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Blocking Hillarycare in the Congress during 1994 was a major victory for Republicans. But it’s a different game our party faces in the coming rematch. This time Sen. Hillary Rodham Clinton (D-N.Y.) is running for president and it’s public opinion that must be won over to turn back her latest proposal. Lobbyists and legislative tactics won’t be able to win this one in the back halls of Congress. We’re playing out in the open and the public will be participating fully.
It may be useful to start planning for this next campaign by looking back at the post-mortems of the last one. A poll taken by CBS News and The New York Times in September 1994 surveyed a national sample of 1,161 adults to assess the importance of various factors in the failure of Congress to enact the Clinton plan. Poll respondents were asked to rate each factor as a major reason for Congress not passing healthcare reform, a minor reason, or not a reason at all.
The responses to this series of questions were not particularly discriminating in finding one key reason for Hillarycare’s demise. A majority of voters thought four of the five factors tested were a “major problem.” Even the laggard, that “Clinton’s plan was just too complicated,” was judged a major problem by a near-majority, 46 percent of the voters polled. Two factors tied for being the biggest problem, each seen by 56 percent of Americans as a major problem: “special interests and lobbyists did not want healthcare reform legislation passed” and “Clinton’s plan had too much government involvement.” The former of these two biggies may not be as influential this time around, as stated already, but the second one stands to be a crucial factor in public perceptions again.
Sen. Clinton has structured her newest proposal in such a way that employment-based policies are maintained. But otherwise, there will be lots of government involvement in handling everyone else. People didn’t want government intrusiveness in 1994 and they don’t want it now either.
But Republicans must be careful in how they handle messaging on this matter. While voters don’t want excessive government involvement, they do believe that government bears some responsibility for ensuring that Americans have healthcare coverage. That’s according to a question that the Gallup Organization has repeatedly asked since January of 2000. And this sentiment is getting stronger. In the latest asking of Gallup’s question, posed in a November 2006 poll, 69 percent of Americans said that “it is the responsibility of the federal government to make sure all Americans have healthcare coverage,” while just 28 percent said that is “not the responsibility of the federal government.” That negative percentage is the lowest recorded by Gallup since 2000.
Republicans also cannot ignore healthcare issues while we focus on national security and fiscal issues. Healthcare-related issues are rising in importance on the overall issue agenda. Some say this is just because Hillary and the Democrats are raising the topic’s salience. I think not; the numbers were rising even before John Edwards, Barack Obama and Clinton started rolling out their proposals. But even if their actions are explicitly altering the issue agenda, making healthcare seemingly more important than it would be otherwise, we still must respond to the new reality. Healthcare is going to be a top issue in 2008.
The other reality gleaned from a review of 1994-vintage polls is that voters never decided whether the high cost of healthcare or the lack of universal coverage was the bigger problem. In all the polls, the public was split down the middle by this choice. Because there was such a breakdown in consensus about “the problem,” it doubtless stymied consensus regarding a solution. This could happen again, too.
Hill is director of Hill Research Consultants, a Texas-based firm that has polled for GOP candidates and causes since 1988.
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