Showing posts with label health care debate. Show all posts
Showing posts with label health care debate. Show all posts

Sunday, May 30, 2010

What Wave?

The Democratic victory in the special election in Pennsylvania 12 might not be the upset that many in Washington believe it to be. That’s because, as we have been saying in this space for the past year, 2010 is not 1994 and the chances of a Republican wave building off shore are far lower now than they were then. The country's demographics have shifted dramatically in the intervening years; the Republican brand is much more tarnished than it was in the 90s; and Democratic governing successes are gradually being recognized by the electorate.
The United States is a much different country demographically than it was in 1994. A decade and a half ago, over three quarters of Americans were white. That number has dropped to just over 60% now and is on the way to falling below 50% by the midcentury. In particular, the percentage of Latinos in the U.S. population has nearly doubled (from about 9% to 16%) over the same period. In addition, half of a new generation—Millennials (born 1982-2003), the largest and most diverse generation in American history—has joined the electorate.
All of these changes have worked to the advantage of the Democratic Party and are should continue to do so in the future. In NDN’s February survey of the 21st century American electorate, Millennials identified as Democrats over Republicans by a 2:1 margin (42% vs. 21%) and non-Caucasians did so by over 4:1 (57% vs. 14%). Women also strongly identified as Democrats (44% vs. 24% Republicans). By the way, the other half of the Millennial Generation, all those now under 18, already live in a world where whites are in the minority, promising an even larger Democratic edge in the future.
At least in part as a result of these major demographic changes, the Democratic Party now holds a clear lead among voters in party identification, something it did not have in 1994. In the most recent Pew national survey released earlier this week, the Democrats enjoy a nine-percentage edge over the Republicans in party ID (45% vs. 36%).In 1994, the two parties were tied at 44% each and in 1995, the year after the GOP won control of Congress, more Americans identified with or leaned to the Republican Party than the Democrats (46% vs. 43%).
Moreover, while it is true that attitudes toward the Democratic Party have declined during 2010, contrary to 1994 the Republican Party is not seen as a viable alternative by most voters. In 1994 favorable ratings of the Democratic Party fell in Pew’s surveys from 61% when Bill Clinton was elected president in 1992 to 50% by the time of the midterm election. In that same time period, positive perceptions of the Republican Party increased dramatically from 46% to 67%. While Pew’s March, 2010 survey showed Democrats with only a 40% favorable rating, down from 57% in the fall of 2008, positive attitudes toward the GOP also declined since President Barack Obama’s election from 40% to 37%, still leaving the Democrats with a slight advantage.
These demographic changes and attitudinal configurations have put the Democratic Party in a stronger position now than in 1994 to hold off a possible Republican wave. Furthermore, as they have enacted major portions of the Obama agenda, Congressional Democrats have improved their standing in comparison to Republicans on the generic ballot since earlier this year. All of the public surveys conducted during the past week show the Democrats with at least a modest lead. Over the last few months there has been a net shift of six-points toward the Democratic Party.






March/April
Democratic
Preference
March/April
Republican
Preference
May
Democratic
Preference
May
Republican
Preference
Gallup44%48%47%46%
CNN45%49%47%46%
Quinnipiac39%44%42%36%
Average43%47%45%43%

An examination of a few key findings from some recent polls shows why that shift has occurred.
First, while voters do not yet believe that America has returned yet to prosperity, there is a clear perception of progress. In the Quinnipiac survey, the number believing that the nation’s economy is getting better rose from 19% in April 2009 and 28% last December to 32% now. The belief that the economy is worsening is down from 32% to 24% over the same period. President Obama is getting some of the credit for the perceived improvement in the economy. His approval score for handling the economy is up from 39% in March 2010 to 44% currently. More specifically, the percentage approving of President Obama’s performance in creating jobs has risen from a low of 34% last January to 40% in May.
Second, after a year of rancor, voters are increasingly positive about the Democratic health care reform plan that passed Congress and was signed by the president in March. According to a recent CBS News poll, approval of the plan rose from only 32% in early March to 43% in May.
As a result, the president’s approval rating for handling health care in the Quinnipiac poll has risen from a low of 35% in January and February to 45% now.
As proof that nothing succeeds like success, the perception of an improving economy and the increasingly positive reactions to the newly enacted health care reform law have led to the most favorable job approval scores for both the president and congressional Democrats this year. For most of 2010, in the Quinnipiac poll, a slightly greater percentage of voters disapproved than approved of the way President Obama was handling his job. But in May, for the first time since early February the president’s approval score was in positive ground (48% approve vs. 43% disapprove). Over the same time frame, the job performance approval of congressional Democrats has gone up from 28% to 34%. By contrast, the approval score for congressional Republicans is down from a high of 34% in March to only 26% in May.
As a result,the forecast of another Democratic election disaster like that of 1994 seems premature and unlikely in today’s changed demographic and political environment. Those expecting a wave may well be left standing on the shore vainly waiting for a high tide that will never come.

