Obama Wins Wisconsin Primary, Hawaii Caucuses; McCain Wins Wisconsin, Washington State Primaries

Democratic presidential candidate Sen. Barack Obama (Ill.) on Tuesday won the Wisconsin primary and the Hawaii caucuses, and Republican candidate Sen. John McCain (Ariz.) won the Wisconsin and Washington state primaries, CNN.com reports (CNN.com, 2/20).

In Wisconsin, an exit poll found that 26% of Democratic primary voters cited health care as the most important issue in the election, and 54% of those voters supported Obama, compared with 46% who supported opponent Sen. Hillary Rodham Clinton (N.Y.) (Washington Post graphic, 2/20). Democratic primary voters cited the economy as the most important issue in the election, followed by the war in Iraq and health care, according to the poll (Gilbert, Miami Herald, 2/20).

The poll, conducted by Edison Media Research and Mitofsky International, included responses from 1,442 Democratic primary voters in 35 precincts in Wisconsin. The poll had a margin of sampling error of plus or minus four percentage points (AP/Washington Post, 2/20).

Texas Democratic Primary
The March 4 Democratic primary in Texas -- a state with a "large population of uninsured" residents -- will "test which candidate's health care policy appeals to voters," the Dallas Morning News reports. Voters will have to decide between the Clinton proposal, which would require all U.S. residents to obtain health insurance, and the Obama plan, which would mandate coverage only for children.

According to Anne Dunkelberg, associate director for the Center for Public Policy Priorities, most Texas residents seek some form of health care security. She said, "Increasingly, people feel very insecure about being able to keep their insurance and continue to afford it."

In response to a Morning News Web site request for uninsured middle-income readers to share their health care stories, the "reaction was mixed to health insurance mandates" (Roberson, Dallas Morning News, 2/20).

SEIU Endorsement
The Service Employees International Union on Friday announced an endorsement of Obama, The Hill reports. SEIU President Andy Stern said, "We have an enormous amount of respect for Sen. Clinton, but it's now become clear members and leaders want to become part of an effort to elect Barack Obama the next president" (Blake, The Hill, 2/15). The union represents a large number of health care workers (Holland, AP/Houston Chronicle, 2/15).

Newsweek, Time Articles
The current issues of Newsweek and Time included articles that examine health care issues in the presidential election. Summaries appear below.

• Jonathan Alter, Newsweek: Clinton "would have to appeal over the heads of politicians with compelling speeches that rally the American people" to implement her health care proposal, and Obama "would have to match his inspirational rhetoric with the toughness needed to get stuff done in early 2009, when he'd have the most leverage," Alter writes. According to Alter, Obama has said that he would hold discussions about his proposal on C-SPAN, rather than seek to draft a "health care program behind closed doors," an indication of his support for "governing in public." Alter writes, "All presidents who achieve big change have been first-rate communicators in the theater of the presidency," adding, "With the help of a few inspiring Obama speeches, even a boring summit would help educate the public and shape the debate" over health care (Alter, Newsweek, 2/18).
  
  
• Richard Wolffe et al., Newsweek: The success of "most presidencies depends far less on promises and rhetoric than the way presidents deal with surprises," and an examination of the record of Clinton "suggests that she has been rattled by change in the past" and raises questions about "whether she really learned from experience," the authors write. During her effort to implement health care reform in the 1990s, for example, Clinton refused to compromise on her proposal and "earned a reputation for being stubborn, haughty and vindictive," according to the authors. Meanwhile, the authors write, a "look at Obama's record shows that he is far more an incrementalist than a bold change agent." As an Illinois state senator, Obama in 2003 helped pass a bill that would expand health insurance to an additional 150,000 state residents -- "but only after an attempt to push a bigger universal health care proposal stalled," according to the authors (Wolffe et al., Newsweek, 2/18).
  
  
• Ramesh Ponnuru, Time: "Liberals hope the public's anxiety about health care, currently running high, will help them finally achieve universal coverage after six decades of trying," but "how strong is the public's demand for universal coverage?" Ponnuru writes. As the general election approaches, "Republicans will be able to say that their proposals would make coverage portable, give patients more control and increase the number of people with insurance" -- without higher taxes, increased spending or "threatening what people value in their current arrangements" -- and voters might decide such a plan "is a good deal, even if it does not cover everyone," he writes. According to Ponnuru, "Republicans can win this argument or at least reduce the Democrats' traditional advantage on health care" (Ponnuru, Time, 2/18).

Editorials

• Chicago Tribune: Presidential candidates "need to be pushed harder on the real costs" of their health care proposals, and they "need to be more enthusiastic and committed to containing costs," according to a Tribune editorial. Clinton and Obama "promise health care for all at a cost that won't bust the federal budget," the editorial states, adding, "That's the campaign trail ... then there's reality" (Chicago Tribune, 2/17).
  
  
• Miami Herald: Many experts "believe some form of universal health care coverage is the answer" to problems with the U.S. health care system, and any proposal for reform "has to meet at least three tests: It must be less confusing, more affordable and more accessible than the current one," a Herald editorial states. According to the editorial, presidential candidates "should be able to explain how the plans they put forward meet these sensible criteria" (Miami Herald, 2/17).
  
