By Miriam Straus, CQ Staff

November 5, 2007 -- By a nearly two-to-one ratio, American voters believe that the federal government should provide health insurance for those who cannot afford it, according to a recent Quinnipiac University national poll.

The survey, released Nov. 1, also found that 57 percent of those polled think it is the federal government's responsibility to ensure everyone in the United States has health care.

"On a broad level, people tend to believe that the government should guarantee insurance," said Robert Blendon of the Harvard School of Public Health. However, "there is not a consensus on how to do that. On a day to day basis, middle-income Americans are not that critical of their own health care coverage. Changing the health care system can be very threatening to them, even though they do want to help [those who are currently uninsured]," he said.

Republicans were more satisfied with health care in this country today than Democrats. Seventy-five percent of Republicans rated the quality of U.S. health care as "excellent" or "good," compared with 40 percent of Democrats. Overall, satisfaction was notably higher on a personal level: 85 percent of those polled rated the health care that they and their family receive as excellent or good.

Women are more likely than men to say that it is the government's responsibility to ensure that everyone in the country has adequate health care coverage (64 percent to 49 percent). Women also are more critical of care in the country as a whole. Forty-eight percent of female voters rated U.S. health care as "not so good" or "poor," compared to 34 percent of male voters.

Among presidential candidates, Sen. Hillary Rodham Clinton, D-N.Y., is overwhelmingly viewed as the most concerned with health care. When asked which candidate places the greatest emphasis on this issue, 53 percent of voters say Clinton, 6 percent say former Sen. John Edwards, D-N.C., 4 percent of respondents said that Sen. Barack Obama, D-Ill., placed the most emphasis on health care issues, and 2 percent of voters say former New York City Mayor Rudolph Giuliani a candidate for the Republican presidential nomination.

"People make judgments [based] on history and experience," Blendon said. Clinton has often been questioned about her failure in 1994 to establish universal health coverage, and Blendon thinks Americans believe that Clinton has learned from that battle. She "has been running on a case that it's a hard problem to solve, but that she is committed to getting something done," he said.

The poll also showed strong support from both Republicans and Democrats (70 percent overall) for the federal government to help pay for high-cost health cases. "That might be a starting point for consensus," said Director of Quinnipiac University's Polling Institute Maurice Carroll. "Democrats favor it, of course, but most Republicans do, too."

Blendon urges caution in interpreting these results, however. When polls give people just a few options, such as expanding Medicare coverage to everyone or reauthorizing the State Children's Health Insurance Program, he says, approval ratings are often around 70 percent. "People really want something done, but they don't have a clear policy focus," he said.