Health care is shaping up to be the most important issue in the United States for the first time since the early 1990s in the coming election. It is an issue that all the Democratic candidates have been addressing here in Iowa and one that they will continue to address until the caucuses. A recent New York Times poll gives a lot of perspective about how the candidates are and should be addressing the issue. According to the poll, 90% of Americans think our health care system needs either fundamental changes or to be completely rebuilt and a disproportionate percentage of Americans, 62%, trust Democrats to improve the health care system. One may think this is an easy chance for Democratic candidates to push a massive reform like a single payer health care system but popular opinion about health care reform is much more complex than it seems.
64% of Americans think the government should guarantee health care for all Americans, which is an increase of 10% since 1996 and by a 2 to 1 margin, Americans think its worth paying higher taxes so everyone can have health insurance. When asked on the details of health care plans, Americans favor a single payer solution over the current model by a margin of 47 to 38 percent. However there is a big gap between how people percieve health care in general in the U.S. and their own individual health care coverage. While 57% of Americans are somewhat or very dissatisfied with the state of health care in the United States, only 20% of Americans are somewhat or very dissatisfied with their own health care. This trend also holds with the cost of health care. A whopping 81% of Americans are somewhat or very dissatisfied with the cost of healthcare in the U.S. but only a bare majority, 53%, are dissatisified with the cost of their own health care.
Only one candidate has introduced a health care plan so far, John Edwards. His health care plan tries to balance the concerns expressed in the poll of universal coverage without affecting people who already have health insurance. Unfortunately, it comes across as a little complex as a result. The poll results belied this. People who expressed an opinion about it favored the plan by a margin of over 2 to 1. However, nearly half of all poll respondents were unsure, which is a sure sign that it confused a lot of people.
This deftly illustrates the problems that candidates face. When like John Edwards, or Bill Clinton in his first term, they fix our dysfunctional health care system while taking into account the relative satisfaction that individuals feel about their personal health care plans, the result is confusion. However, if you try to set up a single payer plan, it makes people afraid that they will lose their health care. The result gives a candidate two difficult choices between what type of health care plan to propose. John Edwards has already picked one option and it will be interesting to see what the other candidates do.
In January, we posted the complete list of how many caucus delegates each county would be apportioned in the caucuses. However, as Drew points out on Bleeding Heartland, the IDP has reduced the total number of delegates from 3000 to 2500. As a result, the number of delegates from each county at the State Convention has been reduced accordingly. Here’s the corrected list:
County Delegate
1 Polk 357.0258199
2 Linn 202.1855356
3 Scott 141.5583295
4 Johnson 136.9502264
5 Black Hawk 116.9633193
6 Dubuque 89.53813553
7 Story 76.49680278
8 Woodbury 67.55177384
9 Pottawattamie 54.72432734
10 Clinton 45.83467967
11 Cerro Gordo 45.67426497
12 Des Moines 41.19029231
13 Dallas 38.58355352
14 Warren 37.41290819
15 Jasper 34.56172796
16 Lee 33.74437689
17 Webster 32.34265801
18 Marshall 31.88624001
19 Muscatine 31.4431899
20 Wapello 31.08798593
21 Boone 23.89606044
22 Benton 22.94694017
23 Marion 22.52298704
24 Bremer 21.24157918
25 Jackson 19.54385699
26 Buchanan 19.5419473
27 Fayette 18.29109462
28 Jones 17.68190071
29 Winneshiek 17.52339572
30 Poweshiek 17.42982048
31 Cedar 16.1751484
32 Clayton 16.14459322
33 Tama 15.73209829
34 Carroll 15.66525884
35 Washington 15.62897456
36 Floyd 15.49147625
37 Jefferson 15.05224554
38 Delaware 14.68367368
39 Dickinson 14.21770718
40 Henry 14.12604164
41 Hardin 14.09357677
42 Kossuth 14.01718882