Sunday, October 11, 2009

Engergizing Millennials: Key to Dem Victory in 2010

The latest unemployment numbers and poll results have led most observers to predict a major setback for Democrats in the 2010 Congressional elections. But a year is a lifetime in politics and much can change between now and then to influence next year’s vote. As Ron Brownstein recently pointed out, the demographic makeup of the electorate is likely to be a key factor in whether or not the Democrats can maintain their current majority margins in 2010. While traditionally Democrats have focused on turning out African-American and Hispanic voters to offset Republican strength among white male voters that equation is no longer the only calculation Democratic strategists need to make.
Today the level and intensity of interest among Millennials young voters 18-28, is equally important in ensuring Democratic victories. But for that group of voters to turn out in large numbers, Congressional Democrats will have to make a much more concerted effort than they have to date to deliver on a series of policy issues of major concern to Millennials, the generation that provided Barack Obama 80% of his popular vote margin over John McCain in 2008.
As with most other Americans, the number one concern among Millennials is the state of the economy and the need for jobs. But Millennials have a unique perspective on this issue, one that Congress must understand and address. Millennials believe there is a clear link between education and employment and are increasingly concerned that the pathway through the educational system into the world of work is becoming increasingly more difficult and expensive to navigate. Two-thirds of Millennials who graduate from a four-year college do so with over $20,000 in debt. A job market with Depression-level youth unemployment (18.5%) and a wrenching transformation of the types of jobs America needs and produces makes the implicit bargain of education in return for future economic success harder for Millennials to believe in every day.
Recently Matt Segal, Executive Director of the Student Association for Voter Empowerment (SAVE) and Founder and National Co-Chair of the “80 Million Strong for Young Americans Job Coalition” presented some ideas to the House Education and Labor Committee on what Congress could do to address this challenge.

He advocated increased entrepreneurial resources be made available to youth; Senate action on the student debt reform bill recently passed by the House; more access to public service careers through internships and loan forgiveness programs; and the creation of “mission critical” jobs in such fields as health care, cyber-security and the environment that would tap the unique talents of this generation. Coupled with the recent passage of the Kennedy Serve America Act, enacting these initiatives would demonstrate that Democrats are serious about improving the economic situation of Millennials and, at the same time, provide organizing ammunition in the 2010 campaign.
Of course no economic program can ignore the impact of health care on this generation’s—and America’s—economic well being. Many of the entry-level jobs young people seek and obtain come from employers who simply can’t afford to provide health care coverage under today’s system. Young adults between the ages of 19 and 29 represent nearly a third of all uninsured Americans, and two-thirds of those uninsured young people reported going without necessary medical care in 2007 because they could not afford to pay for it. As a result, polling has consistently indicated that a majority of young people support President Obama’s health care proposal, especially if it contains a public option to control costs. One of the more compelling components of the president’s plan for Millennials is that it would allow parents to cover their children through the family’s health insurance up to the age of 26 instead of the current limit of 19. And Millennials expect Congress to act. Only a third of Millennials, as compared with half of older generations, are concerned that the government will become too involved in health care.
Yet many pundits continue to perceive health care reform as an “old people’s issue,” likely to increase the turnout of seniors, but not Millennials, in the 2010 elections. Some have even suggested that Millennials will object to a health care system that limits the differential in premiums insurance companies can charge relatively healthy young people vs. older, less well adults. But this theoretical inter-generational transfer of wealth is not likely to stir up much opposition among Millennials. Unlike the Baby Boomers of four decades ago, Millennials do not speak to their elders across a generation gap, but have actually formed strong and enduring bonds with their parents and come to the public arena determined to find solutions that work for people of all ages. Already, Young Americans for Health Care Reform has accumulated 1200 fans on Facebook since the group was formed less than a month ago.
If Congressional Democrats can successfully negotiate passage of a health care reform bill that provides cost-effective coverage for the 30% of Millennials who currently are not insured, Democrats will have another major arrow in their quiver going into the 2010 election.
Millennials, like their GI Generation great grandparents in the 1930s, are facing economic challenges that caught them by surprise and for which no one prepared them. But Millennials aren’t looking for a handout or sympathy. Instead, in the “can do” spirit of their generation, they are organizing to overcome the challenges created for them by their elders. It’s time for Democrats in Congress to recognize these concerns and the loyalty of a generation that identifies as Democrats over Republicans by a 2:1 margin. One way to accomplish this is by passing meaningful health care reform while helping to create new pathways to economic opportunity, especially for young people who are just entering the work force. Doing so now, as the battle for 2010 shapes up, will help energize the newest and most loyal element of the Democratic Party’s 21st Century coalition, the Millennial Generation.

