Wednesday, February 10, 2016

Some Slivers of Partisan Accord Across the Health Care Divide

Do Democrats and Republicans agree on anything when it comes to health care? The bitter debates over Obamacare suggest they do not. And those debates continue even after the election.

Some Slivers of Partisan Accord Across the Health Care Divide


By Robert I. Field, Ph.D., J.D., M.P.H.

Do Democrats and Republicans agree on anything when it comes to health care? The bitter debates over Obamacare suggest they do not. And those debates continue even after the election.

But a few shreds of partisan concurrence may lie beneath the surface.

Researchers at Harvard Public Health School surveyed the health care attitudes of likely Obama and Romney voters the week before the election. (Click here to see the full poll results.)

Not surprisingly, their attitudes toward Obamacare differed sharply. Eighty-seven percent of Romney voters wanted Congress to repeal all or part of it. Sixty-nine percent of Obama supporters wanted Congress to expand it or keep it as is.

More generally, a striking 92% of Obama voters believed the federal government should continue to make some sort of effort after the election to insure that most Americans have health coverage. Sixty-two percent of Romney voters opposed the idea.

Similar, although smaller, partisan divides emerged on the two candidates’ plans for Medicare and Medicaid. A plurality of Romney voters liked the idea of privatizing Medicare (45%), and a majority liked the idea of turning Medicaid into a set of block grants to the states (60%). Both ideas are part of proposals of Romney’s running mate, Paul Ryan. Most Obama voters wanted to leave the structure of those programs as they are (83% and 78%).

So, where did the two sides agree?

Clear majorities of each want the government to play a role in trying to fix the health care system (85% of Obama and 53% of Romney voters). While Obama voters prefer to see the federal government in the lead and Romney voters prefer the states, they clearly concurred that the government at some level should be part of the solution.

Large majorities of each were opposed to making significant cuts to Medicare as a way to reduce the budget deficit (78% of Obama and 68% of Romney supporters). Somewhat surprisingly, the same was true for opposition to cutting Medicaid (77% of Obama and 56% of Romney supporters).

As for cuts in other areas of health spending, a plurality of Romney voters (43%) opposed them along with a large majority (73%) of Obama backers. However, the sides did diverge on whether funding for Obamacare should be reduced.

Concurrence also emerged on the best way to control health care costs. A plurality of Obama voters (46%) and a majority of Romney voters (58%) favored government incentives for more competition over greater regulation of rates and charges.

And perhaps most significantly, the two sides converged on the hot button issue of abortion. Both were clearly opposed to placing substantial new limits on the availability of abortion services (50% of Romney and 70% of Obama supporters).

What can we make of all this?

First, while a partisan split persists on the wisdom of Obamacare and the proper federal role in health care, the two sides clearly agree that the government has an important place in fixing the system.

Second, although there was disagreement on the best approach to reform, there was concurrence on the value of the major government programs we have today – Medicare and Medicaid. Neither side wants major cuts to either one.

Third, when it comes to what the government should do to fix health care, both sides favor the core element of the Obamacare approach. It relies on marketplace competition among insurance companies to hold down premiums rather than direct oversight of rates.

Finally, on at least one hot button issue, there is more agreement than many people realize. Only a minority on either side wants greater restrictions on access to abortion services.

Where should we go from here?

To begin with, let’s stop bickering about whether the government should be involved in health care. There is broad agreement across the partisan divide that it should be. Politicians should debate how the government can best improve the system, not whether it should.

And let’s top dwelling on our differences on social issues. Americans agree on more than we acknowledge. We should pay more attention to areas of accord and less to divisions that represent only part of the story.

Professor, Drexel University Kline School of Law & Dornsife School of Public Health
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Robert I. Field, Ph.D., J.D., M.P.H. Professor, Drexel University Kline School of Law & Dornsife School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson College of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson College of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
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