Fourteen Percent Support

Jim Molpus, for HealthLeaders Media , April 25, 2008

Politics is the art of numbers. Polls turn into voters, and power to govern often is the sum of the number of voters who care about a particular issue.

Few seem to care about healthcare.

At least no one outside of the people most affected by it—the uninsured. An Associated Press exit poll this week of Democratic voters found that 14% rated healthcare as the most important issue, trailing far behind the economy (55%) and Iraq (27%).

It does not take a statistician to know that there are an estimated 45 million of the 303 million Americans without health coverage, which makes for a percentage of roughly 14%. A true statistician may argue that extrapolating a preference poll and comparing it to a statistical designation is at best a mere coincidence. But scientific or not, the numbers hint that healthcare has so far failed to latch on as an issue with sustainable heft in the presidential campaign beyond those Americans most directly affected by it.

The reasons why are varied. Few would suggest that healthcare would or should trump either an ongoing war or a deteriorating economy as the issue of most concern to the American public. Indeed, I suspect that $4-a-gallon gasoline will still be on voters’ minds as they drive to the election precincts this fall.

The endless war of attrition on the Democratic side is preventing either candidate from seizing the high ground on healthcare, and pundits seem to suggest that the fight will continue at least until early summer. Meanwhile, much of Republican nominee-in-waiting John McCain’s healthcare fix is still a work in progress.

In the 2004 election, much of the steam on healthcare got lost behind same-sex marriage and other hot buttons that are easier to punch. Healthcare also lacks the immediate, universal pain points that hit everyone at the same time—like gas prices that cause travel, food and other out-of-pocket costs to rise quickly. The numbers of uninsured creep up and healthcare costs continue to rise. So having healthcare polling in the low double-digits this late in the 2008 campaign sets the debate up for much the same result as 2004 with no real mandate from voters for reform.

So what could change the picture and raise healthcare as an issue between now and then? If Hillary Clinton manages to capture the Democratic nomination, then the healthcare debate becomes a polarizing debate between Clinton’s universal coverage versus McCain’s quality and cost focus. Both candidates will attempt to tie in the rising cost of healthcare a threat to national prosperity, and perhaps rightly so. And it could get ugly. It could make Harry and Louise look like Ozzie and Harriet.

Maybe that would get the voters interested.

Jim Molpus is Editor-in-Chief of HealthLeaders Media. He may be reached at


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