Monday, August 17, 2009

Have Patience-Republicans Just Going through 5 Stages of Grief

In 1969, Dr. Elisabeth Kubler-Ross published a groundbreaking book, On Death and Dying, suggesting that people facing death went through five emotional stages before they could accept their fate. While never proven by subsequent studies, the five stages of grief have entered the realm of conventional wisdom and are often cited to explain the behavior of groups, as well as individuals, facing a life-threatening crisis. The actions of Republicans, and their conservative supporters, in attempting to disrupt Town Hall discussions of President Obama’s health care reform proposal suggests that the concept is alive and kicking in politics as well.
According to Kubler-Ross, the first stage in dealing with impending doom is to deny it’s happening. We witnessed this behavior in the immediate aftermath of the Democrats’ overwhelming victory last November. Republicans reacted almost identically to the way Democrats did after Ronald Reagan’s victory in 1980. The election results were attributed to poor campaign tactics by the loser, or the failure to develop a winning message by the campaign’s media strategists, or a plot by reporters to ensure the victory of the winning candidate, if for no other reason than to give them something new to write about. In the classic words of death deniers throughout history, Republican leaders continued to insist well into January 2009 that they “felt fine” and the results had “nothing to do with me”--the Republican party and its message. The only thing that was about to die, we heard GOP leaders like Rush Limbaugh and Michael Steele assert, was the muddled attempt at moderation by Senator John McCain and the failure of their party to adhere to its most conservative principles.
The second stage of grief according to On Death and Dying is anger, and this summer the Republican Party and its minions have clearly moved beyond denial to anger. Enraged mobs of extraordinarily well informed “average” citizens have descended on Democratic Town Hall meetings to demand that their Representative not follow Speaker Nancy Pelosi’s party line and instead vote against specific provisions of health care legislation that would, for instance, incent the writing of living wills, or substitute the judgment of health insurers for that of objective government entities on what treatments would be allowed based on their cost effectiveness. Above all the evil of government involvement in the health care system is to be labeled for what it is—the work of the devil, who is clearly a socialist, through his agents in the U.S. Congress. The fact that many of those most vociferous in their opposition to government supported health care are carrying their sacred Medicare card in their wallet is only ironic if you ignore the degree to which anger and denial are related emotions. In fact, Kubler-Ross points out that people often oscillate between those stages before moving on. This makes the denial of Barack Obama’s Hawaiian birth by many of these same angry protesters understandable, if not any more credible.
So what can the country expect once the Republican Party moves on to the next stage of dealing with the demise of its former electoral dominance? According to Kubler-Ross, the third stage of grief is “bargaining.” Here the individual or group hopes that it can at least postpone or delay death by promising to reform or turn over a new leaf. There are already early signs in the writings of Peggy Noonan, President Reagan’s speechwriter, that this next stage is coming to the fore. She suggests that if only President Obama would rethink the broad scope of his proposals and join in true bipartisan negotiations, Republicans in Congress would support a bill that leaves most of today’s health care system in place but without the nasty practices of denying health coverage to those with pre-existing conditions or canceling people’s insurance at the first sign that they might actually need medical treatment. The country can expect to hear more such offers from Republicans this fall when Congress returns and the real bargaining over the scope of health care reform takes place. But the party’s past misdeeds in building a majority coalition based on the racist premise of its Southern Strategy or its failure to appeal to the civic beliefs and attitudes of the emerging Millennial Generation or its most recent decision to sacrifice its future among Hispanics by voting against the nomination of Justice Sonia Sotomayor, make any such offer a fool’s bargain. The demise of GOP dominance is inevitable and Democrats should take no part in postponing the inevitable.
If congressional Democrats have the courage to use their majority to pass health care legislation and then go to the voters with an economy on the mend, the 2010 elections should serve to move Republicans to the fourth stage of grief—depression. Suffering from a series of unexpected and unexplainable defeats, Republicans are likely to go off on a prolonged period of silence, punctuated by bouts of crying over just how unfair politics has become. Kubler-Ross suggests that it is important not to try and cheer up the person in this stage of grief, but to let the individual work his or her way through the inevitable depression on their own. That way, her book says, the dying can finally come to the final stage of grief—acceptance.
This stage represents the end of the struggle and a willingness to accept one’s fate. The Republican Party as we have known it since 1968 will die for lack of political support. It may not accept that fate until after President Obama’s re-election, by a landslide, in 2012 just as the Democratic Party’s New Deal liberals did not accept their fate until after Ronald Reagan’s complete demolition of Walter Mondale’s candidacy in 1984. Still the end is inevitable, as many of today’s leading thinkers in the GOP are beginning to realize.
But Republicans can take heart in what Democrats were able to do after reaching the clarity of mind that comes with accepting one’s fate. By recognizing the death of its old ideas and rethinking their approach to the electorate after their landslide defeat in 1984, the Democrats eventually found a new road to victory—tentatively in 1992 with Bill Clinton and then more confidently with Obama’s victory in 2008. At that rate the GOP only has to wait until 2020 to have its next real shot at winning the presidency. If Republicans want to get to that goal sooner, psychologists might suggest that they move quickly out if their “summer of anger” phase, don’t bargain or obstruct too much over health care or anything else when Congress returns, and get ready for a good cry in 2010. Even better, such a course of therapy will improve the rest of the country’s mental health as well.

