Tuesday, October 07, 2008
Political independents now rank health care second among the issues they most want the presidential candidates to discuss, according to a Kaiser Health Tracking Poll for September. The No. 1 issue for independents, as well as for Democrats and Republicans, is the economy.
Independents are the key to victory in this election. Their opinions matter. And asked which candidate best represents their views on health care, 40 percent said Barack Obama and 25 percent, John McCain.
Health care has recently moved up as a concern for independents. While only 11 percent of Republicans named health care as the topic they most wanted the candidates to address, 26 percent of independents did. Democrats showed nearly identical interest at 25 percent. How come the wide differences?
"As gas prices have fallen, and Iraq has declined as an issue," Drew Altman, president of the Kaiser Foundation, told me, "the voters go home to Mama. For Republicans, that's back to taxes and terrorism, and for Democrats (and apparently independents), it's health care."
Let's dig into the numbers. For starters, what do people mean when they say they worry about health care? It's not what employers are spending on it, Altman explains. It's definitely not the cost of entitlement programs. Only a few, mainly in the Democratic base, are focused on expanding coverage to the uninsured.
What truly perks everyone's interest is the cost of their own health care. Earlier surveys have shown that more Americans are worried about affording health care than their ability to pay their rent or mortgage bills.
I've always wondered whether people who tell pollsters which candidate's health plan they prefer understand the details or are just winging it. Altman says that only a subset of the public actually studies the fine print. Most obtain their impression from media coverage and campaign ads.
"They see not a McCain plan or an Obama plan," he adds. "They read Republican or Democrat."
Here are the proposals in a nutshell:
Obama's plan would offer subsidies to help people and small businesses buy insurance and expand eligibility for Medicaid and the State Children's Health Insurance Program. It would create a government-run National Health Plan that the uninsured could join. Those wanting a subsidized private plan could choose one at a new National Health Insurance Exchange.
The plan would be partly funded through improved efficiency of care and a tax on companies that do not make a meaningful contribution to their workers' health coverage. (Small businesses would be exempt.)
The National Health Plan has drawn fire from conservatives, who see it as the makings of a, well, national health plan. They complain that the government program would eventually overwhelm the private insurance option.
McCain's proposal strives to make health coverage less dependent on the workplace, encourage personal responsibility and preserve choice of coverage. It would provide a large tax subsidy -- a $5,000 refundable tax credit with which families could buy coverage. (Individuals would get $2,500.) And it would end the employer's deduction for health benefits and the exclusion of employees' health-care contributions from taxable income.
Critics of the McCain proposal say that the loss of the tax break would prompt companies to drop their coverage. And low-risk workers would have less incentive to stay in their employer's plan. Furthermore, coverage for a family of four averages $12,000 a year, considerably more money than the $5,000 tax credit would provide.
To recap, independents consider health the second most important issue for the candidates to address, and they greatly prefer Obama's vision to McCain's. Independents are nearly 40 percent of the electorate. Do the math however you want to. These numbers have to be encouraging for Barack Obama.
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