requires attention now you get it now. If your situation says you can wait you wait or you can pay extra to jump ahead and go to the US. Nothing complicated.

  • Health insurance is not free. But Americans apparently​ want it to be
    free, because charging​ for it would be perceived​ as a tax increase. Has anyone consider​ed calling​ it what it is, i.e., an insurance premium? Charging​ 5% of gross income, matched by the employer, would raise​ about a trillion dollars a year and at the same time save employers a whole​ lot of money.

  • The US is the only 1st world country without universal healthcare today. There is no reason why a 2-tier healthcare system like in Germany would not work in the US. 33% of support when the conversation is huge! This is going to be the greatest revolution in the US after the Civil Rights movement.

  • This article is bullshit. Since the introduction of Bernie’s Bill originally 2 years ago it has gone from zero Senate cosponsors to 16 within a week. 76 in the hose to over 100. Not cause they wanted to, but due to grass-roots efforts. Pushing this narrative is hurting our country and you’re CLEARLY doing the bidding of the establishment. Please stop it’s gross.

  • True! Corporate America is rich because we love to exploit the sick, the poor. Healthcare is a privilege for the rich, let us make sure we do give it away like stupid socialists.

  • Only socialists/communists want universal care!
    America is great because it is built to serve conmen at the expenses of suckers! Ask the president.

  • The way to get this to happen is reduce the age of qualification for Medicare by one year per year, so it would be a gradual process with the age of qualification getting closer by two years per year. That would give people a hope and a goal, so they would support it.

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