Friday, July 24, 2009

Democrats Should Act Like the Majority They Are

For the first time in decades, due largely to the emergence of the Millennial Generation (young Americans born 1982-2003), the Democratic Party holds a clear and decisive majority in party identification nationally. Whether the Obama administration and the Democratic Congressional leadership take advantage of this historic opportunity will be determined by their success in passing during this session of Congress the type of comprehensive health care reform legislation that Democratic identifiers overwhelmingly favor.
The last time Congress considered comprehensive health care reform in the early 1990s was during an era when neither party had a party identification majority and the margin between the two parties rarely exceeded four or five percentage points. But in 2009 we are in a different era, with completely different political realities.
A mid-July Washington Post-ABC News poll found the Democrats with a clear 53% vs. 38% party ID edge over the GOP, virtually unchanged since the president was inaugurated in January or elected last November. Yet this same poll showed a decline in the president's overall job performance mark and indicated that only a bare plurality approved rather than disapproved of his handling of health care (49% vs. 44%). To preserve their current partisan advantage, the President and Congress need to pass a health care reform bill that addresses the concerns of their Democratic supporters, not Republicans in or outside of Congress.

Democrats, especially young Millennials, who identified as Democrats over Republicans by nearly a 2:1 margin in a June Pew Research Center survey (56% vs. 30%), are significantly less likely than Republicans and older Americans to even have health insurance. Nearly nine in ten Republican identifiers, but only eight of ten Democrats are now insured. That number falls to less than two in three among Millennials (63%). In stark contrast, 96% of senior citizens (who, of course, already participate in a federal health care program) have health insurance.
Because they are less often insured, and perhaps because whatever insurance coverage they do have may not be as comprehensive, Democrats have greater difficulty meeting and paying for their health care needs than Republicans. As the following table indicates, half of all Democratic identifiers (and non-aligned independents) say they have trouble paying for the cost of a major illness and for health insurance. About four in ten are concerned with having to pay a larger share of employer-provided health insurance and for routine medical care and prescription drugs.






