July 3rd 2008
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With their campaigns sniping at one another on the military, campaign financing, and Iraq, Barack Obama and John McCain hardly had any time to talk about health care this week. All of the action that could affect the presidential contest happened off the campaign trail.
But some interesting numbers out this week from the Henry J Kaiser Family Foundation, a non-profit group that tracks and researches health-care policy. Kaiser’s latest tracking poll shows that a worsening economy and rising prices are making it even tougher for middle-class Americans to pay for health care, and, not surprisingly, making health care a bigger and bigger issue.
Six in ten adults told Kaiser they were having a “serious problem” with their finances. For many, that means rising food prices and, of course, four-dollar-a-gallon gasoline. But for one in four said their main economic issue is paying their medical or insurance bills.
Political pundits are nearly unanimous; it seems, in their declarations that a faltering economy is bad news for John McCain. With his party in control of the White House for the past 8 years, it’s hard to imagine the Republican senator benefiting from numbers like the ones that showed up in the Kaiser poll.
But there could be a silver lining for McCain. A plurality of adults in the poll-nearly half-said their number-health concern was the effect or rising costs on their own pocket books. That is, not the cost to the economy, or to the employers who buy most coverage. And that result seems to play right into McCain’s strategy for selling his health plan.
McCain’s plan focuses almost completely on deregulation and cost-cutting. And as a pair of crack pollsters recently told a group of Washington health reporters, it’s no accident. Take the opening line from McCain himself on a campaign video posted on his website: “The problem with health care in America is not the quality of health care. It’s the availability and affordability. And that has to do with the dramatic increase in the cost of health care.”
Bull’s-eye. Forget that nearly every health-policy expert worth their PhD knows that the quality of care, or lack of it, is a primary driver of waste, missed opportunities, and cost. McCain’s is a message targeted right at the heart of what poll after poll is saying. Americans are concerned that their nation is the only industrialised country on earth that doesn’t guarantee health care to all. But they are way more concerned that their own insurance premiums will price them out of the care they already have. McCain knows it, his advisors know it, and Kaiser just helped prove it.
Meanwhile, Barack Obama made a rare appearance on the Senate floor last week. He showed up to cast votes on wiretapping and veterans’ legislation. But while he was there, he also weighed in on a key issue for US physicians.
Congress is going through its annual ritual of legislating for some extra Medicare payment money for US doctors. Instead of a 10% payment cut, Democrats have a bill that gives the doctors a 1.5% pay boost this year. But they take the money from insurance companies running private Medicare plans called Medicare Advantage-a programme that is a darling of insurance companies and Republicans, including President Bush.
But physicians’ lobbying groups loved it. The pushed hard for the bill, and that put Republicans in a no-win situation. A vote for the bill was a slap in the face for insurance companies, a vote against it, a swipe at the all-powerful state physicians’ group the American Medical Association (AMA). One Republican learned that the hard way. Texas Republican Senator John Cornyn voted to block the bill, and it took less than a day for the AMA chapter in his state to cut off its donations to his reelection campaign.
It was an easy one for Obama, who voted to support the bill. McCain didn’t show up for the vote, and it’s probably just as well.
Todd Zwillich
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