Adwatch: John Edwards and Health Care

by: Matt Stoller

Tue Nov 13, 2007 at 17:12

I like this ad, as it creates a real sense of conflict with the powers in DC.  Edwards makes the argument that if 50 million people don't have health care insurance, then Congress shouldn't either.  Rhetorically, it's a continuation of his Two America's theme, and it's quite populist.  In the last five polls about priorities, health care is a close number two or three to Iraq and the economy among voters. 

Health care, though, is not a monolithic subject; discussing the cost of health care and quality of health care is different than discussing the reach of health care.  The uninsured are younger, poorer, more single, and less white than the population as a whole.  Because of Medicare, the elderly have been taken off the table on the issue, which is a structural problem we should solve since prescription drug gaps and the uninsured are both parts of the same problem.  In other words, the uninsured are probably underrepresented in Iowa already, and are certainly underrepresented in the caucues.

To verify this, I sent an email to pollster Celinda Lake about the uninsured and whether they vote, and her response was interesting.

96 percent of voters in 2006 had insurance. It is one of strongest predictors of turnout.

In other words, it doesn't matter if this ad resonates among the uninsured, because the uninsured tend not to vote.  That may change with the increase in youth voter and single women voting registration efforts, but these efforts are unlikely to impact the Iowa caucuses. 

Will this ad resonate among Iowa caucus-goers themselves?  It's hard to say.  Universal health care is something Democrats believe in as a matter of principle, but a whiter, older, married population of caucus goers is unlikely to take the issue itself into account when choosing their candidate.  The goal, of course, is to tell a story about what kind of President Edwards will be, to draw out a character issue and say that Edwards is with the dispossessed rather than the elite.

I've never thought messaging that plays upon the status of voters as victims made sense, and Edwards's earlier poverty arguments suffered from that problem.  Still, the populism is quite attractive and mitigates the victimization strain.  Clinton, Obama and the DC insiders clearly see this as 'angry' and hypocritical, and perhaps the latter charge makes sense since Edwards has shifted his positions since 2004.  Still, the notion of forcing decision-makers to bear the costs of their decisions is a powerful argument, one we don't hear nearly enough.

My read on the race is quite off, but I think it's a successful ad and a good message.  What do you think?

UPDATE: Century of the Common Iowan says this line got Edwards his biggest applause at the JJ Dinner.

UPDATE;  Celinda emailed me to say that it's 94%, not 96%.

Matt Stoller :: Adwatch: John Edwards and Health Care

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I watched sicko for the first time... (0.00 / 0)
Yesterday.  While I am uninsured the question you should have asked Celinda Lake is how many voters in 2006 were happy with their healthcare.  I was insured in 2006, not now.  Either way I don't like the options.  Healthcare is connected to so many other issues...

And Sicko was about people with insurance (0.00 / 0)
I wouldn't worry so much about 96% of Iowans having health insurance. People with insurance aren't very satisfied with their insurance companies. They may or may not sympathize much with being uninsured, but they do know something is seriously wrong with healthcare.

[ Parent ]
you're right (0.00 / 0)
it's too bad none of the major candidates has a health plan that actually fixes the problem.

[ Parent ]
Not so sure (0.00 / 0)
From what I've read, most people actually do like their health insurance, which is why some proposals go to great lengths to say they don't have to change.  However, these same people are very fearful of losing their insurance and understand that prices are out of control.  All this makes the political landscape difficult.  Add in the special interests and it gets really complex and hard to fix.

[ Parent ]
Fighting for the Uninsured Not a Winning Issue (0.00 / 0)
"To verify this, I sent an email to pollster Celinda Lake about the uninsured and whether they vote, and her response was interesting.

  96 percent of voters in 2006 had insurance. It is one of strongest predictors of turnout.

In other words, it doesn't matter if this ad resonates among the uninsured, because the uninsured tend not to vote.  That may change with the increase in youth voter and single women voting registration efforts, but these efforts are unlikely to impact the Iowa caucuses." 


In 2004, I applied to work as a campaign manager for a state rep candidate who wanted to make uninsured one of her big issues in the campaign. I told her this was a terrible idea. I told her that while I agreed that insuring the uninsured is indeed a noble cause and one that I wholeheartedly support, it does not get you more votes in a political campaign. She disagreed, and didn't hire me because of this.

She lost, ran again in 2006 on the same issue, and lost again even when she had 4 times the resources she had in 2004 and a huge amount of local momentum favoring Democrats. I am sure this is not the only reason she lost, but it is reassuring to see that I was not talking out of my ass when I told her that fighting for the uninsured is just not a winning issue.

