Reading the Numbers: Messaging Healthcare in 2010

For much of 2009 and into 2010, healthcare reform dominated political discourse. Now that the bill is law, its electoral importance does not seem as dramatic. Instead, the dominant electoral factors are the economy, voter anger at government and Wall Street and how each party manages to maximize partisan turnout and still win a majority of the limited number of swing voters. Healthcare should be seen as part of that equation, albeit one that must be handled smartly and carefully.
Two mid-April polls reinforce that view. A Zogby Interactive survey showed likely voters opposed to the bill, 51 percent to 44 percent. We also asked voters opposed why they felt that way, and found very high levels of agreement with most objections to the bill, such as too much government control, socialized medicine, forcing people to buy insurance, increased taxes and deficits and weakened Medicare benefits. When asked to choose their most important objection, government control led with 25 percent.
These are primarily philosophical and valuesbased opinions, and (with a few caveats) unlikely to change between now and the election.
The other poll was conducted by Princeton Research for the Kaiser Family Foundation (KFF). It found 46 percent of adults viewed the healthcare bill favorably, with 40 percent viewing unfavorably. Registered voters tied, 44 percent to 44 percent. Other key findings released by KFF were for all adults:
 
• In describing emotional reactions to the bill, 55 percent chose confused, 45 percent pleased, 45 percent disappointed 42 percent anxious, 40 percent relieved and 30 percent angry.
• Even though 55 percent were confused, majorities were aware of 14 of 16 listed elements of the bill.
• The percentage of those who knew the Congressional Budget Office reported the bill will, over 10 years, lower the deficit went up from a March KFF poll, going from 15 percent to 25 percent. Even among Democrats, more believed it would raise the deficit, 35 percent to 32 percent.
• Provisions of the law that will take effect this year are very popular. Even a majority of Republicans like most.
• Adults were split on whether the law would make things better or worse for themselves and their families; and more likely to say the nation would be better off, 45 percent to 35 percent.
Data from both polls meshes well in showing how candidates should approach the issue. Healthcare reform has its perils for both parties, but demands from each party’s bases, particularly among Republicans, make it difficult to ignore.
While conservatives may want the bill repealed, Republicans in competitive districts would be foolhardy to propose that. Instead, they should call the bill an overreach and play on the distrust of government that is shared by swing voters. In that vein, cite Democratic deal-making and claim the whole process was sullied by special interest politics. Voters will like aspects of the law that kick in this year, so try to say these could have been accomplished without a big, expensive bill. The complexities of the bill and voter confusion strongly favor the GOP.
Democrats have the harder job of convincing swing voters the law will benefit them. If attacked on their support for the bill, Democrats should not be defensive. The KFF poll shows an increasing awareness of the CBO’s positive deficit projections. Given distrust of government, voters will be skeptical that a bill costing about $900 billion will reduce the deficit, but Democrats still must make the argument. When hit with GOP warnings about government’s role in healthcare, remind voters the same things were said about Medicare. Target your messaging to those who may already be eligible for benefits, such as young adults who may be able to go back on their parents’ coverage and seniors who may be eligible for a $250 Medicare rebate.
My final words of advice come from the physician’s code: “First, do no harm.” An overly aggressive position on healthcare may be tempting, but it could kill you. The earlier uproar over healthcare reform was a symptom, not the disease. Voters want a cure for the economy and government dysfunction, and that is where your treatment should be focused.John Zogby is president and CEO of the polling firm Zogby International. You can post comments on political topics in the Zogby forums at Zogby.com