Politics

This week we attended a Health Affairs event on Health Reform and the 2008 Election at the Willard (excellent coffee), where Celinda Lake (Lake Research Partners) and Bill McInturff (Public Opinion Strategies) entertained the crowd with the good, the bad, and the ugly stories of polling Americans' great thoughts on health care reform. The pollsters represent different sides of the aisle but agreed that: 1) Americans believe that health care costs are linked to the well-being of our overall economy; and 2) The next American president has a "unique window" to change the health care system early in the first term.

Lake, the Democrat, offered many interesting tidbits about what Americans want in their health care reform:

1. Prevention (not wellness)
2. Provider choice (they definitely don't want to lose access to their doctors)
3. Peace of mind about plan choice (they want to keep their policy and benefits if they like them)
4. Control (this is related to the previous two elements)
5. An American Solution (not Canadian-style reform—they want something uniquely American).

Lake also discovered what Americans do not want to hear:

The Senate Finance committee kicked off a series of hearings on health reform this week, beginning with testimony from two former Health and Human Services Secretaries, Donna Shalala and Tommy Thompson. We were thrilled to see that one of the most powerful committees in the Senate—that will surely play a key role in any major health reform initiative—take on the issue of health reform in an open, bipartisan, and productive manner.

Reuter's Donna Smith has a good summary of the hearing, but having sat just a row behind Shalala and Thompson we'd like to add a few of our own highlights from the hearing.

Senator Max Baucus (D-MT) is a man who not only knows how to quote Goethe (as he did to open the hearing) but clearly knows how to talk about health reform. Stressing the need to move beyond incremental efforts and find a comprehensive way to cover all Americans, he said: "The moral and economic case for reform has never been stronger." We couldn't agree more.

If we learned anything from childhood trips to Browerville, it's that good things come from Minnesota. Take Bob Dylan, Garrison Keillor, or our mother's pickle recipe, for examples. Of course, if you're not convinced by pickles and pop, you should try listening to the state's former Senator, Dave Durenberger (R-MN) talk about health reform, as he did today before the Committee on Ways and Means' Subcommittee on Health.

Serving on both the Senate finance and health committees during his three terms in office from 1978–95, Durenberger knows health care. Further, as a man who witnessed firsthand the failings of the 1993–94 reform efforts, Durenberger has a sense of the kind of the bipartisan compromises that it will take to make lasting health reform a reality. When he talks, we and members of Congress listen.

Our quick takes from the former Senator from the Land of 10,000 Lakes:

Yesterday we explored Senator Hillary Clinton’s early education agenda. Today, we’re taking a look at Senator Barack Obama’s early education proposals.

Focusing on Zero-to-Five

The centerpiece of Barack Obama’s early education agenda would be a new program of Early Learning Challenge Grants, which would provide states with funding to support quality child care, early education, and other services for pregnant women and children from birth through age five. States could use Early Learning Challenge Grant funds to support voluntary, high-quality preschool programs for three- and four-year olds, but universal pre-k is not the central focus of Obama’s early education strategy. Instead, states would be given flexibility in how they choose to expand quality pre-k and other early education programs.

Yesterday, we asked why there hasn't been more attention focused on early education issues so far in this election cycle, noting that both Hillary Clinton and Barack Obama have released detailed and ambitious early education agendas. Today we'll explore Senator Clinton's early education agenda. Tomorrow we'll look at Senator Obama's early education plan.

Supporting High-Quality Universal Pre-K

The centerpiece of Senator Clinton's early education agenda is her Universal Pre-k Plan, which her campaign rolled out nearly a year ago as her first major education policy proposal and one of her earliest big policy releases. Senator Clinton's plan would provide grants to states to establish high-quality pre-k programs. In order to receive funds states would have to:

As almost anyone who lived through the Clinton-era health reform efforts will tell you, health reform will require bipartisan leadership and broad-based support from the American people. But why? Could pursuing a Democrat-only strategy work? And more importantly, if health reform were approved with support from only one party, would it be sustainable over time? Would reform lacking bipartisan support lead to yearly battles about how to undermine or even repeal it?

As the Democratic primary campaign season rolls on—seemingly interminably—we’ve read new articles about every imaginable aspect of the campaign (and some we couldn’t imagine). Today we were even treated to a New York Times story about how Democratic superdelegates’ children—and Wisconsin Governor Jim Doyle’s 7-year-old grandson—are persuading them to back Barack Obama. Yet we at Early Ed Watch have seen almost no coverage on a subject near and dear to our hearts—the candidates’ proposals for early education. While it’s certainly fascinating to hear about how children are helping Obama, we think voters would rather know what Obama—and his opponent Hillary Clinton—plan to do to help children learn.

Why should the media pay more attention to early education issues in the campaign?

Ten years ago we couldn't even agree on the ultimate goal for health reform. Just a day ago, at the American Medical Association's National Advocacy Conference, I heard a whole lot of agreement on where we want to be -covering all Americans, providing better care, and reducing costs. Two very interesting perspectives on how to get there came from from Senators Ron Wyden (D-OR) and Tom Coburn, M.D. (R-OK).

Wyden and Coburn are of course far apart ideologically. But as I listened to them give their separate speeches, I was struck by how similarly they viewed our health reform challenges (if not how to achieve solutions). In particular:

Finally some proof that fewer and fewer people believe that "America has the best health care in the world!" This claim simply doesn't resonate with Americans who have experienced (or heard about) distressing personal encounters with swamped emergency rooms, medical errors, specialists who don't talk to each other, nursing shortages in hospitals, high prices, etc. etc.

According to a new poll from the Harvard School of Public Health and HarrisInteractive, only 45 percent of those surveyed agreed with the statement "the U.S. has the best health care system." Republicans were most likely to agree (68 percent) compared to Democrats (32) and Independents (40). That's a pretty sharp discrepancy - but it also mirrors the approaches and slogans we've heard on the campaign trail this year.

Across the political spectrum, respondents said that the United States does a worse job than Canada, France or Great Britain in making sure that everyone can get affordable health care and control costs. Among Republicans, 40 percent said our country does better than other countries on providing affordable care, but only 19 percent of Democrats thought so. (This particular poll did not test their views on possible solutions to the system).

Brief update - As expected, the Pennsylvania House did approve a scaled-back version of Gov. Ed Rendell's health coverage plan this week. Rendell has now embraced the compromise and strongly urged the state Senate—which has been more skeptical about the finances—to pass it. As coverage expansion needs to go hand in hand with insurance market reform, particularly to help small businesses and individuals purchase policies, Rendell is also pushing for an insurance package in the House. AP has the details.