43 Hamilton 13.64288786
44 Plymouth 13.45764708
45 Iowa 13.36980094
46 Winnebago 13.11390131
47 Chickasaw 12.86945987
48 Mahaska 12.80834951
49 Buena Vista 12.30227934
50 Madison 12.0521088
51 Clay 11.7446473
52 Allamakee 11.61860719
53 Butler 10.81271432
54 Appanoose 10.55872438
55 Crawford 10.28181806
56 Wright 10.12331307
57 Harrison 10.01636994
58 Cherokee 9.55422284
59 Mitchell 9.525577359
60 Cass 9.145547308
61 Union 8.914473759
62 Guthrie 8.876279784
63 Howard 8.845724604
64 Hancock 8.773156052
65 Palo Alto 8.377848411
66 Grundy 8.366390218
67 Greene 8.290002268
68 Clarke 8.032192937
69 Worth 8.005457155
70 Calhoun 7.925249807
71 Shelby 7.923340109
72 Keokuk 7.881326736
73 Louisa 7.864139447
74 Franklin 7.818306677
75 Monona 7.659801681
76 Sioux 7.465012409
77 Page 7.457373614
78 Mills 7.428728133
79 Humboldt 7.405811748
80 O’Brien 7.331333497
81 Sac 7.23393886
82 Lucas 7.014323504
83 Emmet 6.808076039
84 Adair 6.491066047
85 Monroe 6.483427252
86 Decatur 6.45669147
87 Davis 6.187423946
88 Montgomery 6.007912264
89 Pocahontas 6.002183167
90 Audubon 5.4942033
91 Van Buren 5.41781535
92 Fremont 5.140909032
93 Wayne 4.678761934
94 Taylor 4.648206754
95 Ida 4.556541215
96 Ringgold 4.537444227
97 Lyon 4.275815498
98 Adams 3.439367447
99 Osceola 3.082253781
The Politico has this profile of the head of the far right Iowa Christian Alliance, Steve Scheffler. Scheffler has become a major player in Iowa Republican politics over the past six years as the far right has reasserted its dominance over the Republican Party of Iowa as Democratic majorities in both houses of the state legislature, Iowa congressional delegation and our control of the Governorship attest to. Scheffler brags in the article that three quarters of the Republicans who show up to caucus “will be down the line on life, immigration, marriage and spending.” Aside from that fact that these aren’t all typical social conservative hot-button issues, it gets to the question of what the actual composition of the caucus crowd will be.
Every candidate tries to draw out special niches that they think that they will get a lot of support from. In 2004, as Roger Simon’s classic piece about the caucuses noted “Dick Gephardt targeted family farmers; Howard Dean went after the young and disenchanted; [John] Kerry pursued veterans.” With both parties holding highly competitive caucuses, there will be a lot of competition for both groups. It’s fair to say though that we can tell some of the core demographics that candidates will go after in 2008. McCain will go after veterans (and Giuliani may too), Romney will go after fellow Mormons (there aren’t a lot in Iowa but enough to make a difference), Huckabee and Brownback after fellow evangelicals (perhaps special denominational focuses after Protestants and Catholics respectively). All the candidates will go after people in all of these communities but there are some communities where they have a more significant appeal. So why does this matter? Because every person who goes to the Republican caucuses is someone who cannot go to the Democratic ones. In 2004, the fight for the Republican nomination was not competitive. This meant that only diehard Republicans attended the caucuses. In 2008, both parties will feature highly competitive primary battles. That means there will be big advantages for candidates whose niche voters are also their party’s base voters. Of all the candidates mentioned, this has big ramifications for John McCain, his special appeal is with veterans and he will probably try to emulate John Kerry’s strategy of wooing veterans in 2004. Kerry was able to attract quite a few veterans who were Independents and Republicans to come caucus for him in 2004. The problem for McCain is, many Democratic veterans will be participating in the Democratic caucuses. Another problem is that all the Republican veterans who showed up to support John Kerry will getting harassed by Democratic candidates as well, since they showed up to a previous Democratic caucus. This means that they’ll be getting a ton of phone calls from Democrats, which will drown out any attempt by McCain to reach out to them. This puts McCain at a disadvantage and it makes more likely that a right winger will triumph in Iowa on caucus night.