Is each of the following a "major" problem for you and your family?Dem/lean DemIndependent
Rep/lean Rep
Paying cost of major illness51%54%43%
Paying cost of health insurance46%52%36%
Employer making you pay larger share of health insurance38%36%30%
Paying for cost of routine medical care38%42%27%
Paying for cost of prescription drugs37%42%26%



As a result, it's hardly surprising that virtually all Democrats (91%) and 80% of Millennials, but barely half of Republican identifiers (54%) favor "changing the health care system in this country so that all Americans have health insurance that covers all medically necessary care" or that a majority of Democrats (51%) believes that the country is spending "too little" on health care while a plurality of Republicans (46%) believe we are spending "too much." Nor is it hard to understand why few Democrats, especially Millennials, are put off by the possibility of greater federal government health care activity. In a May Pew survey, 69% of Republicans, but only 28% of Democrats and 36% of Millennials, professed concern about the government becoming too involved in health care.
The same July Washington Post- ABC News survey that signaled trouble for Obama on the issue of health care indicated that a majority of all Americans (54%) favor the legislation. This includes three-quarters of Democrats and six in 10 independents, but fewer than a quarter of Republicans.
In spite of claims by Republicans such as South Carolina's Senator Jim DeMint that congressional failure to pass health care legislation could prove to be Obama's "Waterloo," the matter is really an almost entirely Democratic concern. As E.J. Dionne reminded today's congressional Democrats, they "are not living in the Republican congressional eras of 1995 or 2003…they have the strength on their own to win."
Democrats have that strength because the country has entered a new political era, driven by the emerging civic Millennial Generation, in which the Democratic Party is now clearly the majority party within the American electorate and is in position to retain that majority status for decades to come. Most of that Democratic electoral majority personally need meaningful health care reform and expect Congress to enact it. The next several weeks will tell us whether congressional Democrats will take advantage of that new reality or look backward to the old realities of the past. We will soon see if congressional Democrats have the ability and courage to choose wisely and perceptively. The stakes in that decision for the Obama presidency, the Democratic Party, and the nation couldn’t be higher.

Tuesday, July 21, 2009

Generational Health Care Debate

Millennials, young Americans under 28, provided President Barack Obama most of his popular vote margin over John Mc Cain in 2008. Now their belief in the need to involve the federal government in comprehensive health care reform may become the President's most powerful argument in persuading Congress to deliver on that campaign promise this year. But to do so the President will have to overcome some serious differences between members of older generations in both parties, and in both houses of Congress, on just how accomplish that task.

The Senate is almost equally divided between members of the Silent Generation, born between 1925 and 1945 and Baby Boomers born between 1946 and 1964. Recent elections have raised the percentage of Boomers in the lower house to almost three fourths of all members.Of course, partisan allegiance and local politics play an important role in determining a legislator's voting decisions. But the differing perspectives of these two "leadership generations" have already influenced each house's approach to the policy debates on a number of issues so far this year and are likely to do so again on health care this summer.

Democrats in the House of Representatives, for all of their ideological posturing, are actually led by members of the Silent generation, including Speaker Nancy Pelosi (1940), Majority Leader Steny Hoyer (1939), Democratic Whip James Clyburn (1940), Dean of the House John Dingell (1926), and committee chairmen such as John Conyers (1929), Pete Stark (1931), Ike Skelton (1931), Charles Rangel (1932), John Murtha (1932), James Oberstar (1934), Dave Obey (1938), Henry Waxman (1939) and Norm Dicks (1940). The parents of the "adaptive" Silent Generation protected, some would say smothered, members of this generation during the traumatic childhood events of their youth-the Great Depression and World War II. As a result members of the Silent generation are often risk averse as adults and tend to prefer the of bi-partisan compromises that John McCain, a Silent born in 1936, talked about so often during his campaign.

