It’s taken decades for our national politics to become as ideologically polarized and gridlocked as they are today, but it’s only recently that pundits and pollsters have started to converge on a narrative that blames the general public, instead of a flawed political system and culture, for this state of affairs. Especially since the 2016 election, a storyline has taken hold that portrays our dysfunctional national politics as a reflection of our profound divisions as a people. In this account, we’re an alienated society with no ability to understand one another, let alone find common ground or work together toward common ends.
For example, a 2016 series published by the Associated Press, Divided America, argued:
It’s no longer just Republican vs. Democrat, or liberal vs. conservative. It’s the 1 percent vs. the 99 percent, rural vs. urban, white men against the world. Climate doubters clash with believers. Bathrooms have become battlefields, borders are battle lines. Sex and race, faith and ethnicity…the melting pot seems to be boiling over1.
Such rhetoric about divisions among the public has proliferated, and surely it captures something important about the contemporary United States. We are fragmented in many ways, with consequential differences, divides and disagreements that are important to acknowledge and address. But our divisions are hardly the whole story, and this rhetoric can be dangerously self-reinforcing, exacerbating the divisions it chronicles, stunting our political imagination and playing into the hands of those who would manipulate and intensify our differences to their own advantage.
The Hidden Common Ground Initiative explores a different hypothesis and possibility— namely, that as far as the broader public is concerned, there is often enough common ground to at least begin forging progress on many of the problems we face. Moreover, with some nurturing quite a bit more common ground can emerge. The initiative is concerned with locating the common ground that exists on tough issues and giving it greater voice and currency in public conversations and policy debates. And it is concerned with generating insight into how more democratically meaningful common ground can be achieved.
We believe that dispelling the myth that we are inescapably divided on practically everything can not only help fuel progress on a host of issues, but also help us better navigate our real, enduring divisions, from differing philosophies of governance to racial tensions. Hidden Common Ground aspires to tell the story of what unites us by way of concrete, actionable solutions that can make a difference in people’s lives and the fate of their communities—and eventually, perhaps, in our national politics as well.
This report from the Hidden Common Ground Initiative focuses on hidden or otherwise underappreciated common ground in health care. How do people talk across party lines about the problems facing our health care system? What do people think should be done to make progress?
Health care has long been controversial and is certainly among the more partisan problems in American politics today—at least among political leaders. In 2017 alone, the American public witnessed endless debate among leaders over whether and how to repeal and replace the Affordable Care Act (ACA)2 and also witnessed Republicans’ inability to devise and pass new health care legislation—all part of leaders’ age-old ideological disagreements about how health care should work in this country.
Despite such a bleak picture, does the intense partisan division over health care among elected officials and pundits actually reflect partisan divisions among the public at large? Survey research does indicate continuing partisan divisions among the public on the favorability of the ACA. But despite these and other divisions along party lines on the direction we should go to improve health care in the United States, Public Agenda’s research and engagement experience over the past 40 years indicates that even seemingly divided groups may share or be able to find significant common ground.
When people from different walks of life sit down and talk about health care, how do they process the problem and think about solutions? Our approach to exploring the public’s views on the topic began with a review of existing survey data and proceeded to three focus groups in diverse locations with ordinary Americans, with roughly equal numbers of Republicans, Democrats and Independents in each group.3 This report concludes with implications and reflections on the solutions that are most and least likely to garner public support and with ideas for productively engaging the public on the topic of health care.
Health care has long been controversial and is certainly among the more partisan problems in American politics today - at least among political leaders. Despite these and other divisions along party lines on the direction we should go to improve health care in the United States, Public Agenda's research and engagement experience over the past 40 years indicates that even seemingly divided groups may share or be able to find significant common ground.
1Jerry Schwartz, ed., Divided America: An AP Guide to the Fracturing of a Nation (New York: Associated Press, 2016), https://www.ap.org/explore/divided-america/.
2Ashley Kirzinger, Liz Hamel, Bianca DiJulio, Cailey Muñana and Mollyann Brodie, “Kaiser Health Tracking Poll—November 2017: The Politics of Health Insurance Coverage, ACA Open Enrollment,” Henry J. Kaiser Family Foundation, November 17, 2017, https://www.kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-november-2017-the-politics-of-health-insurance-coverage-aca-open-enrollment/.
3For more details, see methodology.