Democratic healthcare ideas favored

WASHINGTON —  Democratic ideas for fixing the healthcare system to cover the uninsured enjoy more support among Americans than proposals coming from Republicans, a new Los Angeles Times/Bloomberg poll shows.

The poll also found that a restive public was pessimistic about the direction of the country and that voters were dissatisfied with President Bush and the Democratic-controlled Congress. Congress was shown to be more unpopular than Bush: Its approval rating was 22%, the president’s 35%.

Healthcare is widely seen as the top domestic issue in next year’s presidential race.

Two of the main proposals advanced by Democrats received majority support in the poll.

Sixty-two percent said they supported requiring large employers to help pay for coverage whereas 31% opposed it. And 51% said they favored a mandate that individuals purchase health insurance, much as drivers are required to carry auto coverage; 39% disagreed.

Tax breaks to make insurance more affordable -- a leading Republican idea -- more closely divided the public, with 44% backing that approach and 45% opposing it.

In one of the most politically significant results, the poll finds that independents and moderates were generally lining up with Democrats in the healthcare debate.

The survey also suggested an explanation for the emerging alignment: Independents were most likely to complain about “job lock” -- the view that they are stuck in jobs they don’t like solely because of health benefits.

In all, 20% of independents said they or someone in their household were forced to stay in a job because it provided healthcare, compared with 13% of Democrats and 5% of Republicans.

“Independents are more insecure in terms of the issue of ‘job lock,’ ” which causes them to lean more toward Democrats on the healthcare issue than Republicans, said Robert Blendon, a public opinion expert at the Harvard School of Public Health. The poll found that Americans were divided on one of the basic questions surrounding the healthcare debate: who should bear the main responsibility in securing health insurance.

Twenty-nine percent said it is the responsibility of government; 23% said employers; 24% said individuals should take care of themselves, without help from government or employers; and 19% said it is a shared responsibility.

The survey, conducted Friday through Monday, was supervised by Times Poll Director Susan Pinkus. The questions were asked of 1,209 adults, and the margin of sampling error was plus or minus 3 percentage points.

The healthcare debate is unfolding against a backdrop of deep public disaffection with government and with leaders of both parties.

Even among Democrats, 65% disapproved of the job Congress is doing. That partly reflects a belief among party members that Congress has not succeeded in blocking Bush’s policies on the Iraq war and other issues. A majority of Democrats -- 52% -- said Congress was supporting Bush’s agenda too much.

“I feel like they are not standing up to the president as I think they should,” said Sinjaporn Lacy, 41, a Democrat who lives in New Hampshire. “They are not worried about the people that put them into office.”

Sarah Feinberg, spokeswoman for the House Democratic Caucus, said she expected that Congress’ image would improve if Democrats did a better job of publicizing what they had achieved since taking control of the House and Senate after the 2006 elections. Legislation signed into law includes an increase in the national minimum wage and a large boost in college aid money.

“We have some more work to do so people will know about our accomplishments,” Feinberg said.

On healthcare, the leading Democratic presidential candidates, Sens. Hillary Rodham Clinton of New York and Barack Obama of Illinois and former Sen. John Edwards of North Carolina, support some form of requirement that large employers help pay for coverage.

Clinton and Edwards also favor a requirement that individuals get health coverage, with government subsidies for those who cannot afford it. Obama favors requiring coverage for children but stops short of a mandate for all.

An estimated 47 million people in the United States are uninsured.

The candidate with the most experience with the insurance mandate issue is Republican Mitt Romney. As governor of Massachusetts, he advocated and signed into law a bill requiring individuals to get coverage.

Yet Romney has backed away from that plan as a national solution; he instead is calling for tax breaks and other measures to make insurance more affordable. GOP front-runner Rudolph W. Giuliani, a former mayor of New York, favors using tax credits to help people buy private coverage.

Linda VanDruff of Kansas City, Kan., a political independent, said she was not comfortable with the idea of tax breaks for health insurance.

“A tax credit is just a tax credit,” VanDruff said. “You get that just once a year, and it is not going to cover the cost to you for health insurance.”

VanDruff, 52, said she was forced to retire from her job as a crane driver three years ago because of lung disease and is now covered by Medicare.

“If you are rich-rich, you can afford it, and if you are poor-poor, they’ll help you with it,” she said of health insurance. “But if you are that in-between guy, you are in trouble.”

The survey found that 53% supported the idea of extending Medicare to cover all Americans, creating a government-run system; and 36% opposed it.

But Blendon, the Harvard expert, said that finding was suspect because the poll question did not make clear that such a system would be financed by taxes.

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ricardo.alonso-zaldivar@ latimes.com

janet.hook@latimes.com