BALANCING HEALTHCARE, PUBLIC POLICY AND POLITICS: Politics and Policy

Monday, November 23, 2009

BALANCING HEALTHCARE, PUBLIC POLICY AND POLITICS: Politics and Policy

Balancing Healthcare, Public Policy and Politics
with Linda de Seife

In this inaugural post, I thought I would start by sharing with you my vision for the column -- that is, to offer some insights into politics and policy based on my experiences both inside and outside the beltway. Each month I’ll discuss a campaign or election or the latest polling data, as well as a hot issue from the headlines. I’ll try to tell you what it means and why it’s important. And, I’ll close with a relevant quotation or political cartoon. I hope that you find these thoughts and opinions worthwhile, and I welcome your comments and suggestions. So, here goes.

Campaigns and Elections - 2009 Results and 2010
By the time you read this, the 2009 elections will be a faded memory to most. However, I choose to see them as a kick-off of the 2010 election cycle. In 2009 in Virginia and New Jersey, Republicans won the governorships. There has been a debate as to whether these elections are a referendum on the Administration’s policies. At least in New Jersey, where I had a ringside seat, the President made five trips to the state and was featured in commercials for the Democratic candidate. In my opinion, there is no doubt that the answer is “yes”.

Former Speaker of the House, Tip O’Neill said, “All politics is local”. And I believe that is true. However, the “local issues” in Virginia and New Jersey were high taxes, the economy, and runaway government spending – issues facing the electorate in every state. So, the Democrats have something to be worried about in 2010 when there will be 435 House races, 35 Senate races, and 37 gubernatorial races, not to mention the state legislatures.

A recent poll by the Pew Research Center found that only 34% of Americans said they want most Congressional incumbents re-elected in 2010. These are among the most negative numbers in twenty years of collecting data. Even more concerning to incumbents is that independent voters are more negative on their elected officials than members of either party. Only 25% of independents want to see congressional incumbents reelected next year.

What it means and why it’s important: Having said that all politics is local, after all the results are in, one can form a picture of trends that are showing up consistently across the nation – like a mosaic where each race is a piece, but you don’t see the complete picture until they’re all put together. The picture in 2009 gives hints of an electorate experiencing a certain amount of buyers’ remorse regarding the 2008 elections; the public is starting to feel that maybe the pendulum is swinging too far in one direction. In addition, both Virginia and New Jersey are states that have historically favored Democats and were carried by the President in 2008.

As a poll worker in my Connecticut town, where there were only local offices on the ballot, I observed that most voters were over 40. Where were all the “youngsters” who came out to vote for President in 2008? Apparently they aren’t interested in the government that is closest to them. This is another phenomenon that does not bode well for 2010 candidates who have alienated more mature voters concerned about the effect of excessive government spending, intrusion, and deficits on their taxes, their retirement, their healthcare, and the future prosperity of their children and grandchildren.

Lastly, there will also be a census in 2010, and those governors and state legislators elected next year will be responsible for redrawing congressional districts in 2011.

This sort of political environment is unpredictable, to say the least, and could lead to some surprising defeats next November. On the other hand, there are many variables, and a lot can happen between now and then. So neither party should count their chickens just yet. That’s why throughout next year we’ll be analyzing some specific races around the country that might be the keystones of our national mosaic.

Issue of the Month – Health Legislation
What else could it be but health care. With new developments almost daily, whatever is printed here could be outdated by the time you read it. So, I’ll discuss one aspect of the issue that strikes me as particularly interesting and not likely to become outdated soon. That is, the fact that the legislation working it’s way through Congress is not health care reform; it is primarily health insurance reform. What we need is both; it will take reforming both the care system and the insurance system to bring down costs and maintain quality and access.

What it means and why it’s important: Trying to make the needed changes by focusing only on health insurance reform can only lead to higher costs, not lower. 60 Minutes has done stories on Pennsylvania’s Geisinger Health System and how it has improved care and reduced costs, and on fraud and abuse in Medicare. And then there is medical malpractice reform which is not addressed in the current legislation.

Personally, I find it very frustrating to learn about all the innovation in technology and care that is happening in hospitals, health systems and technology companies in our country today that should be encouraged; and yet the federal government is spending months (in the current effort alone) trying to force fit changes to the current insurance system instead of looking outside the box and truly transforming the entire health establishment to meet 21st century needs and capabilities. I highly recommend that anyone who is interested in this topic visit the website of the Center for Health Transformation.

In future columns I’ll continue to comment on other aspects of the health care debate. Stay tuned.

Part of what makes politics and policy so fascinating and intriguing to me is that democracy is messy, so many moving parts – the Congress, the Administration, interest groups, the press, and of course the great American citizenry. Just when you think you’ve got it figured out, one, or all, of them throws you a curve ball!

So I’ll close with a quote from Winston Churchill: “It has been said that democracy is the worst form of government, except for all the others that have been tried.”

Here’s wishing everyone a happy, healthy and prosperous 2010!

For more information, please visit Linda's TNNW Bio.