Monday, November 3, 2008

How will we know if the 2008 election created a "mandate" for health reform?

By the end of the day tomorrow, we should know who will be the new President of the United States come January 20th. We should also have a pretty good idea of how many seats the Democrats and Republicans will gain or lose in the new Congress.

How will we know, though, if the election produced a voter mandate for health care reform?

I will post some preliminary thoughts on Wednesday. It is likely, though, that it will be weeks, even months, before we know how the new President views his mandate.

Still, there are things you can be looking for tomorrow.

Drew Altman from the Kaiser Family Foundation describes the four stages of what he calls "the critical path to health reform." The first stage is the general election, for which he poses two questions:

1. Was there "a big debate on health care" that elevates the issue and engages the public?
2. If there was a big debate, do the exit polls show health care was a voting issue, sending a message to politicians that is strong enough to create a mandate?

In my view, the answer to the first question is a guarded yes. Health care reform was a major issue debated by Senators McCain and Obama. The candidates presented voters with radically different views on how to move forward.

How engaged the voters were, though, is less clear. Kaiser's own October health care tracking poll found that "the rising tsunami of economic problems swamped health care and every other issue to dominate the agenda in the weeks before the November vote. Health care remains roughly tied for second, but this ranking is somewhat misleading: it is 50 percentage points lower than the economy, as is the other former top tier issue -- Iraq."

So tomorrow, look at what the exit polls tell us about health care. Then stay tuned for the next stage in Dr. Altman's path: the new President, and whether he makes health care a priority and exercises leadership on this issue.

As the votes come in on Tuesday, post your comments on what you think the election means for health care reform. (But please, no partisan attacks on the candidate you don't like!)

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