NEJM Article Finds That Health Care Is Not Playing A Major Role In 2006 Congressional Elections, But Could Be A Factor In Selected Close Races

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NEJM Article Finds That Health Care Is Not Playing A Major Role In 2006 Congressional Elections, But Could Be A Factor In Selected Close Races

Voters Trust Democrats More Than Republicans On List Of Many Health Issues

A New England Journal of Medicine article to be published November 2 finds that health care is not likely to play a major role in next week’s Congressional elections, but could still be a factor in selected close races.

The article, written by Harvard School of Public Health Professor of Health Policy Robert J. Blendon, Sc.D, and Kaiser Family Foundation President Drew E. Altman, Ph.D., analyzes 11 national opinion surveys, including a fall Kaiser/Harvard survey that shows voters trust Democrats more than Republicans on a wide range of health care issues, from dealing with the uninsured and health care costs to the Medicare prescription drug law to stem cell research. Some of these issues have emerged as salient in individual Congressional races.

The article finds that health care overall ranks well below national security and economic concerns as issues most likely to determine the outcome of the November 7 Congressional elections. In addition, candidates’ stands on the issues are only one of many factors that affect voters’ decisions. Voters’ political philosophy, their party loyalty and the perceived character and experience of individual candidates all play a role. And, this year’s election may be more of a general referendum on President Bush and the Republican Congress than a vote about specific issues.

“Although Americans respond in polls that they are worried about the state of health care in the U.S. today, and especially about the rising cost of their own health insurance, these concerns are not breaking through as a top voting issue in the mid-term election,” Dr. Blendon and Dr. Altman write in the article.

The authors note that there is not a consensus among voters about health care priorities. When asked to say in their own words which health care issues were the most important in their Congressional vote, fewer than a quarter of registered voters in 2006 agreed on any particular issue. The two most frequently cited health care issues were health care costs, including the cost of prescription medicines (22%) and the uninsured/access to care (20%), followed by concerns about Medicare (12%).

Further diluting the mandate for reform right now, the electorate is split along party lines in terms of the saliency of health care to their vote, the study also found. Democratic voters were significantly more likely than Republicans to name at least one health care issue that was important to their vote. Democrats were most likely to cite issues related to the uninsured and access to care (30%), compared with 13% of Republicans. Republicans were most likely to cite issues related to health care costs (20%), comparable to the share of Democrats who cited the issue (23%). Nearly half of Republicans (49%) did not cite any issue, compared with one in three Democrats who did not cite any issue (34%).

“The new leaders of the Congress will find themselves facing scarce new federal revenues, deep partisan division over the direction of health policy and resistance by many conservative members to new health care spending plans,” the authors conclude. “In addition, as we move towards 2008, opposition by members of each party to the other’s health proposals in a presidential election season will intensify. In this environment, significant new health reform initiatives are unlikely, and the Congressional focus will be on incremental policy changes.”

The article, Voters And Health Care In The 2006 Election, is available here.

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The Kaiser Family Foundation is a non-profit, private operating foundation dedicated to providing information and analysis on health care issues to policymakers, the media, the health care community, and the general public. The Foundation is not associated with Kaiser Permanente or Kaiser Industries.

Harvard School of Public Health is dedicated to advancing the public’s health through learning, discovery, and communication. More than 300 faculty members are engaged in teaching and training the 900-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children’s health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit

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