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The Essence of the Health Care Endgame

Probably stating the obvious here. But sometimes the obvious is worth stating. From the latest NBC/WSJ poll:

Also, while just 36 percent believe Obama’s efforts to reform the health system are a good idea, that number increases to 53 percent when respondents were read a paragraph describing Obama’s plans.

That’s a 17-point gap in support for the Democrats’ health care plans when the plan is simply referred to as “Barack Obama’s health care plan” versus when a reasonably fair description of the plan is actually provided to the respondents. Whence the source of the discrepancy?

Majorities in the poll believe the plans would give health insurance coverage to illegal immigrants; would lead to a government takeover of the health system; and would use taxpayer dollars to pay for women to have abortions — all claims that nonpartisan fact-checkers say are untrue about the legislation that has emerged so far from Congress.

Forty-five percent think the reform proposals would allow the government to make decisions about when to stop providing medical care for the elderly.

I don’t think that health care needs to reach approval as high as 53 percent in order for it to be a good idea for the Democrats to pass the initiative. It’s possible that Obama’s approval ratings will decline further even if health care reform is passed. But they’d likely decline by more if health care reform fails: like splitting 8’s in blackjack, sometimes it’s right to accept a small loss if the alternative is a bigger loss.

There’s still a chance, though, for the Democrats to work their way out of this damned-if-they-do, damned-if-they-don’t scenario. There is at least a possibility for health care reform to gain popularity down the homestretch as the President grabs the bully pulpit and explains, in clear and simple terms to the American public, what the reform bill will and won’t do.

Combatting this type of misinformation is not easy — not when health care reform’s opponents have every reason to perpetuate the confusion, not when the President’s messaging has frequently missed a beat, and not when the Democrats have yet to agree on a particular proposal and are fighting over a variety of substantive and non-substantive details. But the President has to make every effort to do so. The fate of health care reform probably depends upon it.

Nate Silver is the founder and editor in chief of FiveThirtyEight.