Health Care Expected to Play Key Role in Presidential Elections
By Late, Michele
Elections 2008 WHEN Americans turn to their TVs or computers in coming months to watch the presidential debates, one of the most important issues they want to hear the candidates discuss is health care.
Concerned by their ability to pay for health services for themselves and their families, Americans want their next president to find ways to improve health care and address costs, recent data show. And voters want to hear what the candidates have to say on the issue now, before they cast their votes for the next political administration.
In polls taken by the Kaiser Family Foundation over the past year and a half, Americans have consistently ranked health care as one of the top four issues they want presidential candidates to discuss, along with the economy, the war and gas prices. While Americans have begun to be more troubled about prices at the pumps and in their households, they’ve also remained concerned about increases in their share of health insurance premiums and out-of-pocket costs.
In a June poll by Kaiser Family Foundation, 51 percent of respondents said that making health care and health msur ance affordable is the health issue they’d most like to hear the presidential candidates talk about. More respondents said they were troubled by personal costs than increases in national health spending, reflecting the recent U.S. economic downturn and the strain on their purse strings.
“The standard that most voters will use to gauge health reform proposals is ‘Will it make health care affordable for me?’” said Drew Altman, president and chief executive officer of the Kaiser Family Foundation.
American voters believe U.S. political leaders can make a difference in reducing health care costs, the foundation poll found. A full 62 percent of respondents said that the president and Congress can do “a lot” about health care costs, which suggests that Americans have expectations for change under the next Congress and presidential administration.
One of the best ways leaders can lower individual health care costs is to promote healthier lifestyles and preventive medical care, poll respondents said. In fact, providing preventive health care to all Americans is one of the top benchmarks of successful health reform, according to a May poll conducted by the Aspen Institute and Zogby International.
The Aspen poll found that 80 percent of Americans support providing financial incentives – such as lower health insurance premiums, deductibles or co-payments – for people who make healthy lifestyle choices. While recent national health data show many Americans are living longer, increasing lifespans is not enough, the Aspen poll showed. More than 90 percent of respondents said that how long they remain healthy is more important than longevity.
The results show that the American public feels prevention is “incredibly important,” according to Michelle McMurry, MD, PhD, director of the Aspen Health Stewardship Project, a bipartisan initiative addressing U.S. health care reform. Almost half of the Aspen poll respondents said that they or someone they knew became ill, were injured or died because of something that could have been prevented through better health care.
“Americans get it: They see that we are not getting a good value for our health care dollars,” McMurry told The Nation’s Health. “They want to see change.”
Overall, Americans believe health care is one of the most serious issues facing the nation, according to data from another May poll, commissioned by ResearchlAmerica and ScienceDebate2008.com. The poll found that 76 percent of Americans rank health care as the most serious long-term issue, followed by alternative energy sources – which may be a reflection of both the growing awareness of climate change and climbing U.S. energy prices.
But regardless of how much it costs to fill the gas tank, health will continue to be an important issue for voters as they cast their ballots in November, predicted Mary Woolley, president of Research!America.
More than half of the respondents in the Research!America poll said presidential candidates should discuss health care, climate change and energy during debates. They also believe decisions on such issues should be based on sound research and science: 67 percent said public policies should be influenced by scientific evidence, not personal beliefs. The finding is important in light of evidence in recent years that science is not informing public policy, Woolley said, noting that “we look to the day it once again will.”
Both Research!America and the Aspen Health Stewardship Project are directly asking candidates to speak out on health care issues, creating public questionnaires for them. The Aspen Health Stewardship Project, supported by a bipartisan advisory board representing the insurance, medical and education sectors, developed a set of principles and questions aimed at health reform. Answers from both Sens. John McCain and Barack Obama, who are expected to be chosen as the Republican and Democratic presidential candidates at the upcoming political party conventions, are posted on the group’s Web site now. Responses from McCain and Obama address issues such as health care financing, health information technology and retention of health care workers.
Research!America has created Your Candidates, Your Health, a nonpartisan voter education initiative supported by three dozen partner organizations, including APHA. The questions in the Your Candidates, Your Health survey – which asks presidential and congressional candidates where they stand on health care costs, prevention, insurance coverage and federal funding, among other issues – were developed using input provided directly by Americans via a call published in Parade Magazine. As of early July, McCain had not yet responded to the questionnaire, but Obama had.
The extent to which the presidential candidates decide to address health care in their campaigns and debates depends on whether the public – and public health community – asks them to, Woolley said. The health discussion is also important at the congressional level, she stressed. Woolley encouraged health professionals to call the campaigns of candidates and offer to serve on their health advisory committees, and to offer to help create one if none exists.
APHA is also encouraging Americans to reach out to candidates for elected office on health care, offering a set of questions for people to ask during town halls and meetings. Available now on the APHA Web site, the questions are designed to generate interest in prevention and support for public health infrastructure.
“The more we each speak up now, the more we can inform and shape the debate on health care and help to improve the health of all Americans,” said Georges Benjamin, MD, FACP, FACEP (E), APHA executive director.
For more information, visit www.health08.org, www.yourcandidatesyourhealth.org, www.aspenhealthstewardship.org and www.apha.org/advocacy/tips.
– Michele Late
Where they stand: Selected stances from the presidential candidates
John McCain
U.S. senator, R-Ariz.
Overall health care goal
* Provide access to health care for every American. Provide control of health care to patients and put families in charge of their health care dollars. Reform the tax code to offer more choices beyond employer-based coverage and make insurance more portable. Expand benefits of Health Savings Accounts.
Expanding access to coverage
* Remove the favorable tax treatment of employer-sponsored insurance and provide a tax credit to all individuals and families to increase incentives for insurance coverage. Promote insurance competition and contain costs through payment changes to providers, tort reform and other measures.
Retaining health workers
* Pay more for diagnoses and care coordination under Medicare. Allow higher payments under Medicare for nonphysician health care providers.
Climate change
* Establish a market-based system to curb greenhouse gas emissions through cap-and-trade policies that allow facilities to buy and sell ri glits to emit. Set emission reduction targets and timetables, with a goal of 60 percent below 1990 levels by 2050. Provide incentives for China and India to participate in international efforts.
Barack Obama
U.S. senator, D-Ill.
Overall health care goal
* Provide affordable, comprehensive and portable health insurance for every American. Modernize the health system to contain costs and improve care. Promote prevention and strengthen public health. Create a new national health plan that will let all Americans buv affordable coverage.
Expanding access to coverage
* Require all children to have health insurance and employers to offer health benefits or contribute to the cost of the new public program. Create a “health insurance exchange” through which small businesses and individuals could enroll in the new public plan or in approved private plans.
Retaining health workers
* Expand funding to ensure a strong work force, using means such as loan repayments, reimbursement, training and infrastructure support.
Climate change
* Establish a market-based cap-and-trade system to reduce carbon emissions that will require all pollution credits to be auctioned. Set emission reduction targets and timetables, with a goal of 80 percent below 1990 levels by 2050. Re-engage with international convention on climate change and “work constructively within it.” As a 501c3 nonprofit APHA docs not endorse candidates running fior political office.
Sources: John McCain.com, BarackObama.com, Kaiser Family Foundation, Aspen Health Stewardship Project
Sen. John McCain, R-Ariz., speaks in Washington, D.C., in June.
Sen. Barack Obama, D-Ill., speaks in Las Vegas in June.
Copyright American Public Health Association Aug 2008
(c) 2008 Nation’s Health, The. Provided by ProQuest LLC. All rights Reserved.