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Is Healthcare Seen as a Privilege or a Right? Public Opinion on Medicare-For-All

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By The Center for Public Policy at VCU’s Wilder School
February 25, 2020

Healthcare is a hot issue of debate among today’s presidential candidates. In order to better understand public opinion on this issue, the Center for Public Policy at Virginia Commonwealth University included a question measuring Virginia’s support of Medicare-for-all in their Fall 2019 Wilder School Commonwealth Poll.


With Democratic primary elections taking place across the country, candidates are focusing their platforms, debates and advertisements on some of today’s hottest issues in the hopes that voters will support their vision. One issue that has emerged as a rather divisive topic amongst the top candidates is that of public healthcare for all, also known as Medicare-for-all. This is an idea supported by only two of the remaining candidates: Senator Bernie Sanders and Senator Elizabeth Warren. The majority of other candidates support a more modest approach to healthcare reform, in which public and private healthcare options would exist.

The United States currently structures healthcare provision through a multi-payer system, in which a wide variety of organizations (e.g. private insurance companies) are responsible for funding healthcare costs. While this is often a supportive system for those with the economic means to afford or obtain insurance, oftentimes through their employers, those lacking access to insurance are left with few (if any) choices. With treatment options becoming increasingly more expensive, many Americans choose to be without medical care rather than forgoing other needs.

Many other countries, including the United Kingdom, Germany and Japan, all have versions of a government-funded healthcare system and there has been significant debate on whether a similar model would be possible in the United States. Opponents argue that it is against the spirit of the country’s capitalist system, resulting in those with economic means paying for those without. Supporters argue that healthcare structured around capitalism leaves citizens with a lower socioeconomic status without healthcare, and believe that healthcare should be a universal right for all rather than a privilege afforded to only a few.

In order to better understand public opinion on this issue, the Center for Public Policy within the L. Douglas Wilder School of Government and Public Affairs at Virginia Commonwealth University included a question measuring Virginia’s support of Medicare-for-all in their Fall 2019 Wilder School Commonwealth Poll. The poll was a representative sample of 801 adults in Virginia, was conducted by landline and cell phone, and had a margin of error of +/- 4.08 percentage points. Specifically, poll participants were asked:

Do you favor or oppose having a national health plan, sometimes called Medicare-for-all, in which all Americans would get their insurance from a single government plan?

Once participants responded whether they favored or opposeded the plan, they were asked if they felt that way strongly or somewhat.

Results indicated that there was a nearly even split between support and opposition, with 51% strongly or somewhat favoring and 49% strongly or somewhat opposing. Family income paid a significant role in the individual’s support of Medicare-for-all, with 32% of those making less than $50,000 per year strongly in favor and 38% somewhat favoring it. There was also a significant difference based on race/ethnicity, with 71% of minorities strongly or somewhat favoring the implementation of Medicare-for-all, and only 39% of the white population strongly or somewhat favoring the option. As was expected, there was also a significant contrast between party lines, with Republicans strongly opposing (62%) and Democrats strongly favoring (44%).

There is a clear distinction between those in favor of Medicare-for-all and those who oppose it. Those who would most benefit from its implementation, particularly those with a lower socioeconomic status, are in favor of Medicare-for-all while those who have and are happy with private insurance are in opposition. The fear of excessive increases in taxes, longer wait times and the loss of their current insurance plan will provide little incentive for those who are benefiting from the current system to vote in favor of a change.

As the Democratic primary season transitions into the 2020 Presidential Campaign, it seems highly likely that Medicare-for-all will continue to be a primary topic of debate between President Trump and the Democratic nominee. President Trump, who entered the White House with intentions of removing the Affordable Care Act (frequently referred to as, “Obamacare,”), will most likely rally his supporters against the concept of Medicare-for-all within his campaign. Senator Sanders, one of the leading candidates for the Democratic nomination, has been a consistently vocal proponent of Medicare-for-all with no copays, deductibles or fees out-of-pocket from the individual after a doctor’s visit. As primary elections continue across the country, we expect to see a clearer picture of which Democratic candidate will win the nomination and, in turn, the extent to which voters favor more progressive or more moderate policies.


Author: The Wilder School’s Center for Public Policy advances research and training that informs public policy and decision-making to improve our communities. Drawing on the wide-ranging expertise of Wilder School faculty, we services including leadership development and training, economic and policy impact analysis, survey insights, and program evaluation to clients in governments, nonprofits, businesses, and the public, across Virginia and beyond.

Twitter: @CPPatVCU

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