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Hoping to attract many of the hundreds of reporters in town to cover Tuesday’s first-
in-the-nation presidential primary, the American Citizens’ Foundation held a press briefing
yesterday to promote its ongoing campaign to put health care atop the 2012 election agenda.
Heartened by its share of the credit for the bipartisan compromise that produced the
Social Security Reform Act of 2009, the group now hopes to enlist the public in an effort to
make the health care issue the centerpiece of what is shaping up to be hotly competitive race
for both the Democratic Party nomination and the White House.
The ACF began pressing the 2012 candidates to embrace the issue last August. So
far, neither surprise Iowa Caucuses winner Senator Hillary Rodham Clinton (D-NY) nor
New Hampshire front runner Senator John Edwards (D-NC) has made health care a top
priority. But the ACF’s ambitious national advertising campaign has apparently made some
headway with voters. Polls predating last summer’s ACF campaign launching showed that a
plurality of Americans—25 percent in a July Gallup poll--already regarded the twin
concerns of health care access and cost as “the most important problem facing the country.”
The most recent surveys indicate that concern is increasing. The issue currently ranks third
behind the latest crisis on the Korean Peninsula and inflation, both of which have recently
dominated the news.
The health care debate has been marked by intense ideological conflict for nearly
two decades. Following the Republican defeat of the Clinton Administration universal
coverage initiative in 1993, private-sector employer-provided insurance that featured
managed care programs such as HMO’s and preferred provider organizations (PPO’s)
increased in importance. By the end of the 1990’s such programs had expanded to cover
more than 150 million people nationwide. Managed care was credited with helping to bring
down the rate of increase in health care costs. But both doctors and patients complained
about cost-cutting pressures and denial of services by program administrators. Meanwhile,
increasingly expensive premiums, cutbacks in employer coverage and cyclic spikes in the
unemployment rate sometimes swelled the ranks of the uninsured above 60 million people.
Competition for the votes of seniors brought what would have been the largest
expansion of Medicare since its 1965 inception to the point of passage in 2003 when
overlapping $400 billion bills proving prescription drug assistance passed each house of
Congress. But the bill died when a conference committee was unable to resolve ideological
differences between Senate Democrats and House Republicans over reliance on private
competition versus government regulation. The same basic dispute ended the 1993 Clinton
initiative. And similar disagreements threaten the chances for legislation that addresses the
health care access and affordability problems the ACF is pressing in 2012.
Since 2003, the problems have continued to worsen, as have the prospects for
bipartisan compromise. Bush Republicans kept control of the White House in 2004 and
2008. But a razor-thin margin of Republican control of Congress after 2004 and the capture
of the Senate by Democrats in 2008 have prevented significant movement on either
prescription drugs for seniors, the growing number of uninsured, or spiraling health care
costs. At the press briefing Foundation spokesperson Olympia Snowe pointed to this
Convention