Hostname: page-component-848d4c4894-sjtt6 Total loading time: 0 Render date: 2024-07-04T21:16:27.413Z Has data issue: false hasContentIssue false

In the Shadow of 9/11: Health Care Reform in the 2004 Presidential Election

Published online by Cambridge University Press:  01 January 2021

Extract

Health care reform is an important issue in the 2004 presidential elections and is receiving serious attention from the Democratic and Republican candidates. Changes in the economy that fuelled increased productivity and depressed job growth have also shifted more of the costs of medical care and insurance onto employees. The rising costs of insurance premiums and health care are far outpacing the general inflation rate and workers’ wages. Meanwhile, state governments reacted to widening budget deficits from 2001 to 2003 by reducing Medicaid eligibility and benefits. These changes in employer-based health insurance and government policy have contributed to the largest rise in the share of Americans without health insurance in a decade. In 2002, the uninsured numbered 43.6 million and, according to the Congressional Budget Office, 57 to 59 million non-elderly people are uninsured at some point over the course of a year.

Type
Symposium
Copyright
Copyright © American Society of Law, Medicine and Ethics 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, R., “Health Care a Defining Issue for Democratic Candidates,” CQ Weekly, May 24, 2003, at 1255; U.S. Census Bureau, Health Insurance Coverage in the United States: 2002 (Washington, D.C.: U.S. Department of Commerce, 2003).Google Scholar
Bouton, M.M. and Page, B.I., eds., with Jacobs, L.R., Longsworth, R.C., Kull, S., Hug, C., and Whitney, C., Worldviews 2002: American Public Opinion and Foreign Policy (Chicago: Chicago Council on Foreign Relations, 2002).Google Scholar
Jacobs, L.R., Shapiro, R.Y., and Schulman, E.C., “Poll Trends: Medical Care in the United States — an Update,” Public Opinion Quarterly 57, no. 3 (1993): 394427; Jacobs, L.R., “Health Reform Impasse: The Politics of American Ambivalence Toward Government,” Journal of Health Politics, Policy, and Law 18 (Fall 1993): 629–55.CrossRefGoogle Scholar
The Harris poll (Louis Harris and Associates 1992) found that the economy and candidate character were the top two issues while the Roper poll (Roper Center 1992) reported the economy and budget deficit received top billing.Google Scholar
Jacobs, L.R., Policy Trumps Politics in the Choices of Voters in Democratic Primaries and Caucuses, A Study by the 2004 Elections Project, Humphrey Institute, University of Minnesota Website, at <http://www.hhh.umn.edu/centers/csp/elections/policy_trumps.pdf> (last visited July 22, 2004).+(last+visited+July+22,+2004).>Google Scholar
The question read, “Next I'd like you to rate your satisfaction with the state of the nation in some different areas. For each of the following areas, please tell me whether you are very satisfied, somewhat satisfied, not too satisfied, or not at all satisfied. How about the availability and affordability of health care?” The sources were a Gallup/CNN/USA Today poll (1993); Harvard School of Public Health/Robert Wood Johnson Foundation/International Communications Research poll (2003).Google Scholar
Jacobs, , “Health Reform Impasse: The Politics of American Ambivalence Toward Government,” supra note 3.Google Scholar
The question wording was the following: “Which of the following statement comes closest to expressing your overall view of the health care system in this country? (1) On the whole, the health care system works pretty well and only minor changes are necessary to make it work (better), (2) There are some good things in our health care system, but fundamental changes are needed to make it work better, (3) Our health care system has so much wrong with it that we need to completely rebuild it, (4) Not sure/don’t know.” The 1991 polling results were found in both a CBS/NYT poll from August 1991 and a Harris poll in November 1991 (see Jacobs, , Shapiro, , and Schulman, , supra note 3). The 2003 polling results were found by a 13–27 July 2003 CBS/NYT poll.Google Scholar
Blendon, R.J., Benson, J.M., and DesRoche, C.M., “Americans’ Views of the Uninsured: An Era for Hybrid Proposals,” Health Affairs Web Exclusive (August 27, 2003): W3–409, at <http://content.healthaffairs.org/cgi/reprint/hlthaff.w3,405v1>.CrossRef.>Google Scholar
Jacobs, L.R., The Health of Nations: Public Opinion and the Making of American and British Health Policy (Ithaca, NY: Cornell University Press, 1993): 192; The question wording was the following: “If you had to choose between a federal law which would provide medical care for the aged by a special tax, like Social Security, or a plan of extended private health insurance, which would you choose?”.Google Scholar
The wording of the question is the following: “(Regardless of which (2004) presidential candidate you support, please tell me if you trust…George W. Bush or John Kerry to do a better job handling each of the following issues.) What about…health care, including Medicare? Which do you trust to do a better job handling this issue…Bush or Kerry?”.Google Scholar
Jacobs, , Shapiro, , and Schulman, , supra note 3.Google Scholar
Jacobs, , Shapiro, , and Schulman, , supra note 3; Jacobs, L.R. and Shapiro, R., Politicians Don’t Pander: Political Manipulation and the Loss of Democratic Responsiveness (Chicago: University of Chicago Press, 2000): 98100. Also, see Jacobs supra note 10.Google Scholar
Jacobs, and Shapiro, , id. American Political Science Task Force on Inequality and American Democracy (Chaired by L.R. Jacobs), “Inequality and American Governance.” Available at <http://www.apsanet.org/Inequality/governancememo.pdf> (last visited July 26, 2004).+(last+visited+July+26,+2004).>Google Scholar
Bartels, L., Economic Inequality and Political Representation, paper presented at The 2002 Annual Meeting of the American Political Science Association, Boston, August 29-September 1. Available at <http://www.princeton.edu/-bartels/papers> (last visited July 27, 2004).+(last+visited+July+27,+2004).>Google Scholar
A 10 percentage point increase in support for policy change among the wealthiest (i.e. those in the 90th percentile of the income distribution) was associated with a 4.8 percentage point increase in the likelihood of a corresponding policy change; the preferences of the poorest (i.e. individuals in the 10th percentile of the income distribution) produced only a 2 percentage point increase in the likelihood of a corresponding policy shift. Gilens, M., Unequal Responsiveness, paper presented at the Inequality and American Democracy Conference, Princeton, New Jersey, November 7–8, 2003.Google Scholar
Jacobs, L. and Page, B., Who Influences U.S. Foreign Policy Over Time? American Political Science Review (November 2004; forthcoming).Google Scholar
West, D.M., and Loomis, B., The Sound of Money: How Political Interests get What They Want (New York: W.W. Norton, 1999).Google Scholar
Hall, R. and Wayman, F., “Buying Time: Moneyed Interests and the Mobilization of Bias in Congressional Committees,” American Political Science Review 84, no. 3 (1990): 797820.CrossRefGoogle Scholar