Perhaps it will turn out differently for John Edwards. I'm not holding my breath.

healthcare (0.00 / 0)
Perhaps the first thing Edwards should do is stop proposing unconstitutional measures in his campaign ads.  Per Cass Sunstein, this is a crock.

Sure doesn't help the credibility much.

OK (0.00 / 0)
First you state Gary Hart is a founder of the DNC, and now you quote Sunstein to say that Edwards' proposal is a crock? Sunstein confirmed the legality of it.

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[ Parent ]
People change and grow from their experience (0.00 / 0)
Edwards has grown from his experiences, just as Al Gore has grown from his.  I liked what I saw at the Democratic Party convention in San Diego last spring - he's sincere in his populism.

The ad is good from my perspective.  Whether it plays to the votes he needs is only a question of whether this country's people are ready for a strong, populist leader who will serve them well.

Right now, based on the numbers people are throwing around about the uninsured not voting, plus my own observations about the rank stupidity and apathy of the American people over the past 15 years, I don't know if the American people deserve John Edwards.

I have insurance (4.00 / 2)
until I leave or lose my job.  That is most likely true of most insured Americans.  There is no security to any of our health insurance, even Medicare, since it covers so little and filling in the blank spots gets more expensive every year.

And, I have insurance, yet I will vote for John Edwards, and work for him, because I too care about my fellows.  I don't vote just for me, because without my community, my nation, my planet being healthy, my health is worth shit. 

Sometimes I think we forget that we aren't Republicans, who truly only vote for themselves and the devil take the hindmost.

I think this ad helps Edwards (0.00 / 0)
with people who worry about losing their insurance in the future, as well as Democrats who are very concerned about social justice issues (especially liberals and Catholics).

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[ Parent ]
Iowa and NH polling (0.00 / 0)
shows two things:
1.  It is the second most important issue
2.  It is the issue where Hillary has her biggest net advantage over the other candidates.

Some recent polls:
CBS - in Iowa, Healthcare was the issue voters most wanted to hear about, with 24% choosing it (War/Peace was second at 19).  In NH it was the second most issue (22% choose it versus 24% for War and Peace.  When asked what was the most important issue in determining their vote, Health Care was second in both Iowa and New Hampshire (first was the war in Iraq)
UNH/Boston Globe Poll - found 33% said Health Care was the most important issue.  Health Care was the number 1 issue.

I cannot find data on the second point - though I remember seeing it in either a UNH of Franklin Pierce NH poll.

Why Healthcare matters (0.00 / 0)
Why most voters care about? I don't know if my links below work, but here's why and why it's not a 'victim' issue (althogh that alone is an interesting choices of words for a 'progressive' to use):

To start, I think it's important to understand where Americans are on healthcare. I provide below a few links:


This research is fairly old. It is succinct. Here is an important excerpt that should be understood in any real discussion about what the American people have been saying on this issue:

"The public wants the government to play a leading role in providing health care for all. For example, in an October, 2003 Washington Post/ABC poll, by almost a two-to-one margin (62 percent to 33 percent), Americans said that they preferred a universal system that would provide coverage to everyone under a government program, as opposed to the current employer-based system. Similarly, in Kaiser polls from 1992 to 2000, a large majority of the public agreed that the federal government should guarantee medical care for people who don't have health insurance. In a slightly different question asked more recently by Kaiser in June 2003, more than seven in ten adults (72 percent) agreed that the government should guarantee health insurance for all citizens, even if it means repealing most of the tax cuts passed under President George W. Bush, while less than one-quarter (24 percent) disagreed with this statement. Finally, the last time Gallup asked whether the federal government should make sure all Americans have health coverage, they agreed that was a federal government responsibility by 62-35 (November, 2002)."

I want to emphasize the important number again- 62 percent want a universal system of some kind. The specific details differ, but not the core value of healthcare for all.  There will be those who say this may have changed. Here is a more recent link:

http://www.cbsnews.c... 1/opinion/polls/main2528357.shtml

Here is part of the key finding:

"Nine out of 10 say the system needs at least fundamental changes, including 36 percent who favor a complete overhaul."

I want to repeat that again to you- 9 in 10.  So over the last few years, these numbers suggest the desire for fundamental changes--including universal coverage has only intensified.  I imagine people can come up with any number of reasons to ignore the polling data, but what of the actual system itself?

By the way, this is not a corporate versus us thing. This isn't a big business versus union discussion. Wal-Mart (which has it's own reason for wanting a free rider situation but that's another matter) joined with union leaders for some kind of fundamental overhaul.  Back in 2004 big business took out ads in support of change. So- who is against change? This is a big healthcare insurance company versus everyone else in America thing. It's really this simple- too much money lining too many pockets. Including the Democrats.

