Monday, January 28, 2008

Over the past year, health care has consistently ranked as the top domestic issue voters wanted the presidential candidates to discuss on the campaign trail. Since March 2007, the Kaiser Family Foundation has conducted five tracking surveys, each finding health care edging out the economy — and falling just under the war in Iraq — as the issue Americans want discussed on the road to the White House.

This growing and intense focus is understandable. Health care represents an area of increasing salience for most Americans. The overall costs of medical care are on the rise. Parents worry about everything from paying the bills for a sick child to the long-term medical needs of an aging parent. Losing health care due to changing jobs or getting laid off is another concern, particularly as the economy slows. And as more new medicines emerge to treat formerly incurable diseases, many wonder it they have the economic resources to purchase these miracle drugs. Furthermore, of course, unlike annoying traffic problems or tax rates, health care can literally produce life-or-death consequences.

So, are Americans getting what they want in terms of politicians discussing health care? Do voters think the Republicans or Democrats talk too much, too little, or about the right amount when it comes to this critical issue? We probed these questions in the most recent nationwide American Survey, conducted Jan. 10-14 among 800 registered voters.

The results reveal some dramatic differences in voter perceptions of the parties’ health care loquaciousness. As the chart below demonstrates, 57 percent say Republicans did not talk about the issue enough, while only 31 percent believe that about the Democrats. More disturbing for Republicans is that a whopping 63 percent of self-identified independents say the GOP does not talk about health care enough, compared to 39 percent saying the Democrat Party discusses the issue enough. And only 15 percent of independents say Republicans talk the right amount, while twice as many (30 percent) say that about Democrats.

Ironically, however, the party of smaller government may have more to say about health care than you think. For example, as David Frum writes in his new book, “Comeback: Conservatism that Can Win Again,” many of the problems in today’s health care market are the direct result of government distortions. Mandates, lack of transparency and not enough competition produce higher prices and fewer choices for consumers — so do medical malpractice laws backed by the Democrats’ special interest allies in the trial bar. Republicans could address many of the problems and concerns voters express about health care by promoting more market-oriented reforms as alternatives to the continuation of Democrats’ big-government policies that distort health care pricing and delivery in America.

Surveys also demonstrate a consistent gap on which party voters trust more to handle the issue of health care. Republicans lag behind Democrats by double digits, usually in the range of 12 to 20 percent in national polls.

So, in another section of the survey we asked voters which party they trust more on health care and “why.” The answer among those who trust Democrats: Democrats care more about their health care concerns. Those who trust Republicans give a different response: Republicans have better ideas about health care.

Again, this should come as no surprise. In Washington policy debates, effectiveness in addressing problems is measured by size of the government solution — and bigger programs or more spending are code for more compassion. As the party of smaller government, Republicans usually find themselves with a deficit in both programmatic bravado and rhetorical empathy.

But by talking more about curing the distortions caused by misguided regulations, the party of smaller government can find the medicine it needs to help improve its standing on the issue of health care.

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