A Tale of Two NBC/WSJ Health Reform Questions

03/18/2010 02:46 pm ET | Updated May 25, 2011
  • Mark Blumenthal Mark Blumenthal is the Head of Election Polling at SurveyMonkey.

The two-question sequence on health care reform asked by the highly regarded NBC News/Wall Street Journal poll -- slightly updated since I wrote about it in my column two weeks ago -- has been getting a fair amount of attention.. And rightly so. Although I've been arguing for a long time that, our chart aside, it's a bad idea to try to boil all of public opinion on health reform down to a single measure, these two questions do a good job of getting at what people know and how they react when asked about "Barack Obama's health care plan."

They begin with a question that they have tracked since April:

From what you have heard about Barack Obama's health care plan, do you think his plan is a good idea or a bad idea? If you do not have an opinion either way, please just say so.

On the most recent survey, just 36% consider the plan a good idea (up from 31% in late January), 48% consider it a bad idea (up from 46%) and 16% either have no opinion or are unsure (down from 23%). This question, which prompts to say when they have "no opinion," also shows a slow steady decline over the past year in the percentage without an opinion, from 41% last April to just 16% now.

Then they follow up:

Do you think it would be better to pass Barack Obama's health care plan and make its changes to the health care system or to not pass this plan and keep the current health care system?

Here opinion divides evenly: 46% say pass and change, 45% do not pass and keep the current system, with the rest volunteering a response of "neither" (4%) or unsure (5%).

What is even more interesting is the pattern of the result when tabulated by party identification. The tabulations below (kindly provided by the NBC/WSJ pollsters) includes party "leaners" among the partisans, so the independent group represents the 15% of adults on their most recent survey that think of themselves as "strictly independent."


Republicans are solidly, consistently opposed to Obama's health reform bill. Four out of five (83%) think its a bad idea -- a number that has not changed since January -- and almost as many (79%) would rather not pass the plan and keep the status quo.

While a majority of Democrats favor the legislation, we see an 11-point gap between the number who think it's a good idea (64%) and those who prefer to pass the bill (75%). Among independents the gap is 19 points: Only 26% are convinced the bill is a good idea, but far more want to pass the bill and change the system (45%).

So while Republicans are uniformly opposed, many Democrats have doubts, even those who prefer to see the bill pass than to do nothing. For some, these doubts are about the lack of a public option or too much compromise, but for others, the doubts stem from their perceptions (right or wrong) about the bill's cost or the increased role of government (for more, see Nate's Silver's word clouds of the very helpful Gallup open-ended data).

The slight increase in support for reform measured by most surveys in recent weeks (the just released Pew Research Center poll being an apparent exception) comes mostly from Democrats. That pattern makes perfect sense, since the intramural disagreements among Democratic leaders have faded considerably in recent weeks. Consider Glenn Greenwald's summary:

For almost a full year, scores of progressive House members vowed -- publicly and unequivocally -- that they would never support a health care bill without a robust public option...Up until a few weeks ago, many progressive opinion leaders -- such as Moulitsas, Howard Dean, Keith Olbermann and many others -- were insisting that the Senate bill was worse than the status quo and should be defeated. But now? All of those progressives House members are doing exactly what they swore they would never do -- vote for a health care bill with no public option -- and virtually every progressive opinion leader is not only now supportive of the bill, but vehemently so.

The important point: Neither of these poll questions gets at the whole of public opinion on health care reform nor provides even a complete picture of the general impressions of the legislation. If you focus exclusively on the "good idea/bad idea" question (which, incidentally, now matches almost perfectly the Pew Research "favor or oppose" results released today), you miss that three quarters of Democrats and nearly half of independents prefer to move forward with this bill than remain locked in the status quo.

But if you focus exclusively on the pass-and-change/don't-pass-don't-change question, you miss the big doubts expressed by the vast majority of true independents and nearly a third of Democrats, and the huge gap in intensity of opinion on this subject that separates Republicans and Democrats.

Finally, I received two emails yesterday taking us to task for including the first NBC/WSJ question in our chart but "completely ignoring" the second. Here's one:

Right now, you're using the "good idea/bad idea" numbers from the NBC/WSJ poll today. However, the name of the graph on your website is "Favor" or "Oppose". If someone favors something, they would say pass it.

You should be using this metric or both metrics - not the "good idea/bad idea" metric by itself, which does not fit whatsover into your chart.

Our chart admittedly flaunts a bit of polling orthodoxy by combining results from different questions using different language and response categories. The more traditional approach would stop at the sort of apples-to-apples comparisons plotted in my post yesterday. So reasonable people will likely disagree with the questions we have chosen to include or exclude on the chart. If we dropped the good idea/bad idea result from the most recent NBC/WSJ poll, and replaced it with the pass & change/don't pass-don't change result, our overall trend estimates would narrow slightly (from 43.4% favor, 48.9% oppose to 44.7% favor, 48.5% oppose).

But I disagree with the argument that the second NBC/WSJ question is obviously closer to the standard "favor or oppose" question asked by other pollsters. It does ask if the respondent wants to pass the bill, which is straightforward, but it also frames the question in terms of change versus the status quo. How many Republican leaders have you heard state that they oppose the Democratic plan because they want to "keep the current health care system" as it is now?

Moreover, the most important purpose of the chart to track trends apparent across multiple polls, not to somehow magically derive the true levels of support and opposition from multiple polls. The NBC/WSJ poll has tracked their good idea/bad idea formulation for almost a year. Abruptly switching introduces some discontinuity. For better or worse, we will stick with this measure for NBC/WSJ unless and until they start tracking something else.