In the aftermath of Republican Scott Brown's win in the Massachusetts special election for U.S. Senate and with support in national public-opinion polls for health care reform (as a general proposition) clocking in around 40%, there have been calls for the Democrats to scale back their aspirations for reform. In particular, many Republicans (and some, shall we say, "cautious" Democrats) have suggested the Congress move away from comprehensive health care legislation such as what passed the U.S. House last November (including various mechanisms to cover roughly 30 million uninsured Americans and regulate the insurance industry) and instead aim for something more limited.
As one example, Republican Representative Bill Cassidy advocates a number of narrow provisions that seem unlikely to increase the number of insured persons by anything near the extent proposed by the Democrats. House Speaker Nancy Pelosi (D-CA), in constrast, has argued that health policy changes cannot be effective in isolation, thus necessitating a more comprehensive approach.
A new ABC/Washington Post poll (in the field February 4-8) contained the following item, which has received considerable publicity:
Do you think lawmakers in Washington should (keep trying to pass) a comprehensive health care reform plan, or should (give up on) comprehensive health care reform?
Keep trying to pass 63%
Give up on 34
No opinion 4
The public, knowlingly or not, thus appears to side with Pelosi on this matter. Another item, which appears to have received much less attention, to some extent gets at Pelosi's idea that effective reform requires the coordination of many "moving parts." It reads:
Do you think the proposed changes to the health care system are too complicated, or do you think the changes have to be this complex to accomplish what they're trying to do?
Too complicated 60
Have to be this complex 35
No opinion 5
Whether the 35% who claimed the Democratic plans' complexity is unavoidable truly were exhibiting systems-oriented thinking or were just rationalizing in defense of a plan they support, we don't know. Peter Muhlberger, a colleague of mine at Texas Tech, has written about political-science theories claiming "that many people have simplistic understandings of human agency. These understandings result in an inability to conceptualize complex
systems of governance and an inability to take alternative political perspectives" (p. 54).
Whatever else one can say about the pending health care reform legislation, it certainly exemplifies the operation of "complex systems of governance."
UPDATE: A Zogby poll that was in the field from January 29-February 1 obtained findings opposite to the ABC/Post poll summarized above, regarding the public's desire for comprehensive legislation.