  
• USA Today: Clinton and Obama "are heavy on promises about making insurance affordable and available," and the "big difference" in their proposals is whether U.S. residents should have to obtain coverage, a requirement supported by Clinton and opposed by Obama, according to a USA Today editorial. For voters, "this narrow policy difference provides little basis for judgment" because "both plans are sketchy and incomplete, making the mandate on individual coverage kind of like a loose piece on a giant puzzle," the editorial states, adding, "Until they fill in the blanks, the issue of a personal mandate is a somewhat abstract debate" (USA Today, 2/19).
  
  
• Washington Times: Trust in the ability of Republicans to address health care issues has increased among seniors in recent years, possibly because of the implementation of the Medicare prescription drug benefit, but, amid increased costs, support for the program could "hurt Republicans in the long run," a Washington Times editorial states. According to the editorial, "it will be interesting to see how ... McCain's opposition to the program influences voters and future faith in the party's ability to handle the health care crisis" (Washington Times, 2/18).
  
  
• Washington Times: The economic package that Obama announced last week "provided unmistakable proof why the National Journal's ideological ratings, based upon votes, ranked him as the senate's most liberal member for 2007," according to a Washington Times editorial. The package includes his health care reform proposal, which "he implausibly asserts will reduce the average family's insurance premium by $2,500 per year," the editorial states. According to the editorial, the proposal would "cost between $50 billion and $65 billion per year" (Washington Times, 2/20).

Opinion Pieces

• Gary Andres, Washington Times: Health care has become a "dominant issue" in the presidential election, and, although Democrats "hold a historical advantage as the party voters 'trust' more" to address the issue, Republicans could "win support with a broader agenda that addresses a wider swath of policies" than expansion of health insurance, Andres, vice chair of Dutko Worldwide, writes in a Washington Times opinion piece. According to Andres, "Republicans can begin to close the trust deficit on health care by building a credible alternative to a bigger government system," as well as "just 'showing up' more and talking about their ideas" (Andres, Washington Times, 2/18).
  
  
• Tyler Cowen, New York Times: The next president might "well extend health care coverage to more Americans," but "[h]ealth care costs will keep rising," Cowen, an economics professor at George Mason University, writes in a New York Times opinion piece. He adds that "most of the country's economic problems won't be solved at the voting booth" and that the "public this year will probably not vote itself into a much better or even much different economic policy" (Cowen, New York Times, 2/17).
  
  
• Susan Jacoby, Los Angeles Times: Efforts by President Clinton to implement a health care reform proposal in the 1990s failed because of an "inability or unwillingness" to "educate the public about complex, long-term issues," Jacoby, author of the "Age of American Unreason," writes in a Los Angeles Times opinion piece. The "conventional wisdom about the collapse" of the proposal is that Clinton "failed to bring all of the major interest groups, especially the insurance industry, to the table"; the "more fundamental mistake" was a "failure to prepare Americans for change," according to Jacoby. She writes, "If I were a presidential candidate ... I would already be sitting down on the campaign trail with doctors, nurses and patients in unscripted give-and-take sessions throughout the country," adding, "I would listen as well as explain my ideas: Education is a two-way street" (Jacoby, Los Angeles Times, 2/17).
  
  
• Betsy McCaughey, Wall Street Journal: The Democratic primary is "shaping up to be a health care Alamo," McCaughey, a former lieutenant governor of New York and adjunct senior fellow at the Hudson Institute, writes in a Journal opinion piece. According to McCaughey, Clinton and Obama "should be asked" several questions that call for "less oratory and more specifics" about health care. For Clinton, the questions should focus on mandatory health insurance for immigrants and young adults, as well as the future role of high-deductible health plans, and the questions for Obama should focus on mandatory coverage for children and the ability to purchase coverage across state lines, McCaughey writes. In addition, questions for both candidates should address electronic health records and limits on health insurer profits, according to McCaughey (McCaughey, Wall Street Journal, 2/20).
  
  
• Peter Pitts, Detroit News: The problem with "so-called 'universal,' or government-run health care," is that "these schemes ... only provide lowest-common-denominator health care, while putting cutting-edge medicine ever further out of reach," Pitts, president of the Center for Medicine in the Public Interest, writes in a News opinion piece. According to Pitts, "when big bureaucracies are faced with finite budgets, they put cost ahead of individual patient care." However, he writes, a "market-driven system can" by bring "all the latest treatments to the public and letting competition drive down prices" to create "sustainable individuals" (Pitts, Detroit News, 2/20).
  
  
• Robert Samuelson, Washington Post: The "trouble" with the Obama campaign "is the huge and deceptive gap between his captivating oratory and his actual views" on health care and other issues, Post columnist Samuelson writes in an opinion piece. According to Samuelson, a "favorite Obama line is that he will tell 'the American people not just what they want to hear but what we need to know,'" but "he hasn't so far." For example, Samuelson writes, a "truth-telling Obama might say: 'Spending for retirees -- mainly Social Security, Medicare and Medicaid -- is already nearly half the federal budget. Unless we curb these rising costs, we will crush our children with higher taxes. Reflecting longer life expectancies, we should gradually raise the eligibility ages for these programs and trim benefits for wealthy retirees.'" Samuelson adds, "Instead, Obama pledges not to raise the retirement age" and to protect benefits (Samuelson, Washington Post, 2/20).