Infographic of the Day: Who, Exactly, Supports a Public Option?

As it turns out, lots of people. But the results vary widely by income: The rich are nonplussed, but middle-income and poorer families are in strong support.

This is a big week in the decades-long debate over providing health care to the uninsured: Both the House and Senate are expected to deliver their reform bills. Granted, we’re still a ways off from a bill that hits the president’s desk–but we’re finally getting close to seeing what that bill will look like. And all indications are that the bill will contain a fairly strong public option.

healthcare 2004

So let’s take a step back: Among the American populace, who supports the public option? Overall, over 60%, actually. But the figures are heavily bifurcated by income. Middle-income and poorer households strongly support spending more to cover the uninsured. Richer households tend not to, which isn’t surprising. People’s political beliefs generally conform to self-interest, and the rich tend to already have health insurance. But what is surprising is how pronounced the differences in opinion are. And the graph above, drawn from 2004 data, ingeniously illustrates that point.[Full-size here]

Each of the small U.S. maps represents a portion of the American populace, divided by income. Among each, support for increased public-spending for the uninsured is shown by a color code: The more blue, the greater the share of those in support of the spending. The more brown, the lower the share. As you can tell, the map is simple and intuitive, but contains an enormous amount of data. The one misleading part about it is that it doesn’t quite give the relative size of those income groups–the middle-to-lower brackets are far larger than the richer. You can’t really tell it at a glance, but overall, the support for increased coverage for the insured is 72%. (The graph might have been improved if the size of the mini-maps were varied, based on the size of each group.)

Obviously, the health-care reform debate has entered a new round of contentiousness since that data was gathered in 2004. If you compiled this survey now, the split would probably be closer. But the data do provide far better context to the town-hall/teabagger hoopla that dominated the discussion over the summer. And also, it helps explain exactly why the White House and health-reform advocates have tried to recast the debate as an issue of controlling health-care costs.

Now, there’s reason to support a public option on economic grounds: It simply isn’t possible to control health-care costs, if you don’t cover more people–thus creating larger “risk pools” and boosting buying leverage (which brings down cost).

But politically, bringing down costs is a cause that rich and middle-income voters alike can agree on, given how health-care costs are spiraling–and that’s why the Obama administration, for so long, has argued that the issues are inseparable. It makes political sense, give the broad divisions shown in the map above.


For a deep discussion of the graphic, check out Five-Thirty-Eight. For a broader discussion of these issues, check out this post by veteran health-care reporter Maggie Mahar.

[Five-Thirty-Eight, via Chart Porn]

About the author

Cliff is director of product innovation at Fast Company, founding editor of Co.Design, and former design editor at both Fast Company and Wired.