Health Care Not ‘Determining’ Issue in Election, HIAA Survey Says
Health care issues were not the determining factor for voters in
the Nov. 7 election, according to a "bipartisan" post-election
survey released yesterday by the Health Insurance Association of
America. Since 1991, the HIAA, an association representing
insurance companies, has conducted post-election surveys on how
health care issues influence voters' decisions (HIAA release, 11/9). In conjunction
with the HIAA, pollsters at Public
Opinion Strategies and the Mellman Group completed two
nationwide surveys: a pre-election survey on Oct. 16-19
including 800 likely voters and a post-election survey on Nov. 7
among 800 actual voters. The results from this year's post-
election survey include the following:
- When asked which one or two issues were "most important"
when voting for president (aside from character or other personal
issues), 11% of voters chose health care, coming in 5th behind
social security (24%), education (23%), abortion (16%), taxes
(13%) and the economy (12%);
- Regarding House and Senate choices, surveyors asked voters
to rate the importance of candidates' positions on a variety of
issues. Eighty-three percent of voters ranked "helping more
families and children get health care coverage" as "extremely" or
"very" important. Eighty-three percent also ranked "requiring
that doctors, not HMOs, make medical decisions" extremely/very
important. Seventy percent rated "reforming HMOs by passing a
patients' bill of rights," as extremely/very important. Bill
McInturff, partner and co-founder of Public Opinion strategies
and pollster for Sen. John McCain (R-Ariz.)
during his presidential race for the primaries, explained that
although these two issues represent roughly the same thing,
voters are more receptive to the "language" in the former issue
-- enough to account for a 13-point spread. Seventy-nine percent
of voters felt providing seniors with prescription drug coverage
was extremely/very important, and 76% gave this ranking to
"comprehensive reform of today's health care system;"
- Regarding campaign commercials aired in the three weeks
leading up to the election, 63% of those polled said they "heard
a lot" or "some" on the topic of prescription drug coverage,
making it the third most heard-about topic in campaign ads;
- When asked "how good of a job" the federal government or the
private sector would do if given the responsibility of
"implementing and actually running the health care system," 78%
felt the federal government would do a "poor or fair job," while
only 18% of voters felt the federal government would do an
"excellent" or "very good" job. Sixty-five percent of voters
surveyed felt the private sector would do a poor/fair job, while
32% felt the private sector would do an excellent/very good job.
Mark Mellman, CEO of Mellman Group and a leading strategist for
the Democratic Party, noted that these results suggest "the
difficulty voters had in navigating" health care issues. He
added, "There is very little clarity on what to do, who should do
it and how it should be done."
HIAA President Charles "Chip" Kahn concluded that health
care issues "did not tip the scales at the end of the day."
However, he noted that the level of interest in the issue of health
care costs among voters in this year's election is
"unprecedented" compared to past elections. Mellman pointed out
thatTexas Gov. George W. Bush's focus on health care issues, a departure from traditional Republican strategy, played a role. "If Bush had not
come out with a plan ... if he simply said the Democrats' plan
was 'bad' but had none of his own," we would have seen a "bigger
gap of voters that favored Gore" on health care issues, he said,
noting that Republicans have learned not to "just [say]
no on these issues." In addition, Mellman reported that voter concerns shifted toward Social Security during the last three
weeks of the campaign. According to the survey, three weeks prior to the
election, 15% of voters named Social Security as "most important"
when deciding their vote for president but that number jumped to
24% of voters by Election Day. Mellman said, "We saw that shift
because Democrats started to move away from health care issues as
they got attacked on those issues." He added that Democrats
moved instead toward "an issue that has traditionally been harder
for Republicans to make a case against, and that's Social
Security." Finally, Mellman noted that voter interests in this
election were much more divided than in past elections. In the
1992 election, HIAA surveys reported that 65% of voters named the
economy as the most important issue. In this year's election,
voters' interests were not so heavily focused on a single issue,
but markedly divided between health care, education, Social
Security and other issues.
Implications of the Divided Congress
Taking into consideration the sharply divided Congress,
McInturff and Mellman offered their predictions of how health
care issues would be addressed under a Bush or Gore
administration. McInturff predicted that under a Bush
administration and with no clear majority in Congress, it will
require an "enormous amount of accommodation to accomplish
anything." With Democrats
hoping to gain more seats in the 2002 election, McInturff said, "Democrats will have zero
interest in wanting a Republican administration to take credit
for [accomplishing] reasonable reforms or ... to be able to show
they accomplished resolution on health care issues." Still, McInturff said that the Republican party "would be
well advised ... to not lose the focus on health care issues,"
especially looking forward to the 2002 congressional elections.
Mellman
added that patients' rights legislation could pass in a Bush presidency, though Medicare prescription drug coverage will most likely not. Mellman said that if Gore is elected president, "the question is ...
'are you going to have a Republican filibuster against the
patients' bill of rights?'" Noting that it would
not be a "politically wise" idea for Republicans to filibuster,
Mellman said, "I think it is possible" to pass a patients' bill
of rights under Gore. Republicans will look at the political
realities and make the judgment that it is better to have the
[patients' bill of rights] than to filibuster against it."
The HIAA briefing
will be webcast by kaisernetwork.org, a free online webcasting
and news summary service of the Kaiser Family Foundation that
launches today. The HealthCast (audio & video) and related
online materials will be available today at
http://www.kaisernetwork.org. (Meredith Weiner, Kaiser
Daily Health Policy Report, 11/10).
This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.