HIGPA: Is Healthcare Top of Mind in the Election?

A recent reader opinion poll in Modern Healthcare asked, “As the presidential primary season winds down to its final months and the economy has faltered, where do you believe healthcare reform stands as a national priority?” The preliminary results (as of April 24) suggest that:

  • Only 6 percent believe that healthcare reform is the No. 1 issue.
  • 75 percent believe it is a top-tier issue, but not No. 1.
  • 18 percent believe it is not a top-tier issue.

Not exactly a scientific or representative sample, given the demographics of the average Modern Healthcare reader. Nevertheless, the preliminary results appear to be strikingly prescient. Given the recent signs that the economy is slowing, chances that the nation will undertake a comprehensive overhaul of the healthcare system after the election appear to be fading.

Of all the presidential candidates, Hillary Rodham Clinton (D-N.Y.), has taken the most aggressive approach. Clearly, she has a history of aggressiveness on healthcare reform, given her role in the failed 1993 healthcare debate. More recently, she has proposed that all individuals be required to buy health insurance. Her Democratic rival, Barack Obama (D-Ill.) has taken a less intrusive approach. He has proposed a government mandate that requires parents to buy health insurance for their children and that also creates a program of reinsurance to address the most expensive healthcare cases. John McCain (R-Ariz.), meanwhile, has suggested that the issue be addressed with changes to the tax code. To increase coverage, McCain would, among other things, create tax incentives ($2,500 for individuals/$5,000 for families) for health insurance coverage.

But as the Democratic primaries continue, healthcare as an issue appears to be decreasing in importance for voters. A recent Kaiser Family Foundation poll showed that while Democrats continue to rank the issue high, for Republicans and independents, healthcare may have peaked. For example, the same poll, conducted last October, showed that 31 percent of Republicans and 38 percent of independents named healthcare as one of the top two issues they would like candidates to discuss. In February, however, healthcare ranked in the top two for only 18 percent of Republicans and 20 percent of independents.

Because voters appear to be more focused on job security, gas prices and the cost of groceries, candidates are more apt to talk about their efforts to secure the Medicare, Medicaid and SCHIP programs than about making sweeping changes to healthcare.

The latest polling data suggests that the country may be more comfortable with an incremental approach to change. One of the many ironies of this campaign may be that Clinton’s signature issue looks more and more like a relic than a modern or progressive move on an important concern.