MANAGED CARE REFORM: Still An Election Issue?
"In this year's campaigns, many believed managed care would be the No. 1 health care topic, but that has not been the case," NPR's Bob Edwards reported yesterday. "Once the Starr report was released, people stopped talking about Social Security, they stopped talking about HMOs. It really did suck the oxygen away from most of the Democratic issues," said Indiana political analyst Brian Howey. U.S. Rep. John Hostettler (R-IN), who is facing a Democratic challenger touting HMO reform in her campaign, said his constituents support the Republican approach to the issue. "Whenever I talk to [constituents] and tell them what we passed in the House [GOP] bill, then obviously that is what the vast majority of folks in our particular neck of the woods want to hear about. Greater choice, less cost and not a government mandate that will cause maybe 3,600 in my congressional district to lose their insurance coverage," he said. Harvard University pollster Bob Blendon said this lack of interest among voters could mean Democrats have lost what was once a powerful voting issue. "The Wall Street Journal/NBC since 1992 has asked people which party is best for health care. And the Democrats on average have had about a 20-point lead on the health care issue over Republicans. But on the issue of patient care bill of rights, they are almost identical," Blendon said. National polls also show that "the lack of interest" about health care is "typical," NPR's Joanne Silberner reported.
Mistrust Of Government?
Republican pollster Bob Castro pointed to other factors besides the presidential scandal that have taken the heat off managed care reform. "You have to remember there's still the underlying skepticism at Congress' ability to come up with the right solution. So anyone who says it's probably better to let the House bill that passed sit and be ripened to maturity so that they don't do the wrong thing has a reasonable argument," he said. Blendon said the question of the uninsured -- a huge issue earlier this decade -- is "not showing up at all in polls or on the campaign trail." The reason, he said, is because of "lack of trust in government." He said, "This looks like a possible election issue but at the moment it appears that there's almost a left-over anxiety from [President Clinton's 1994 health reform plan] that if we talk about the uninsured issue again, we're talking about a large, single plan of government. And I think that has made it harder for people to say this is the issue I want acted on."
Silberner reported that at least one health-related issue may be playing into the upcoming elections -- hundreds of HMOs nationwide pulling out of Medicare. Analysts say if seniors "blame" the Medicare HMO defections "on Washington, that might hurt incumbents." Silberner concluded however, that "overall, it's not looking like public concern about health care is going to have much of an effect on elections this year" ("Morning Edition," 10/19). In a weekend talk show appearance, outgoing White House Senior Advisor Rahm Emanuel said, "I think people will look at this election and see it as a referendum on a Congress that has decided to investigate rather than legislate, and to look at what was not done ... Why a patients' bill of rights didn't get passed, and who benefitted from it not being passed and who raised money off it?" ("Face the Nation," CBS, 10/18).