With Election Day almost six months away, no one knows the answers, but top health care analysts, pollsters, and advisers offered insights at a Washington, D.C., forum Tuesday — and some surprising answers. They suggested, for example, that the Iraq War might increase rather than decrease the chances of an overhaul, and that while the public looks to Democrats more than Republicans for answers on health care, Sen. John McCain of Arizona, the presumed GOP presidential nominee, may have embraced an unexpectedly strong strategy in focusing on health costs rather than universal coverage.
Democratic pollster Celinda C. Lake conceded at the forum sponsored by the policy journal Health Affairs that McCain is “very audacious and very smart in leading on cost.” People come to the health overhaul debate as consumers, not altruists, she said. Their gut concern is “what’s it going to do with my coverage.”
Worries about unaffordable care cause insured Americans to cling more tightly to their current health care benefits, she suggested, adding that they are likely to resist proposals that water down their current benefits to pay for universal coverage. Lake also noted that insured Americans can bring the greatest political pressure to bear on the health care debate.
“Ironically, one of the strongest predictors of not voting is not having health insurance,” she said.
Although Americans see health care as a right, they worry about the cost implications of universal coverage, including longer waits for care and less access to doctors, according to Lake. Women — who Lake sees as key to how the next election will turn out and to the fate of health care proposals in the next few years — worry that instead of having 25 minutes with the doctor they will only have 10 minutes.
Americans also want a uniquely American answer to the problems in the health care system. “They recognize that the U.S. system is in crisis, but they seek to improve the system instead of adopting a foreign model,” Lake and her co-authors wrote in an article released Tuesday by Health Affairs. “The majority of America is not fine with going to government health clinics,” she told the forum.

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