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Democrats vs. Republicans: Health Policy Battle Royale

Conventional wisdom holds that the U.S. has become more and more partisan and the views of both Democrats and Republicans have become less moderate over time. Is that the case with respect to views on health policy?

A paper in JAMA last week by Blendon et al. (2021) conducted probability-based national surveys on four topics with sample sizes ranging between about 1,000 and 15,000 respondents. A summary of the perspectives of both sides is below.


Despite much of the rhetoric in the news, both Democrats and Republics believe addressing COVID-19 should be a top priority. Both sides highly prioritize not only additional funding for COVID-19 testing, vaccination, and personal protective equipment (PPE), but also economic stimulus and unemployment relief. In short, the country is certainly unified in fighting COVID-19.

The key differences is that most Democrats (64%) prefer that the federal government develop the policies and plans to limit the spread of COVID-19, whereas most Republicans (63%) prefer that these policies were developed and administered at the state or local levels.

Universal Health Coverage

On the topic of universal health coverage, we observe a substantial divide across parties.

Nearly 9 in 10 Democrats (87%) (n = 703 surveyed) reported that they believe it is the responsibility of the government to ensure all individuals in the US have health insurance coverage, a view shared by fewer than 1 in 4 Republicans (23%) (n = 580 surveyed). Among Democrats, 75% reported that they prefer a health insurance system mostly run by the government, whereas 79% of Republicans reported that they prefer a system based mostly on private health insurance.5

Not surprisingly, Democrats also supported expanding the Affordable Care Act (ACA), single payer/Medicare-for-All, or Medicare-buy-in/public option whereas Republicans did not.

Health Reform

Despite all the issues of US health care system discussed in the new, most Democrats and Republicans do not want a major overhaul of the current system. A bit more than half of individuals in both parties (53% of Democrats and 55% of Republicans) responded that they have a great deal of confidence in the current US health care system.

Further, any change to the system will be problematic due to the deep divide in how it will be accomplished.

About two-thirds of Democrats (68%) (n = 703 surveyed) indicated that they believe the federal government should be more involved in health care, a view held by only 17% of Republicans (n = 580 surveyed)

One issue that both groups do agree on is reducing the cost of prescription drugs, but Democrats and Republicans do not agree on the best method to achieve this goal.

Racial Disparities

Democrats were much more likely than Republicans to place be concerned about racial disparities in health outcomes. In general, 84% of Democrats believe racism is a major problem in the US compared to only 33% of Republicans.


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