Sen. Obama Wins South Carolina Presidential Primary; 25% of Voters Cite Health Care as Most Important Issue

Sen. Barack Obama (Ill.) on Saturday won the South Carolina Democratic presidential primary with 55% of the vote, followed by Sen. Hillary Rodham Clinton (N.Y.) with 27% and former Sen. John Edwards (N.C.) with 18%, the AP/Winston-Salem Journal reports (AP/Winston-Salem Journal, 1/27).

According to an exit poll, among three issues, 52% of voters cited the economy as the most important in the election, compared with 25% who cited health care and 19% who cited the war in Iraq. Among voters who cited health care as the most important issue, 56% voted for Obama, compared with 26% who voted for Clinton and 18% who voted for Edwards. The poll, conducted by Edison Media Research and Mitofsky International, included responses from 1,905 voters (Washington Post graphic, 1/27).

Focus on Health Care
The San Francisco Chronicle on Sunday examined how, with "health care emerging as a chief domestic issue in the 2008 presidential race, the various candidates are pitching numerous platforms designed to reduce costs and broaden coverage."

"Noting the importance of individual choice and responsibility in shaping health care," Republican candidates have proposed tax credits or tax deductions to help U.S. residents purchase private health insurance and have encouraged health insurers to "offer a wide, fiscally competitive array of options," the Chronicle reports. Democratic candidates have proposed to expand health insurance to all or most residents and to "outlaw the sale of insurance that allows risk ratings based on health status," according to the Chronicle.

Robert Blendon, a professor of health care and political analysis at the Harvard School of Public Health, said, "Everyone in the country agrees there is a heath care crisis, but the visions of the two parties are very different," based on "the views and values of the people in each of the parties." He said, "Republicans are not interested in a candidate who wants to cover everyone and create a new spending program," adding, "They are more likely to think that individuals have more of a responsibility to have their own insurance coverage." However, "what is incredibly important to Democrats is that everybody be covered; they feel it's in the national interest," Blendon said.

The Chronicle also profiled the health care positions of Clinton, Obama, Edwards, former New York City Mayor Rudy Giuliani (R), former Arkansas Gov. Mike Huckabee (R), Sen. John McCain (R-Ariz.), Rep. Ron Paul (R-Texas) and former Massachusetts Gov. Mitt Romney (R) (Fernandez, San Francisco Chronicle, 1/27).

Need for Universal Health Insurance?
Voters, policy analysts and health care advocates "agree universal coverage is needed to get a handle on costs," the Salt Lake Tribune reports.

Commonwealth Fund president Karen Davis said that voters "certainly see ... major growth in the number of uninsured." In addition, she said, "They certainly see health insurance premiums are going up a lot faster than their wages, and, as a result, they have less take-home pay." Judi Hilman, executive director of the Utah Health Policy Project, said, "You've got to get everybody in. Whether you call it a mandate or shared responsibility, it is a very important feature of any reform."

Democratic presidential candidates argue that risk and costs should be spread across a broader pool of people, according to Jennifer Tolbert, principal policy analyst for the Kaiser Family Foundation's Commission on Medicaid and the Uninsured. But Republican candidates "generally oppose an increased government role or any requirements on people to buy" health insurance, the Tribune reports. Drew Altman, president and CEO of the Kaiser Family Foundation, said, "The general thrust for all of the Republicans is to find ways to make insurance more available in the private individual marketplace and to make that marketplace more affordable for people" (Rosetta, Salt Lake Tribune, 1/28).

Editorial
"Americans may be divided about the form that health coverage should take, but they're united on the need for better access to health insurance," a Daytona Beach News-Journal editorial states. A recent poll found that a majority of Republican voters supports a "requirement that everyone can carry health insurance and wants that responsibility to be shared," the editorial states, adding, "It's clear voters expect to hear candidates offering realistic solutions and a firm commitment to better health care." The editorial states, "Americans show far more enthusiasm for universal health coverage than many of the candidates for president," adding, "The clear message: Candidates, for Congress and state offices, as well as president, shouldn't be so cautious" (Daytona Beach News-Journal, 1/25).

Opinion Pieces

• Gary Andres, Washington Times: Many of the "problems in today's health care market are the direct result of government distortions" supported by Democrats, Times columnist Andres writes. According to Andres, the "party of small government may have more to say about health care than you think." He writes, "Republicans could address many of the problems and concerns voters express about health care by promoting more market-oriented reforms as alternatives to the continuation of Democrats' big-government policies," adding, "In Washington policy debates, effectiveness in addressing problems is measured by size of the government solution -- and bigger programs or more spending are code for more compassion" -- and "Republicans usually find themselves with a deficit in both programmatic bravado and rhetorical empathy." However, he concludes, "by talking more about curing the distortions caused by misguided regulations, the party of smaller government can find the medicine it needs to help improve its standing on the issue of health care" (Andres, Washington Times, 1/28).
  
  
• Paul Krugman, New York Times: Former President Bill Clinton "may not have run as postpartisan a campaign as legend has it," but "he did avoid some conflict by being strategically vague about policy" on health care and other issues, a move that "turned out to be a disaster," Times columnist Krugman writes. "Much has been written about the process by which the Clinton health care plan was put together," he writes, adding, "Above all, however, it was too slow." Some believe that "Mr. Obama's rejection of health insurance mandates -- which are an essential element of any workable plan for universal coverage -- doesn't really matter because, by the time health care reform gets through Congress, it will be very different from the president's initial proposal anyway," Krugman writes, adding, "But this misses the lesson of the Clinton failure: if the next president doesn't arrive with a plan that is broadly workable in outline, by the time the thing gets fixed, the window of opportunity may well have passed" (Krugman, New York Times, 1/28).
  
  
• Former Sen. Harris Wofford (D-Pa.), Philadelphia Inquirer: "If voters elect a Democrat next fall, this country will have a new chance to secure universal health coverage," Wofford writes in an Inquirer opinion piece. He writes, "We are so close to agreement on the basic approach for a new Democratic administration that it's no time to dwell on nuanced differences," adding, "What the country doesn't need in the present campaign is further bickering over the details of the three Democrats' proposed health care plans," which is "beginning to sound like a game of 'my plan is bigger and better than yours.'" He writes, "What's good is that all of the Democratic proposals are designed to reach the goal of universal coverage," adding, "I consider Sen. Barack Obama's health care proposals the most workable way to get us to universal coverage" (Wofford, Philadelphia Inquirer, 1/28).