Pre-election Surveys Show Deep Concern About State Of Health Care

The article, written by Robert J. Blendon, Sc.D., Professor of Health Policy and Political Analysis at the Harvard School of Public Health, Drew E. Altman, Ph.D., President of the Kaiser Family Foundation and five co-authors, is the second in a series of reports published in NEJM examining how the election can provide insights about future health policy. The article examines the public's perceptions of the state of the American health care system, the role of health care as a 2008 election issue, and the contrasting health policy views of registered voters who intend to vote for Senator McCain and Senator Obama. The findings are based on a Kaiser/Harvard survey of registered voters in September, as well as other surveys this year and historical Election Day exit polls. The first article in the series, released in January 2008, examined health care's role in each party's presidential primaries.

"Voters want a major change in health care," said Robert J. Blendon, Professor of Health Policy and Political Analysis at the Harvard School of Public Health, "but a new administration is going to have to face the very real divide that exists between McCain and Obama supporters on the shape of future reform."

"Health care is a part of the economic anxieties of the public. People are having major problems getting and paying for health care and, if this trend continues, addressing health care as part of the nation's economic turmoil may be a priority for the nation's next president," said Kaiser President and CEO Drew Altman.

While voters are dissatisfied with the current health care system, they may have very different views about how the next president should address the issue, particularly those intending to vote for Senator McCain versus those intending to vote for Senator Obama. When asked to choose the most important issue relating to their vote choice, health care ranked second among Obama voters and tied for fourth among McCain voters. Further, while a large majority of voters favor changes in health care, supporters of the two candidates differ greatly when it comes to their views on the direction and magnitude of such change.

The article explores in detail a number of health care concerns and priorities through the lens of this election season's presidential choice. While McCain and Obama voters differ in their responses on many health care issues and approaches to health reform, registered voters – whether McCain or Obama supporters – all rank affordability as the top health care priority for the new administration. The findings confirm what surveys have shown in the past, that there is broad support for a range of approaches to health care reform, though there may not be agreement on the best way to move forward.

The authors conclude the article by writing, "because health care is likely to be a second-level priority for presidential action when compared to the country's current economic situation, it will take leadership from the White House and the Congress for health care reform to be achieved."