- The Washington Times - Monday, February 18, 2008


Opinion polls confirm that health care is a dominant issue this election year. A tracking survey by the Kaiser Family Foundation, for example, finds it consistently ranks as the topic Americans most want to hear about from presidential aspirants. Many other surveys reveal similar patterns: health care, the economy and jobs — three interrelated, kitchen-table issues — battle it out for top billing in most recent surveys gauging what worries voters.

Health policy is also an issue with deep philosophical and ideological roots. And the Democrats — the party more at ease with a larger government role — hold a historical advantage as the party voters “trust” more to handle the issue. Medicating public concern with new programs and more spending has been the standard Democrat prescription for American health care angst.

The Wall Street Journal has been tracking the issue of which party Americans trust more on health care since at least 1991. Every one of its polls shows Republicans lagging behind on the issue, usually by double-digit margins. The most recent American Survey (800 registered voters conducted Jan. 10-14) confirms this Democratic advantage. When asked which party they trust more on health care, voters give Democrats a solid 15-point advantage. Looking behind the numbers, however, reveals some fascinating variation, offering both encouragement and concern for the GOP.

First, Republicans face a breathtaking deficit among African-American voters. The trust numbers among blacks are so lopsided they make the overall trust deficit look particularly large. The GOP numbers are also especially low among independents, unmarried voters and women. Republican numbers improve dramatically among white men, married individuals and seniors.

The results among seniors — a near draw between the parties as more trusted on health care — are particularly noteworthy. Looking back at polls done by other survey organizations during the late 1990s and prior to 2003, Republicans consistently lagged among seniors on the question of which party could better handle the issue of health care. Trailing the Democrats by only three points among those 65 and older represents a strong showing for the GOP compared to previous polling. It raises the question: has support for the Medicare prescription-drug legislation in 2003 Democrats dominate the conversation in addressing the issue of the uninsured.

But this could provide a political opening for the Republicans. About 85 percent of all Americans already have health insurance. And if voters view “handling” the health care issue in broader terms than just helping the uninsured, Republicans could win support with a broader agenda that addresses a wider swath of policies to improve health care. Proposals ranging from reducing health care costs and expanding affordability (through competition and lawsuit reform) to improving convenience, to providing incentives for prevention and managing costly chronic disease. All offer ways to improve health care through market-oriented options — and expand the debate beyond just insurance coverage.

The public’s hunger for more dialogue on health care forces both parties to put more ideas on the table. Republicans can begin to close the trust deficit on health care by building a credible alternative to a bigger government system. They need to practice the Woody Allen rule (80 percent of success is just showing up) when it comes to health care — just “showing up” more and talking about their ideas will go a long way toward closing the trust deficit.

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