The fact is that we pay twice as much for our system, but according to various studies we achieve outcomes that are worse than the cheaper systems abroad. Let me repeat that- we pay twice as much for less benefits.  If you want to know more, see this link:

If you are curious, you can Google "quality of American healthcare system versus cost compared to other countries", and see the rather sobering litany of reports.

Even if one has health insurance, one is looking at an inflationary rate as follows:

"Premiums for employer-based health insurance rose by 7.7 percent in 2006. Small employers saw their premiums, on average, increase 8.8 percent. Firms with less than 24 workers, experienced an increase of 10.5 percent (3)"

For a full picture of cost, see this link:

Indeed, entrepreneurs, small businesses and freelancers- the lifeblood of the American dream- were hit hardest. One cannot care about the middle class and not care about this issue. Let me repeat that- if you don't care about healthcare, you don't care about the middle class (much less the poor). 

Here is where it gets complicated (0.00 / 0)
In 1994 Vermont Governor Howard Dean was given a fairly large grant to try and develop  UHC program in Vermont.  There was significant momentum behind the effort (I was living there at the time).

And yet, in one of the most liberal states in America, it failed.  There were two reasons, only one of which is relevent here.

People don't like the system. You are dead right. But if you ask them if they are happy with their doctor, and their treatment, the polling changes dramatically.  People don't like the system, but they DO like their Doctor.

And this is where the trouble begins.  UHC opponents in Vermont were able to argue that not only would the system be changed, but the relationship between patient and doctor would be changed. It is this complexity that is frequently missed in the polling, and is at bottom why Hillary failed in '94, Dean failed in '94 and why the referendum in Oregon that proposed a cigarette tax to pay for UHC went down in flames.

Don't get me wrong - I am absolutely for UHC.  But the fight for it is substantially more complicated than the polling indicates.

[ Parent ]
What year is it? (0.00 / 0)
I don't mean to be rude, but you cite a 1994 example as to how Americans who have been through hail since 1994 think? History has its place, but its also can be a hiderance when you aren't listening to people anymore, but instead favoring that history overwhere they are now. None of us, including the American voters are where we were in 1994. In 1994, I was in favor of free trade and would shout down a union rep if he said it was bad. Things changed.

[ Parent ]
One other thought (0.00 / 0)
Your post is indicative of why the party seems perma stuck. Again no rudeness intended here, but you are using past loses as an indicator of where the country is now. What if Reagan had used Barry Goldwater's failures or those of Nixon as a benchmark for where he thought the country was rather than understanding that in actuallity the country had changed in the conservative favor. America in 1994 was still in love with the Reagan revolution-indeed even in the bluest parts of this country the closest we really came to liberal was Clintonism of which I was an avid ahdherent unable to articulate what was wrong with it. Time passed, life changed, and people changed. Now we have people like my friend a GOP woman who is ardently conservative in favor of healthcare at the very least unlong the lines of OBama but she would prefer something even more radical. I believe the Democrats do not, absolutely do not , understand where the American people are on this issue.

[ Parent ]
You are not being rude (0.00 / 0)
And all I meant to say is that this is more complicated than might appear.

Don't get me wrong, I am for UHC, and I would put in near the top of my agenda.  In fact, I think it is why the Health Care proposals from Edwards, Clinton and Obama look they way they do. They are consiously trying to AVOID the mistakes that were made in the past.

But that in itself is creating a problem.  Because none of the is embracing some form of single-payer, their proposals are, I think, not what I would like them to be.  Most people don't know what single payer means in my experience, but it has policy advantages that are not in any of the leading candidates plans.

[ Parent ]
hope this works this time because I really found your posting dismissive (0.00 / 0)
Sorry this is not net neutrality or some other side issue, but its something that does affect most Americans now.

Reposting the links and hope it works this time because it provides context without the political class arm chair analysis:



The Iowa applause means a lot more than the pollster (0.00 / 0)
It's not that the pollster is wrong -- I'm sure she's right, though that statistic is pretty startling.

But in politics, especially presidential politics, and especially primary politics, self-interest is not often the determinant of voting behavior. Many conservatives vote because of abortion or gay marriage, but the laws they seek to pass could never help them. And much of the Democratic activist base are white, educated, relatively comfortable. Standing up for minorities, immigrants, the poor, the uneducated (not to mention the Iraqi people) has nothing to do with self-interest -- they do it because they think it's right.

I like a candidate for president who's version of "right" looks like mine, and doesn't care to stop at what's expedient.

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