Candidates' views on healthcare reform important but not crucial in Iowa

Iowa voters likely will use healthcare to gauge a candidate’s view of the role and size of government but not choose a candidate’ based on solutions to healthcare issues, according to Dr. Peter Damiano, director of the University of Iowa Public Policy Center in Iowa City. The center provides interdisciplinary academic research in health care, human factors and transportation and housing policy.

Damiano offered some insights on the role of health reform and healthcare issues in the run-up to the Iowa caucuses Jan. 3. Damiano also is a professor of preventive and community dentistry at the University of Iowa.

Q: How are healthcare issues influencing Iowans choices in the caucuses?

A: For healthcare issues that people are thinking about for the caucuses, I think at this level it’s going to be much more the global healthcare reform, or ObamaCare, or whatever term you use, and how people feel about that, for whether that’s going to influence which caucus they’re going to go to and which candidate they may support.

Q: Is there a general sense of how Iowans think about health reform?

A: My impression is that it’s like in most places. You’ve got a group that is supportive, some that say it is evil, and then most people who just don’t really understand — and you have that in both groups — the specifics and what’s in the law and when it’s coming. It’s very difficult for anyone to understand the issues in healthcare reform, which are both complex and personal. So the way you end up feeling about it from a political perspective is even more challenging in a lot of ways than something like Wall Street reform or some other complex policy issue.

Q: Whoever wins the caucuses, will their view of healthcare contribute to their victory? 

A: Because the caucus goers tend to be people a little more at the fringe of both parties, those are going to tend to be, this time for the Republican Party, to think of the health reform law more as evil. For those who believe that’s a central issue or a reflection of a candidate, I think Mitt Romney will be the person who will most get hurt by that and somewhat by Newt Gingrich because there is evidence that both supported a proposal that had an individual mandate component. That’s one of the pieces that people are most upset about here. I think the real question is where does healthcare reform and healthcare in general rank relative to the other issues on which they are voting. My sense is that if you ask people about it, it is not necessarily that high in and of itself, but it gets at their underlying doctrinal belief level about a particular candidate or party, their different approaches to the size and role of government. I think that’s where healthcare is going to be probably more influential and in ways that you may not necessarily pick up when you ask about issues. I don’t think it’s as central in their thoughts, but I do think that it reflects on their perception of the role of government.