The Public’s Contribution to Congressional Gridlock on Health Care Reform

The outcome of the national debate over health care reform was obviously affected by many factors, including the behavior of interest groups, the effectiveness of presidential and congressional leadership, the evolution of public opinion, and media coverage. Here we focus solely on the mes-sages Americans sent to legislators throughout the debate. Public opinion did not drive the debate in any single direction. In fact, the public sent at least three distinct messages to Congress throughout the debate. First, middle class Americans were worried about the cost and security of their health care insurance coverage, and they wanted major health care reform to be high on the congressional and presidential agenda. Second, although they wanted government action on this problem, the country was deeply divided on what Congress should do to achieve comprehensive reform. And, third, when ultimately faced with specific proposals to overhaul the health care system, the public became more afraid of the negative effect of what Congress might enact than they were of the health care problem itself. To understand how these three divergent messages contributed to congressional gridlock, we examine in more detail the public views on health care reform. Salience of Health Care Reform The increasing worries of middle class Americans were a driving force behind the latest health care reform debate (Blendon and Szalay 1992)