Abstract
Arthur Scarritt, Michael Kreiter, Amelia Jobe, and Danilla Kowalczuk on surprising support for social programs.
Robust social democratic programs like medical leave consistently poll well, even amongst conservatives. But what is behind the numbers? People can readily dismiss polls as reflecting fickle desires that can quickly change, or as not truly showing people’s commitments, suggesting that when offered trade-offs, for instance, people’s stances flip. These questions are particularly acute for conservatives. What is their commitment based on? How deep is it?
As illustrated on this page, recent polls indicate that large majorities of Americans support government-funded childcare and family and medical leave, with Republicans not far behind the general population at 80% and 76% respectively. Even the more politicized and controversial topic of single-payer universal healthcare enjoys the support of the majority of citizens and, at 45%, almost a majority of Republicans.
As part of a larger project, we interviewed 16 self-described conservatives, all expressing robust if variable support for such programs. Interviews took place from February through May of 2024, around the same time as the above polls. Participants hailed almost equally from rural (Kuna (9)) and urban (Boise (7)) Idaho. All respondents were White, ranging in age from 26-71 with a median age of 43. Most were professionals, with all but 3 having college degrees, and 10 holding professional jobs.
Rather than dismissing such programs as horrible leftist ideas, conservatives critiqued our current system from a conservative standpoint. They saw robust social democratic programs as solutions serving conservative priorities—particularly of human dignity, family, and business.
* From May, 2024: https://www.ffyf.org/2024/05/16/new-polling-on-child-care-and-the-2024-election/
** From November, 2023: https://today.yougov.com/topics/politics/trackers/support-for-universal-health-care
*** From November, 2023: https://irp.cdn-website.com/167e816a/files/uploaded/Lake.Paid.Leave.for.All.Poll.Press%20Memo.pdf
humanism against profit
Rather than motivated to inflict cruelty, as Adam Serwer maintains in his 2021 New York Times bestseller, humanistic concerns about the cruelty of our system overarched conservatives’ views. Regarding single-payer (i.e., universal healthcare), one man who supported such policies told us, “[I]t’s a travesty that we can’t afford to do that, or there’s so much money and lobbying blocking those ideas.” He shared further, “I happened to lose my older brother because he couldn’t afford health insurance.”
Even people with full health coverage told us they hesitated to use it for fear of incurring high uncovered costs. Said one woman among many, single-payer healthcare would be “awesome.” She continued, “I would go to the doctor a lot more often, get a physical. It’s been years since I’ve been to—I mean, I have insurance, you know. But it’s kind of scary what the things that insurance doesn’t pay for.” These participants speak to the cruel irrationality of the pricing system and the United States’ excess morbidity and mortality, with an estimated 400,000 excess deaths every year compared to Europe, according to a 2021 study by population health researchers Samuel H. Preston and Yana C. Vierboom in the PNAS journal.
humanity and family
In our interviews, a sensible humanity tied broad social democratic programs to the conservative priority of family. One man complained that EMTs like him have no “[maternity] leave, which is crazy because it’s—you can have a patient that lashes out and kicks you, you can get bumped with a stretcher, things that could really put the mother and the baby in harm’s way.” Others similarly emphasized the difficulty and formative importance of a baby’s first months.
And they similarly support publicly funded childcare. “I couldn’t imagine someone who is entry level covering all of those [child care] expenses and still being able to put food on the table,” said one respondent. Such conservatives believe that people should not have to suffer, regardless of party affiliation. One woman elaborated: “It’s not just a mom thing. It’s a family thing. It’s already a stressful time. So, the lack of having any support financially when it comes to maternity leave, that’s a burden on everybody.” Conservative politicians can condemn such programs as harming families. But the everyday conservatives we spoke with saw these programs as empowering conservatism by maintaining the strength of the family.
business
The people in our sample did not see the current healthcare system as a legitimate business. One man complained that “billing is just so horrendous,” with constant errors causing serious problems. “What I really want is to be treated. I don’t want to have to pay 10 people to figure out how to pay for what I just got served. I want 10 people to serve me.” A business logic in a market-like system is supposed to generate efficiency, innovation, and increased quality. While this man was pro-business, he found that our market-like system instead generates massive waste, inefficiency, and poor quality.
