Election ‘08: Who Has the Health Care Edge?

May 13, 2008 — Could Sen. John McCain’s health care plan outsell the Democrats’ plan this November?
Democrats are traditionally seen to have a home-court advantage when it comes to the health care debate. But Washington’s political pollsters say that McCain, the presumptive Republican nominee, has already aimed his health care message right at the heart of what voters say they want: choice of doctors and health plans, and lower cost.
No one is saying McCain can beat Sen. Barack Obama or Sen. Hillary Clinton blow for blow on health care. Polls show Democrats still enjoy up to a 30 percentage-point advantage over Republicans on who voters think is best equipped to handle rising costs.
But those people who make their living taking the pulse of public opinion and crafting that into political messages say McCain is poised to earn more support than Republicans usually expect from Americans concerned about health care.
“I think that McCain has posed a very serious challenge for Democrats,” says Celinda Lake, president of Lake Research Partners and one of Washington’s leading Democratic pollsters.
Both Clinton and Obama have ambitious plans to cover many, if not all, of the 47 million Americans who now have no health insurance. Those plans score big points with voters in Democratic primaries.
But as soon as the race for the Democratic nomination is finally settled, the winner will have to start matching up with McCain, Lake said at a forum on the politics of health reform sponsored by the policy journal Health Affairs.

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McCain’s Message
Lake points out that the vast majority of voters have health insurance already, and that, aside from rising costs, most of them are satisfied with their coverage. Those without insurance are far less likely to vote at all, she says.
That could mean the candidates will not try to impress those with the most to lose in the health care debate, but instead those who already have it relatively good. And with those voters, McCain has already targeted his message at what Lake says are voters’ top concerns about health care: cost, choice, and piece of mind.
“People are very concerned about, are you going to disrupt a system that, for eight out of ten Americans, works very well for them,” says Bill McInturff, a top Republican pollster who had a hand in crafting the “Harry and Louise” television ads credited with helping sink the Clintons’ health care reform plans in 1993.
“They’re worried they’re going to get 10 minutes with their doctor instead of 20 minutes,” Lake says.
Targeting Cost
McCain’s plan is far less ambitious than the plans offered by the Democratic candidates. He wants to tax employer-sponsored health insurance and use the money to provide tax credits for individuals and families to shop for coverage on their own. McCain says the plan will lower costs by forcing insurance companies to compete head-to-head for customers who now have their own money to shop for coverage they choose.
When it comes to medical coverage, most people who already have it “don’t want it altered,” says McInturff, a partner at the Washington polling firm Public Opinion Strategies. That almost certainly explains why all three candidates preface their health care arguments with assurances that anyone who likes their coverage won’t have to change it.
Meantime, the Democratic candidates won’t stop talking about the need to cover the uninsured.
“You’d lose the Democratic primary if you did that,” Lake says.
But in the general election, when the Democrats are busy competing with McCain and not one another, the uninsured are likely to get shorter shrift. Unless, Lake says, they decide to turn the pollsters’ numbers on their heads and vote.