Why Government Health Care Keeps Falling in the Polls

The health-care debate is part of a larger moral struggle over the free-enterprise system.

By ARTHUR C. BROOKS

Regardless of how President Barack Obama's health-care agenda plays out in Congress, it has not been a success in public opinion. Opposition to ObamaCare has risen all year.
According to the Gallup polling organization, the percentage of Americans who believe the cost of health care for their families will "get worse" under the proposed reforms rose to 49% from 42% in just the past month. The percentage saying it would "get better" stayed at 22%.
Many are searching for explanations. One popular notion is that demagogues in the media are stirring up falsehoods against what they say is a long-overdue solution to the country's health-care crisis.
Americans deserve more credit. They haven't been brainwashed, and they aren't upset merely over the budget-busting details. Rather, public resistance stems from the sense that the proposed reforms do violence to three core values of America's free enterprise culture: individual choice, personal accountability, and rewards for ambition.
First, Americans recoil at policies that strip choices from citizens and pass them to bureaucrats. ObamaCare systematically does so. The current proposals in Congress would effectively limit choice across the entire spectrum of health care: What kind of health insurance citizens can buy, what kind of doctors they can see, what kind of procedures their doctors will perform, what kind of drugs they can take, and what treatment options they may have.
Meanwhile, ObamaCare would limit the ability of people to choose affordable insurance coverage through less-comprehensive, consumer-driven insurance plans. And it wouldn't allow Americans to shop for better health-care plans from out-of-state carriers.

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Second, Americans believe we should be responsible for the consequences of our actions. Many citizens bitterly view the auto and Wall Street bailouts as gifts to people who took imprudent risks, imperiled the entire economic system, and now appear to be walking away from the mess.
Similarly, Americans are cold to a health-care system that effectively rewards individuals for waiting to get insurance until they get sick—subsidizing their coverage by taxing those who responsibly carry insurance in good times and bad.
On its face, the reformers' promise to provide health insurance to nearly all, regardless of pre-existing conditions, is appealing. But as most instinctively realize, if people don't have to worry about carrying insurance until they need it, many won't buy it. Already, the Census Bureau tells us that 21% of the uninsured are in households earning at least $75,000. Although there are certainly plausible reasons for this in some cases, this phenomenon will worsen under ObamaCare.
Third, ObamaCare discourages personal ambition. The proposed reforms will institute a set of government mandates, price controls and other strictures that will make highly trained specialists, drug researchers and medical device makers less valued now and in the future. Americans understand that when you take away the incentive to make money while saving lots of lives, the cures, therapies and medical innovations of tomorrow may never be discovered.
Yet we are told this is all for the best. In his commencement speech at Arizona State University earlier this year, Mr. Obama told the graduates not to "fall back on the formulas of success that have been peddled so frequently in recent years": "You're taught to chase after all the usual brass rings . . . let me suggest that such an approach won't get you where you want to go."
Crass materialism is indeed a tyranny that can lead to personal misery. But most Americans believe it's up to individuals, not a nannying government, to decide what constitutes too much income and too much ambition.
An April 2009 survey conducted by the polling firm Ayers, McHenry & Associates for the conservative nonprofit group Resurgent Republic asked respondents which of the following statements about the role of government came closer to their view: (a) "Government policies should promote fairness by narrowing the gap between rich and poor, spreading the wealth, and making sure that economic outcomes are more equal"; or (b) "Government policies should promote opportunity by fostering job growth, encouraging entrepreneurs, and allowing people to keep more of what they earn." Sixty-three percent chose the second option; just 31% chose the first.
This is consistent with nonpartisan surveys showing that most Americans think our increasingly redistributionist government is overstepping its bounds. For example, a September 2009 Gallup Poll found that 57% believe the government is "doing too much"—the highest percentage in more than a decade. Just 38% said it "should do more."
We will continue to hear both sides of the health-care debate argue about particulars of insurance markets, the deficit impacts of reform, and the minutiae of budgetary assumptions. These arguments, while important, do not address the deeper issues involved.
The health-care debate is part of a moral struggle currently being played out over the free enterprise system. It will be replayed in every major policy debate in the coming months, from financial regulatory reform to a cap-and-trade system for limiting carbon emissions. The choices will ultimately always come down to competing visions of America's future. Will we strengthen freedom, individual opportunity and enterprise? Or will we expand the role of the state and its power?
Mr. Brooks is president of the American Enterprise Institute and author of "The Battle: How the Fight Between Free Enterprise and Big Government Will Shape America's Future," to be published by Basic Books next June.