05/26/2010 05:12 am ET | Updated May 25, 2011

70% Say Country "Dangerously Divided" by Health Care Debate

Over the past 10 months, we have partnered on nearly a dozen projects that have surveyed more than 30,000 likely voters. Unlike previous surveys where we have agreed in our analysis, in this one we have differences.

Our latest survey, taken immediately after the U.S. House passed the health care bill, found:

· 52% are dissatisfied with the new health insurance reform law, and 44% are satisfied. The question offered a four-point scale, and 46% said they were very dissatisfied compared to just 14% who were very satisfied.

· Those who were dissatisfied were asked whether their Congressional representatives should either work to repeal or amend the law, or to focus on other issues of economic and security importance. Seventy-seven percent of these voters wanted repeal or amendment of the bill. They represent 40% of all voters.

· 48% were less inclined to vote against representatives who supported the bill, and 40% were more inclined. Also, 45% were more inclined to vote for opponents of the bill, and 43% would be less inclined.

· Finally, 70% said the country has become "dangerously divided" by the debate, and 16% believe these feelings will quickly fade.

Q. Polls taken immediately after passage seem to differ as to whether opinion of the bill became more positive. What is your take?

Casscells: I thought we might see voters already moving toward greater acceptance, and wanting Congress to shift its attention to jobs, financial reforms, education, homeland security, and the environment. I thought people were tired of hearing about health care, since we know they are sick of all the carping and exaggerations. But most want Congress to focus on amending the new health reform law! It is not - as Democratic leaders claim - a matter of ignorance or misinformation: in a recent survey, we found 85% said they were familiar with bill's key components. So the opinions we see now are not due to wild fear- mongering about death panels. In fact, even Republican voters told us last summer they are approve of incentives for living wills. Yet nearly one-half of voters are very dissatisfied with the new law, mostly because they worry about taxes, deficits, and a bigger government.

Thus, the president and Democratic Congressional leaders should not assume that public acceptance of the bill will be rapid. They will need to be magnanimous in victory, patient in their educational campaign, open to revising the law in a bipartisan way, and sparing in their moralizing and smugness, and not rub the salt in Republican wounds. Even more critical is for Republican leaders to adamantly denounce their own lunatic fringe who are throwing rocks through the doors and windows of Democratic officials. They need to say it over and over again.

Zogby: Clearly, opposition to the bill is greater than support. But I also want to point out that we've asked a different question than a simple approve or disapprove of the bill. Some have asked the question in this way, but we've asked whether people are satisfied or unsatisfied with the bill. In some ways, it's a similar measure, but it is certainly possible to be "somewhat dissatisfied" and yet still approve of the bill. Obama and the Democrats are not going to get many votes from the 46% who are very dissatisfied with the bill, but they still have room to rebuild the coalitions that elected them in 2008.

Q. Are Republicans on solid political ground by wanting to repeal or amend the bill?

Casscells: Democrats have said that when people find out what is in bill, fears will subside. I thought that too, but I'm not so sure now. This bill is a significant shift that takes from the wealthy and healthy to support the sick and poor. I don't object to that, but we have found that a majority do not believe health care is a right. People are saying that we need to commit to fixing things in the bill that do need to be fixed.

Zogby: There is no denying the strong feelings against the bill, but our poll shows only 40% want Congress to take the issue up again with repeal or amendments. If the Republicans make this a campaign theme, it may help turn out the base, but will hurt with independents and moderates who want to move on to fixing the economy. Additionally, we're now seeing something that was missing from our previous polls - a high intensity of support for this legislation among Democrats. Previously, the intensity was among Republicans opposed to legislation. But in this poll, we clearly show that 80% of Democrats are very or somewhat satisfied, which suggests effects of both President Obama's strong backing as well as a reaction to the heavy, almost shrill, Republican opposition. Republican opposition is regenerating Democratic support, which will make repealing or amending the bill difficult.

Q. How much will passage of this bill impact the mid-term elections?

Casscells: As I said previously, Democrats believe fears will subside when people find out what is in bill. I thought that too, but I'm not so sure now. They may have been too optimistic that people will forget about the health care bill and vote for Democrats if the economy gets better.

Zogby: By a small margin, risks of a backlash against supporters of the bill are greater than the potential benefits for those who voted no. Still, the margins are not great. When we asked about the relationship between a legislator's vote on the bill and chances the respondent would support that legislator's re-election, we found that 87% of Republicans would be less inclined to support the re-election of legislators voting for health care reform. Regardless, most Republicans wouldn't have voted for the re-election of many of the legislators who voted for the bill. Meanwhile, 73% of Democrats would be less inclined to support the re-election of legislators voting against health care reform. In my view, then, the key group to watch electorally are independents, as well as senior citizens. The former are less predictable and more likely to make decisions based on the economy. Seniors will definitely become persuadable for the Democrats when many of them receive $250 if they hit the Medicare prescription drug "donut hole."

Q. Has this issue made nation hopelessly and dangerously divided?

Casscells: We've had some tough bills to deal with in the past like with war, Medicare and Social Security. They have been bitterly fought, but not as totally partisan as this. It is worrisome. President Obama needs to use his peerless explanatory skills to show this is a sensible plan. He needs to mend fences with Republicans. In the words of Lincoln, he needs to show "malice toward none and charity toward all." The Republican leaders must condemn violence. So far, they have used the anger out there for political advantage.

Zogby: Ward and I agree on this one. Republicans must cool the rhetoric and Obama and the Democrats must realize that people have very real concerns and even fears about the impact of such a far-reaching bill. But Republicans also need to remember two things: (1) they still have to go before voters in November with a record of accomplishment (holding up a stop sign is not policy) and (2) their strong opposition is breathing life back into Democrats and could make some of these races closer and more interesting in November than we suspected.

The University of Texas Health Science Center at Houston (UTHealth) commissioned Zogby International to conduct an interactive survey on healthcare reform on March 23-24, immediately after the bill was passed by the House of Representatives. This Zogby Interactive poll of 1,933 likely voters carries a margin of error of +/- 2.3%.

S. Ward Casscells, MD, the Tyson Distinguished Professor of Medicine and Public Health at the University of Texas at Houston, was Assistant Secretary of Defense (Health Affairs) from 2007-9.

John Zogby, Chairman of the Board of Zogby International, is the author of "The Way We'll Be: The Zogby Report on the Transformation of the American Dream."