Healthcare as realigning issue

Pollsters and other public opinion researchers must be careful when employing anecdotal “evidence” drawn from a single person to make a point about the attitudes of mass publics. No matter how convincing and compelling one evidentiary tale may be, it is dangerous to project that singular anecdote to an understanding of the opinions of a larger population. It is even more dangerous for the professional researcher to use personal or family anecdotal evidence. So I am aware of the liabilities associated with the anecdote I am about to share, but it makes the point better than any other way I know of.

In 1998 and 1999, my father became embroiled in an extended healthcare crisis. Suffering from normal-pressure hydrocephalus, a disorder that affects the brain, he went through several surgeries, including a botched one that caused more brain injury. Finally, we placed him in the capable hands of the neurosurgeons of Shands Hospital at the University of Florida. Neurosurgery and treatment is expensive — very expensive. On one occasion when my mother and I were visiting my comatose father, a young physician asked if he could speak with me privately for a moment. In a small consultation room, he informed me that my dad was on the brink of exhausting his Medicare benefits. I responded that I didn’t even know this was possible. He assured me it is possible and that his expensive neurosurgery specialty forces him to pass along this bad news frequently. He proceeded to tell me that the typical course for families like ours would be to switch to Medicaid — the program for indigent persons. But before Mom and Dad would qualify, they would have to exhaust all their personal assets, forcing them to, among other steps, sell their home. The doctor promised to send me an updated statement of all the charges to date.

As we drove home, I dared not tell my mother the bad news, that if Dad needed yet another surgery, we would pop the cap, setting off a chain of events that would force her to sell her house. My parents were of modest means and the sum total of their assets, including the house, would not have paid for much more care at the rate we were paying. A few days went by and a huge package arrived with the Shands hospital bill. It looked like a ream of paper, but I am sure it was only a quarter of that. I could tell that the mass of charges intimidated my mother. I peeked at the bottom line, and it was slightly below the figure the physician had mentioned. I wondered silently if Shands had given us a break. To reassure my mother, I reminded her that Medicare paid for all this. Not a political person, and certainly not an ideologue, but a patriotic American nevertheless, my mom, standing in the middle of the kitchen before the massive bill on the counter, said, “Well, it’s a great country, isn’t it?” I stumbled through some words of agreement, but didn’t come clean with the news that our great country might soon have her in poverty and house-less to pay the medical bills. If that had occurred, and mercifully it didn’t, her patriotic zeal might have wavered somewhat.

The lesson of this anecdote is that opinions hang in the balance on an issue like healthcare. There are going to be big winners and big losers, no matter what occurs in the last stages of the debate.

And the wins and losses will be highly personal. This is not an issue that one intellectualizes, particularly if you are a loser. That’s why healthcare portends to be a realigning issue that can move voters across party lines. Handle carefully, politicians.

Hill has been a Republican pollster since 1984. This cycle he is polling for gubernatorial campaigns in four states.

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