With the advent of the Affordable Care Act, the share of Americans convinced that health care is a right shrank from a majority to a minority.
This shift in public opinion is a major victory for the Republican Party. It is part of a larger trend: a steady decline in support for redistributive government policies.
Emmanuel Saez, an economics professor at Berkeley and one of the nation’s premier experts on inequality, is a co-author of astudy that confirms this trend, which has been developing over the last four decades. A separate study, “The Structure of Inequality and Americans’ Attitudes Toward Redistribution,” found that as inequality increases, so does ideological conservatism in the electorate.
The erosion of the belief in health care as a government-protected right is perhaps the most dramatic reflection of these trends. In 2006, by a margin of more than two to one, 69-28, those surveyed by Gallup said that the federal government should guarantee health care coverage for all citizens of the United States. By late 2014, however, Gallup found that this percentage had fallen 24 points to 45 percent, while the percentage of respondents who said health care is not a federal responsibility nearly doubled to 52 percent.
The conservative shift in public attitudes on health care and on issues of redistribution and inequality pose a significant threat to the larger liberal agenda.
The 2013 paper published in Public Opinion Quarterly that I mentioned at the beginning of this article, “The Structure of Inequality and Americans’ Attitudes Toward Redistribution,” suggests that Democratic programs providing tax-financed benefits to the poor are facing growing hostility.
The author of the paper, Matthew Luttig, a Ph.D. candidate in political science at the University of Minnesota, found that while “numerous political theorists suggest that rising inequality and the shift in the distribution of income to those at the top should lead to increasing support for liberal policies,” in practice, “rising inequality in the United States has largely promoted ideological conservatism.”Why? The cliche has long been that Americans are ideological conservatives and operational liberals: that is, they support limited government in the abstract but big government in the particular. But these data suggest issues where the opposite is the case: that many people like items on the liberal menu but turn conservative when they see the prices.
Moreover, there was a huge gap between the promises of the Affordable Care Act -- the president pledged that it would be essentially painless -- and the reality. Barney Frank said: "But frankly, he should never have said as much as he did, that if you like your current health care plan, you can keep it. That wasn’t true. And you shouldn’t lie to people. And they just lied to people.”