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April 14, 2008

With the presidential election coming up in November 2008, an examination of recent public opinion data as well as historical trends can give some insight into the potential role health care might play as an election issue. When it comes to the relative importance of different issues in deciding their vote, health care was one of the top five issues chosen by voters in three out of four presidential elections since 1992, while its ranking varied in congressional elections from 1994 through 2006.

Although the 2008 presidential election is close to nine months away, polls conducted in February provide an early indication that health care may play a role in this election. To provide insight into that role, the Kaiser Family Foundation has issued a new resource analyzing current and historical polling data from Kaiser and from other public pollsters.

Among the findings from the Kaiser Public Opinion Spotlight on Health Care and Elections are:

• As an independent issue, health care ranked third among registered voters in a February poll in terms of the percent of people saying it will be the top issue determining their vote for president in November (named by 21 percent), far behind the economy (43 percent), and somewhat behind Iraq (29 percent).

• While most polls treat health care and the economy as separate issues, Kaiser tracking polls suggest that such discrete categories do not necessarily capture the full picture. For example, in February, similar shares of voters cited health care costs and a number of other specific worries as the most important economic concerns facing their families: high taxes (13 percent), the price of gasoline (11 percent), the cost of health care (10 percent), and problems with getting a good-paying job or a raise in pay (9 percent).

• Trends from publicly available polls show that the share of the public saying that the American health care system needs to be completely rebuilt reached 38 percent in July 2007, close to the measure's peak of 42 percent recorded in 1991 leading up to the 1992 presidential election. This does not necessarily mean the public is ready to support the steps necessary for a complete overhaul, but it is a barometer of growing interest and concern.

• In an interesting shift from the recent past, polling data from February 2008 suggest that younger voters (under age 40) are twice as likely as seniors to cite health care as a top issue in their choice for president this year (27 percent compared with 13 percent). In previous years, seniors were more likely than younger voters to see health care as a top issue in their vote. This shift may be due, at least in part, to the higher prominence Medicare had in discussions and debate of health policy during previous elections.

• On the other hand, the Spotlight shows that health still has a way to go to reach the intensity of public interest generated during the Clinton health reform debate. In 1993, 55 percent picked health as one of the top two issues for government to address, compared with 22 percent in February 2008 -- a higher percentage than in recent years and similar to levels seen during the 1992 campaign, but still much lower than the numbers reached at the height of the last big national debate.

Prepared by Kaiser public opinion researchers, the new Spotlight compiles and analyzes public opinion data from Kaiser surveys and other sources -- including exit poll data from this year's primary election as well as from presidential and midterm elections as far back as 1992. It examines the priority the public puts on health care issues and differences in views by party identification and by age. In addition, it highlights several groups to watch in the 2008 presidential election, including political independents, health-focused voters and the uninsured.

The full Spotlight is available.

For more information, please contact Craig Palosky at cpalosky@kff.org or (202) 347-5270, or Kate Schoen at kschoen@kff.org or (650) 854-9400.