By contrast, almost all of the House Republican leadership is from the Baby Boomer Generation. Boomers are the latest incarnation of what William Strauss and Neil Howe, the originators of generational theory, call an "idealist" generation. Members of this generational archetype tend to believe deeply in their own personal values and seek to use the political process to implement their personal ideological convictions for the whole nation to follow. Because the Boomer generation has been divided about equally between the two ideological poles and parties(half of them voted for Obama, half for McCain in 2008), America has experienced political gridlock for the past four decades.

Boomers have spent a lifetime rebelling against the Silent Generation's belief in institutional allegiance and compromise and will find themselves once again having to accommodate the older generation's sensibilities if they actually want to pass legislation such as health care reform. Democratic Boomers will need to find common cause with the Silents in their party, while Republican Boomers are likely to emphasize their ideological differences from their Democratic counterparts. Republican Boomers will want to demonstrate their ideological commitment to lower taxes and a less active federal government. Moderate Democrats from the Blue Dog and New Democratic caucuses, who share some of these concerns with Republicans, are likely to be more willing to compromise on these issues with their Silent Generation leaders than liberal Boomers might want or be willing to.

In the Federalist Papers, James Madison said that the Senate would be a "necessary fence" against the "fickleness and passion" of members of the House of Representatives. Either George Washington or Thomas Jefferson was reputed to have called the Senate a "saucer" designed to "cool" House legislation. Whether the Senate was meant to be a fence or a saucer, in this Congress it often operates as a generational bulwark against the increasingly hot passions and partisan bulldogs who serve in the U.S. House of Representatives.

The Senate has already played this role during this session of Congress. In the debate on the President's Recovery Act, Silent Generation Senate leaders forced the House to accommodate some of the demands of the Senate's most moderate members. During the course of that debate, House Democrats were able to prevail in the name of party unity on their Senate counterparts to accept a "recission rule" in the budget resolution that would allow Democrats, if they so chose, to ignore the Republican minority and pass health care reform with only 51 votes. But even after that agreement, Silent generation Montana Senator Max Baucus (1941) has been determined to find a bi-partisan bill that his Republican counterpart and Silent, Charles Grassley (1933), can support. Meanwhile, Senator Chris Dodd (1944), thrust into the health care debate due to the illness of Senator Edward Kennedy, has played the very typical role of those born on the cusp between both generations--seeking to find a solution that leans more to his ideological beliefs, but one which still contains an element of compromise for the other side.

But how this inter-generational interplay between the two houses and the two parties will actually play out in the health care debate will depend on how much President Obama uses his instinctive knowledge of what Millennials want to convince the Congress to get something done. Born in 1961, on the cusp between the Baby Boomers and Generation X, the President's generational style is hard to pin down. Liberal Boomers appreciate his idealism and commitment to economic equality.On the other hand, like many Gen Xers, Obama has sought to distance himself from the divisive, ideological debates of the recent Boomer past. At the same time, Obama's political behavior does not square with the harsh and cynical approach of clear-cut Gen Xers like Sarah Palin. Whether it's because of his unique upbringing in Indonesia and Hawaii, removed from the debilitating debates of the 1960s; or whether it's because his chief speechwriter is a precocious Millennial; or because of his intellectual tendency to search for consensus, President Obama's political style consistently seems to capture the very traits that his loyal Millennial supporters most admire.

Millennials are not interested in letting ideological posturing stand in the way of "getting stuff done," as Obama likes to say, especially in an area as crucial as health care. Like the members of other generations, virtually all Millennials (90%) believe that it is time that health care is made more accessible and affordable for all Americans. However, only a third of Millennials, in contrast to about half of those in older generations, are concerned about the impact of greater governmental involvement in the health care system (36% vs. 47%). And, Millennials are far less likely than older generations to prefer once again deferring health care reform to avoid higher taxes or larger deficits.

The fundamental question that members of Congress from each generation, and each party, will need to answer during this summer's health care debate is just how much they want to accomplish as opposed to scoring political points or pursuing ideological agendas. It's a classic question to which members of the Silent Generation are likely to respond with offers of compromise, even while Boomers on both sides of the aisle insist on what they consider to be non-negotiable principles. For Millennials, however, the answer is clear--reform the nation's health care system now as the next step in delivering on the kind of "change we can believe in" that their leader, Barack Obama, promised and now asks Congress to deliver.