President Obama’s ability to shape the debate on health care appears to be eroding as opponents aggressively portray his overhaul plan as a government takeover that could limit Americans’ ability to choose their doctors and course of treatment, according to the latest New York Times/CBS News poll.
Americans are concerned that revamping the health care system would reduce the quality of their care, increase their out-of-pocket health costs and tax bills, and limit their options in choosing doctors, treatments and tests, the poll found. The percentage who describe health care costs as a serious threat to the American economy — a central argument made by Mr. Obama — has dropped over the past month.
Mr. Obama continues to benefit from strong support for the basic goal of revamping the health care system, and he is seen as far more likely than Congressional Republicans to have the best ideas to accomplish that. But reflecting a problem that has hindered efforts to bring major changes to health care for decades, Americans expressed considerable unease about what the end result would mean for them individually.
“We need to fix health care,” Mary Bevering, a Democrat from Fort Madison, Iowa, said in a follow-up interview, “but if the government creates the system, I’m afraid the quality of care will go down and costs will go up: We will pay more taxes.”
“It’s going to come down to regulation,” Ms. Bevering said. “What also worries me is whether we will be told what physician we can have.”
The poll was taken at a moment of extreme fluidity, both in terms of the complicated negotiations in the House and the Senate as lawmakers and the administration sort out the substance and politics of competing proposals, and in the efforts by both sides to define the stakes of the health care debate for the public.
With Congress now almost certain to recess until after Labor Day without floor votes on any specific plan, a vigorous advertising and grass-roots effort to shift public opinion is likely in the next month or two. The poll offers hope to both sides.
The changes in the public’s attitude over the past month, even if not huge, suggest one reason Mr. Obama sought so hard to get Congress to vote on some version of an overhaul before heading home.
Opponents of the proposed health care overhaul have already spent $9 million on television advertisements raising concerns about it, said Evan Tracey, the chief operating officer of Campaign Media Analysis Group, which tracks political advertising. The advertisements are financed by the Republican National Committee and aimed at constituents of wavering lawmakers. The committee is also running radio spots.
Officials said the advertising would accelerate as the legislators returned home for the summer. The advertisements present the overhaul as a risky experiment, or a government takeover of health care that would prevent people from choosing their own doctors.
Mr. Obama is making an intense effort to rebut those claims. On Wednesday, he flew to Raleigh, N.C., for a town-hall-style meeting to address the kinds of public concerns reflected in the poll results.
“First of all,” Mr. Obama said, “nobody is talking about some government takeover of health care. I’m tired of hearing that. I have been as clear as I can be. Under the reform I’ve proposed, if you like your doctor, you keep your doctor; if you like your health care plan, you keep your health care plan. These folks need to stop scaring everybody, you know?”
Mr. Obama sought in particular to reassure people who already have health insurance and whom the overhaul plans under consideration in Congress would benefit by preventing insurers from dropping them or diluting their coverage if they become ill, while also bringing rapidly rising costs under control. And he sought to stoke a sense of urgency for getting a bill signed this year.
“If we do nothing, I can almost guarantee you your premiums will double over the next 10 years, because that’s what they did over the last 10 years,” Mr. Obama said. “It will eat into the possibility of you getting a raise on your job because your employer is going to be looking and saying, ‘I can’t afford to give you a raise because my health care costs just went up 10, 20, 30 percent.’ ”
The national poll was conducted by telephone starting on Friday and ending on Tuesday. It involved 1,050 adults, and has a margin of sampling error of plus or minus three percentage points.
Mr. Obama’s job approval rating has dropped 10 points, to 58 percent, from a high point in April.
And despite his efforts — in speeches, news conferences, town-hall-style meetings and other forums — to address public misgivings, 69 percent of respondents in the poll said they were concerned that the quality of their own care would decline if the government created a program that covers everyone.
Still, Mr. Obama remains the dominant figure in the debate, both because he continues to enjoy relatively high levels of public support even after seeing his approval ratings dip, and because there appears to be a strong desire to get something done: 49 percent said they supported fundamental changes, and 33 percent said the health care system needed to be completely rebuilt.
The poll found 66 percent of respondents were concerned that they might eventually lose their insurance if the government did not create a new health care system, and 80 percent said they were concerned that the percentage of Americans without health care would continue to rise if Congress did not act.
By 55 percent to 26 percent, respondents said Mr. Obama had better ideas about how to change health care than Republicans in Congress did.
There is overwhelming support for a bipartisan agreement on health care, and here again, Mr. Obama appears in the stronger position: 59 percent said that he was making an effort to work with Congressional Republicans, while just 33 percent said Republicans were trying to work with him on the issue.
Over all, the poll portrays a nation torn by conflicting impulses and confusion.
In one finding, 75 percent of respondents said they were concerned that the cost of their own health care would eventually go up if the government did not create a system of providing health care for all Americans. But in another finding, 77 percent said they were concerned that the cost of health care would go up if the government did create such a system.