Who Cares if the Public Doesn't Support Obamacare?

Christopher Flavelle writes editorials on health care, energy and environment for Bloomberg View. He was a senior policy analyst for Bloomberg Government and chief speechwriter for the leader of the Liberal Party of Canada.
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Republicans seeking to shut down the government over Obamacare are right about one thing: More Americans oppose the law than support it. Does that make it less legitimate? Or is it the new -- and worrisome -- normal for important government policies?

If public support were a prerequisite for government action, the U.S. would be in serious trouble. A polllast week showed that just one-third of Americans think the Federal Reserve has a significant ability to promote economic growth. As Binyamin Appelbaum noted delicately in the New York Times, that puts most Americans at odds with economists, who generally agree the Fed has helped, but disagree about how much.

Another recent example of the public good colliding with public opinion is the 2009 stimulus -- an $830-billion package of tax cuts, infrastructure spending and state aid that saved the country from an even deeper recession. The Congressional Budget Office concluded that a year and a half after the stimulus became law as many as 3.6 million more Americans had jobs than would have otherwise.

Yet Americans railed against the stimulus, while favoring its component parts. Polls in early 2010 found that while 80 percent of respondents supported government spending on infrastructure and aid for the unemployed, and 70 percent supported stimulus in the form of tax cuts, a majority opposed the law as a whole. The average American seems to believe the government gave most of the stimulus money to Solyndra and blew the rest re-paving Joe Biden's driveway.

The public's view on Obamacare is a continuation of the same trend. A polllast year showed that while 56 percent of respondents opposed the law, strong majorities supported some of its main components. That includes 82 percent who favored preventing insurers from denying coverage to those with pre-existing conditions and 72 percent who supported requiring large companies to provide coverage for their workers.

Meanwhile, as of August, 44 percent of respondents to a Kaiser Family Foundation poll didn't know the law was still in effect. If Democrats can't even communicate that Obamacare is still happening, explaining the virtues of federally subsidized state exchanges and minimum medical-loss ratios starts to look like a pretty tall order.

This raises some vexing questions: If officials can't persuade the public that something is a good idea, even if it accomplishes a goal the public favors, should they still proceed? Is good government better than popular government?

Supporters of President Barack Obama will note that the public's opposition to his policies is often the result of Republican disinformation. That still doesn't resolve the tension: There's no clause in the contract between government and citizens that says public opinion matters less when it's misinformed.

I had a professor who liked to say the American people will always make the right decision, at least based on the information they have. I used to think he meant policy makers could win the public over by talking with them. Now his mantra strikes me as deeply pessimistic -- an insinuation that the public would support a given policy if they only understood it, but when that's too much to ask, the government should proceed without that support.

That's a grim take on contemporary American politics, as it assumes that pursuing the public interest may entail disregarding the public will, at least during times of broad distrust toward government. It's a paternalistic mindset, and it risks breeding contempt for voters. But in terms of the quality of people's lives, the alternative may be worse.

This is a conflict at the core of what it means to be a modern and cranky democratic republic facing complicated policy challenges: It pre-dates the Obamacare debate and will certainly live long beyond it. But it's a tension that even the president's supporters should worry about, whatever happens this week.

This column does not necessarily reflect the opinion of Bloomberg View's editorial board or Bloomberg LP, its owners and investors.

To contact the author on this story:
Christopher Flavelle at cflavelle@bloomberg.net