Analysis: Healthcare as political quagmire

By OLGA PIERCE, UPI Health Business Correspondent

WASHINGTON, Dec. 8 (UPI) -- A new poll suggests Americans want action on healthcare issues, but there is no consensus about what kind of action, and also a lack of will to make difficult trade-offs.

Meanwhile, a dogfight in the waning days of the lame duck Congress illustrates the difficulty of turning vision into policy.


"People do not think in terms of ideology ... they just want some help," said Drew Altman, president and CEO of the Kaiser Family Foundation at an event Friday, unveiling the results of a new national poll on Americans' political priorities.

Eighty-five percent of Americans support more action by Congress on uninsurance, and 77 percent want more action to control healthcare costs, according to the poll of 1,867 adults conducted by the foundation and the Harvard School of Public Health. But no clear policy proposal appealed to a majority of those polled.

Proposals spanning the philosophical spectrum from a law requiring all employers to provide insurance to tax credits allowing people to purchase insurance each roughly gained the support of a quarter of surveyed respondents.

"When you ask people to choose one policy -- there is not one that everybody likes," said Mollyann Brodie, vice president of the Kaiser Family Foundation. "That's why the (universal coverage plan) in Massachusetts was successful. Everyone could see something they liked in it."


Regarding the Medicare program, on one hand, there was surprising consensus about current controversies. For example, more than two-thirds of Republicans, Democrats and Independents favor allowing the government to use the program to negotiate lower prescription drug prices.

On the other hand, proposals to address long-term solvency issues in the program failed to garner much support. Raising the age of eligibility had the support of only 28 percent, and support for requiring seniors to pay higher out-of-pocket costs was in the single digits.

Only the vague idea of "rolling back tax cuts" had the support of a majority, and that reflects many people's reluctance to make trade-offs, believing the money can "just come from somewhere else," said Robert Blendon, a health policy professor at Harvard University who worked on the survey. "Getting the program financially stable is not easy if you care about getting a lot of public support."

In Congress, last-ditch attempts to pass stop-gap funding to tide many health programs over until the new Congress meets have left casualties in their wake.

For example, important programs like the Ryan White Act, which provides care for AIDS patients, and the State Children's Health Insurance Program (SCHIP), which insures low-income children were left out of the catch-all funding extension bill.


Now a dispute over funding for the National Institutes of Health suggests no legislation on the programs will move before the end of the year, said Kate Leone, senior health counsel to Senate Democratic Leader Harry Reid, D-Nev., leaving more than 500,000 children at risk of losing their SCHIP coverage.

"We're hoping it will pass," Leone said, "but it would be a heavy lift at this point."

For the next Congress, the Democrats, newly in control of both houses, have made Medicare drug negotiation and funding for stem cell research priority items, but they likely will encounter stiff opposition from both congressional Republicans and President Bush.

While there are some opportunities for cooperation, it is "very difficult to come together on ideas so we can move forward," said Elizabeth Hall, director of health policy for Senate Majority Leader Bill Frist, R-Tenn.

Julie Goon, special assistant to President Bush for economic policy, and member of the National Economic Council, would not discuss possible Bush vetoes, but somewhat ominously, said "the government doesn't do a very good job at negotiating."

The lessons for 2008 presidential candidates are clear, Blendon told UPI.

"What really is effective is laying out issues," he said. "My view is a lot of details will not help candidates."


Successful campaigns will "make people see they have a real sense of priorities," he said.

Republican candidates may be able to overlook the issue of healthcare in the primary, Blendon added, but to win over Democrats and Independents -- who rank healthcare among their top three issues -- they will still need to have a plan.

"It's going to be hard to be a Democratic candidate and not talk about healthcare," he added. "It's going to be hard to be a Republican candidate and find a reason to talk about it."

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