POLL: Opposition to Health Care Reform Is on the Rise

Tellingly, in a result that's been steady since spring, even among Republicans, fewer than half – 46 percent – have confidence in their own party to make "the right decisions" for the country. And just 25 percent of Americans identify themselves as Republicans, vs. 35 percent Democrats – roughly steady since 2007, as disapproval of George W. Bush pushed the country away from what had been political parity a few years earlier.

Obama gets 52 percent approval for handling the economy, unchanged from July and down from his peak, 60 percent, in February and late March. Nonetheless perhaps the best result for him is in economic expectations: Fewer than half, 48 percent, now think the recession will last more than another year, down very sharply from 70 percent last winter.

Obama's best hope is that a less gloomy economic outlook could leaven the public's mood more generally. One risk is that economic expectations can improve long before current conditions follow suit. Another is that when economic discontent eventually does ease, other contentious issues may simply supplant it. Such is politics.

One example is the war in Afghanistan; as reported separately, while Obama still retains 60 percent approval for handling it, dangers lurk. For the first time more than half call the war not worth fighting. Support for a reduction in U.S. troops has grown sharply. And barely more than four in 10 think the United States is winning.

HEALTH – Another risk, clearly, is health care. The decline in support for a public option and rise in suspicion that reform will do "more harm than good" are no surprise; ABC/Post polling earlier this summer showed the continued vulnerability of health care reform to pushback. That's because broad concerns about the system overall are tempered by individual satisfaction with current care, coverage and even costs – things people don't want to see worsened.

There are such concerns: Anywhere from 33 to 41 percent in this poll think reform will worsen their own quality of health care, insurance coverage and health care costs, while far fewer, 14 to 19 percent, think any of these would be improved.

Countering those views, 37 percent think health care for "most people" would be improved – essentially as many as say most people would receive worse care (38 percent), but no more. Among uninsured adults, moreover, 56 percent think reform would improve their ability to get coverage – but that leaves many, even in this group, in doubt about the benefits of reform.

Health Care Reform and Your Own Care

These views strongly inform positions on reform. It's supported by 84 percent of those who think it would improve their own care, and also by 84 percent of those who think it'd improve care for most people. But support falls to 57 percent of those who see no change in their own care and 50 percent who see no change for most people – and drops further, to 6 percent of those who think it'd worsen their care, and 5 percent of those who think it's worsen care for most people.

Sociologists – and polling data – long have demonstrated how concerns about impacts on society often trump personal self-interest in attitudes on political issues. Health care reform, though, is one issue on which self-interest does matter. Views on reform's personal impact, as well as on its impact on "most people," both independently predict attitudes on the proposal overall.

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