One woman went out of her way to stress “I’m very conservative,” yet supported single-payer healthcare which she openly described as socialist. “I think insurance is a racket. So healthcare, I mean, everybody needs to go to the doctor…. I’m not a socialist, but I think [single-payer] would be okay. I wouldn’t mind that. And I wouldn’t mind putting my money toward that.” This woman, who normally derides socialism, believes that healthcare should be driven by human caring rather than profits. In this instance, she sees socialism as the way forward.
Indeed, several people commented that socialized medicine is pro-business and that single-payer healthcare would increase the efficiency and effectiveness of workers. At the height of the Obamacare debate, even the Business Roundtable, one of business’s most powerful lobbying groups, argued that Europe’s robust healthcare systems were putting U.S. industry at a competitive disadvantage.
Conservatives saw social democratic programs as legitimate means to serve the complex problems in their lives and forward core conservative priorities.
complex ambivalence
Rather than fickle positions, these are well-considered perspectives based on the complexity of people’s lives. While they do not change with the wind, these people’s stances can be reconsidered in light of the interconnected nature of issues of well-being. Thus, some conservatives hesitated to support single-payer, yet their personal experiences made them open to its possibility, especially as healthcare has penetrated into so much of life. One woman explained her resistance to single-payer with a typically conservative “nothing is free” blanket rejection. But, she continued, “with the healthcare system, it is really hard to get benefits that are actually, when you look at it, go ‘Oh, that’s not bad.’” Her family is solidly middle-class, with a dual-earning household that nevertheless struggles. She knows what it’s like to sacrifice to get “not bad” healthcare.
And what she had to sacrifice was what she regarded as one of her core conservative values: family. “I did not want to put my kids in a daycare program… I wanted to be present [with my kids]. And so, the only thing that I could do, because I needed that health insurance, was to put them in that daycare program.” Despite prioritizing motherhood, she had to work to get health insurance for her family. “My paychecks pretty much went to daycare, and then the rest of it went to a tank of gas and my health insurance.” The health care system is such that people not only have to work just to get insurance, they have to sacrifice family to do so—and that undermines conservative values.
This woman’s personal experience made her reconsider the nothing-is-free dismissal and come to desire government-funded childcare programs, as do 80% of Republicans (see figure, p. 70). She continued: “I didn’t see much of my paycheck, so some sort of credit for afterschool care even…. the littlest things can go a long way if we can get something funded where we can have an after-school program, if we can do something with day care.” And she fully embraced the idea of six-month maternity leave, paid out of Idaho’s $1.4 billion budget surplus: “[T] hat would have been amazing. You know, that wasn’t a thing. And so, I had to really just hoard my nickels for the whole entire pregnancy, because I knew once my little one popped out, I was on empty until I got back [to work]. So, it was just kind of like, ‘Shoot this sucks.’”
That is, while this woman did not endorse single-payer, she saw how humane and helpful government funding for programs like maternity leave and childcare would be. This may shed light on the patterns in the figure on p. 70. And experiencing these as intimately tied to the problems in our existing healthcare system, such as having to work and sacrifice family just to get insurance, substantially eroded her blanket, nothing-is-free condemnation of single-payer. Thus, even amongst those not embracing it, the humanity of other government programs combined with the ills of our current system meant that universal health care remained an option.
Even with universal healthcare, the lowest polling and most politicized of these social democratic issues, 11 interviewees embraced it outright, 3 saw it as a potential option, and only 2 said it would be bad. All but 1 person recognized that our current system is largely broken—inhumane, irrational, and economically unsound. One man said, “I think that universal healthcare would be a total disaster. But I don’t know that the current system that we have is frankly any better.”
Regardless of political affiliation, people want socialized medicine because they know the current system is deeply flawed. They believe these shortcomings have to do with putting profits before people. Further, they see the healthcare system as dehumanizing when, as a fundamental aspect of human existence, healthcare could and should undergird human flourishing. Even those not fully convinced saw this logic. Conservatives saw the other social democratic programs that poll even higher—childcare and family leave—as legitimate means to serve the complex problems in their lives and forward core conservative priorities.