Health Care Reform: Caddell and Schoen Have It Wrong

A few crocuses have braved the snow, but it's been a long winter in Washington. It started in August, with the town hall meetings on health care reform. The latest icy blast was the March 12 Washington Post opinion piece ("Democrats' Blind Ambition") aimed at Obama and congressional Democratic leaders by Democratic pollsters Pat Caddell and Doug Schoen. They make many points we have made, but miss the signs of spring.

We pointed out last June that Democrats were cherry-picking the polls to argue that Americans supported the House of Representatives' health reform bill, so we can hardly argue with Caddell and Schoen on that point. Nor can we dispute their view that Congressional Democratic leaders are "out of step" with the public, since in December and January the public told us the Democrats were not "out in front" but "out of touch."

Moreover, our data support their assertion that most Americans want health care reform, but not the House and Senate bills. And yes, the naysayers feel more strongly than the supporters. And yes, Americans are more concerned about jobs and federal deficit-spending than health care reform, as we reported last month (though reform outranked homeland security, education, and the environment.)

But Caddell and Schoen go further, castigating the Democrats'

...blind persistence...Democratic politicians and their media supporters deceive themselves into believing that the public favors the Democrats' current health-care plan...Never in our experience as pollsters can we recall such self-deluding misconstruction of survey data.....Unless the Democrats fundamentally change their approach, they will produce not just a march of folly but also run the risk of unmitigated disaster in November.

They miss two points: just after the summit we asked Americans to compare the Obama plan to a specific alternative (the Republican House plan) and listed the main provisions of each, Americans were evenly split. In six previous surveys we had asked how they liked the House or Senate bills compared to no bill, or starting over. The bills were always poorly rated, and most favored a fresh start. But asking the question using Obama's name, and a specific Republican alternative, yielded a dead heat.

Second, when we asked which party (in the health debate) is putting the nation ahead of politics, most Independents (who, by the way, prefer the Republican plan), and almost half of Republicans, chose the Democrats!

For this reason we think there is still some chance that a few brave Republicans will re-engage on health care reform, especially if the Democrats are willing to return to the drawing board, as Schoen and Caddell are urging them to do. We agree with them that,

There are enough Republican and Democratic proposals -- such as purchasing insurance across state lines, malpractice reform, incrementally increasing coverage, initiatives to hold down costs, covering preexisting conditions and ensuring portability -- that can win bipartisan support.

We don't agree that Democrats will get all the blame whether the Obama plan passes or fails.

Americans credit Obama with walking into the lion's den at the recent meeting of House Republicans in Baltimore. He went without his teleprompter, made his case, and handled tough questions with authority and generosity, without notes or aides. (It brought to mind the story of Jack Benny, alone on the railroad platform, encountering Bob Hope and his retinue: Hope got off a line at Benny's expense; looking forlornly from side to side, Benny replied, "you wouldn't get away with that if my writers were here!").

The next week, in the seven hour summit, Obama again demonstrated not just his understanding of the legislation but also of the legislators, in the process setting a new standard for civil political debate, and showing Obama single-handedly urging legislators to find common ground.

This week he has barnstormed the country, showing an un-feignable passion and commitment to health care. Even his opponents - and supporters who think him too quick to compromise - must now admit "there's no quit in him."

Like his silent midnight visit to Dover Air Force base to salute the remains of our fallen, his efforts on health care show he is not just someone who can read a teleprompter. Though he is frustrating his liberal base with his policy compromises, and frightening Democratic moderates with the prospect that his health plan could cost them the House or Senate in November, he is winning the unconscious battle for the respect of Americans. He is showing the "damn the polls, full speed ahead" purpose that pundits see as folly, but Americans see as strength. Like Reagan's "Mr. Gorbachev, tear down this wall," or George W. Bush's surge in Iraq (Casscells - Yes; Zogby - No), its unpopularity will give way to respect.

When the dust settles, whether ObamaCare passes or not, Americans will sense that Obama cared. He cared enough to compromise - until he was cornered, and came out fighting. Besides, Republicans will have to face voters in the Fall and show that they did something (saying "no" is not a plan); at the same time, the Democrats who have committed to health care reform have taken their beating, and this is not the time to back down lest they look like wimps.

If unemployment is falling in November, the missteps on the road to health reform will be forgiven. But if some form of health reform does not pass by then, incumbents of both parties will be out in the cold, wishing they had met in the middle, when the crocuses were in bloom.

S. Ward Casscells, MD, the Tyson Distinguished Professor of Medicine and Public Health at the University of Texas at Houston, was Assistant Secretary of Defense (Health Affairs) from 2007-9.

John Zogby, Chairman of the Board of Zogby International, is the author of "The Way We'll Be: The Zogby Report on the Transformation of the American Dream."

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