Donald Trump

Health Care Concerns Run Deeper Than Politicians Realize

The current national political debate over health care reform may run deeper in the electorate than ensuring universal access to health insurance. Americans with health insurance are concerned about rising costs, surprise hospital bills and long-term care expenses.

The current national political debate over health care reform may run deeper in the electorate than ensuring universal access to health insurance. Americans with health insurance are concerned about rising costs, surprise hospital bills and long-term care expenses.

The national political debate on health care is stalled on access to health insurance. Politicians may be smart to stop and listen to concerns by Americans with health insurance about higher deductibles, rising medical costs, surprise hospital charges and uncovered long-term care expenses.

Americans are feeling the pinch of escalating health insurance premiums and medical costs. This expands the anxious audience to people with health insurance as well as people with no coverage.

The political potency of health care costs was demonstrated in the 2018 mid-term elections as Democrats swept back to control in the House. The issue is expected to loom large again in the 2020 presidential election.

The debate, which rarely descends below the superficial, pits Medicare-for-All against a vague promise from Republicans of something great and affordable. President Trump has pledged, as he has before, to unveil major health care legislation in the next few months. Expectations aren’t high.

Oregonians have learned that discussions about universal access to health insurance must be accompanied by a serious conversation about how to control health care costs. Access to an unaffordable health care system isn’t materially different from no access to health insurance when it comes to paying huge bills.

Former Oregon Governor John Kitzhaber provided teachable moments on confronting costs embedded in the health care delivery system – long-term care for low-income older adults, lack of behavioral resources, inefficiency in treating chronic disease and failure to address social determinants that lead to a lifetime of outsized health care costs.

As prescient as Kitzhaber’s perceptions have been, health care costs in Oregon and elsewhere continue to rise. And the health care delivery system remains uncomfortably uncoordinated and sub-optimized, as even health care professionals acknowledge. 

Democratic presidential candidates have jumped on health care as a seminal 2020 campaign issue. However, the political cure Democrats offer may miss the mark.

“The Democrats’ emphasis on Medicare expansion plans is partly a missed opportunity and partly a reflection of the slice of the electorate that participates in Democratic primaries,” according to pollsters and political strategists. The concern of a majority of actual Democratic voters in 2020 may center instead on issues such as the price of drugs like insulin, exploding co-pays, unaffordable health insurance premiums and the uncovered costs of long-term care for older adults.

The efficacy of health care on the campaign stump has prompted President Trump to return to the issue, which previously resulted in an embarrassing loss on the Senate floor when the late Senator John McCain torpedoed a GOP-backed repeal of Obamacare. It remains questionable whether Republicans can identify a center-point on how to move beyond the Affordable Care Act.

Democrats stand on the same political quicksand. Senator Bernie Sanders has pushed his Medicare-for-All legislation, which would cashier private health insurance, expand existing Medicare benefits and require substantial additional revenue. Moderate Democrats have pitched a public option under Obamacare to create competition for private health insurance plans. There are variations, often with vague details, somewhere in between. 

Rising prescription drug prices also have galvanized American political discontent. Trump has flirted with actions to reduce drug prices, but has achieved nothing definitive to brag about, at least so far, heading into the 2020 election. Congress is acting on bipartisan legislation to address prescription drug prices, but it is too complex to translate into news coverage or the national consciousness. Drug pricing has risen to the level of a special work group evaluating the US-Mexico-Canada trade agreement.

Tellingly, Senator Elizabeth Warren, easily the most cerebral 2020 Democratic presidential candidate, has a “plan for that” for almost every issue except health care. She has stopped short of embracing Medicare-for-All. Her hesitancy is perhaps the surest indicator that health care reform is a systemic idea requiring a sophisticated response that doesn’t fit on a bumpersticker.

The big idea for health care reform in Congress may remain a puzzle or, if known, a hidden secret. Chances are the ultimate successful idea will need the embrace of significant parts of both political parties. Its revelation is unexpected along the 2020 presidential campaign trail.

However, the 2020 electorate may erase any doubt Americans of all political stripes want a national health care system that is better than the patchwork system now in place. The presidential election may serve as a political sounding board that health care should rise above partisanship. A logical, sustainable response would require the forbearance of both political parties – and partisan apologists.

The American solution to health care may not resemble anything anywhere else. Its test will be whether it delivers affordable and accessible health insurance, health care delivery, prescription medications and new technology. It is a tall order, but the person, political party or organization that conceives of that system may reign supreme in the public’s mind for a generation or more. 

As flawed as Obamacare may be, it stands as a testament that any improvement can be a legend-making milestone.

 

Looking Behind the Trust in Family and Friends

A recent poll indicates people trust family and friends, and barely anyone else, for political information, which begs the question why when many families and friends shun political conversation. The answer may lie in the continuing and consuming culture war that has made people skeptical of everything, so they trust who they know, even if they disagree.

A recent poll indicates people trust family and friends, and barely anyone else, for political information, which begs the question why when many families and friends shun political conversation. The answer may lie in the continuing and consuming culture war that has made people skeptical of everything, so they trust who they know, even if they disagree.

Politics may be verboten at family dinner tables and social occasions, but a recent poll shows the most trusted sources of political information are family and friends. Super PACs and candidate political campaigns are the least trusted.

Seventy-one percent of respondents in the online poll conducted in August say they trust friends and family a lot or somewhat, dwarfing the news media in second place at 46 percent. Trust in businesses registers at 44 percent, the Democratic Party at 39 percent and the Republican Party at 35 percent. Super PACs trailed at 17 percent.

A key finding showed only 42 percent of respondents trust major companies to behave ethically, which is down from 47 percent in a similar poll in 2017. Only 9 percent say they have a favorable opinion of major companies, which barely tops the 7 percent favorable rating for the federal government.

Conducted by Morning Consult for the Public Affairs Council, the poll found only 10 percent of respondents have a favorable opinion of President Trump’s tweets, 17 percent don’t understand his criticism and 41 percent say it doesn’t change their opinion. Interestingly, slightly more Democrats admit reading Trump tweets than Republicans.

If family and friends are who we consider most trustworthy, why do family members and friends find it so hard to talk about politics, especially when they fall into different ideological camps? There probably isn’t a simple answer. Most likely the answer has something to do with shared experience, if not shared perspective. 

This graphic illustrates the irony of trust in political figures who routinely lie and trash the news media and political opponents.

This graphic illustrates the irony of trust in political figures who routinely lie and trash the news media and political opponents.

Families have a common heritage and history; friends a common school or set of interests. Achievement or lack of achievement can be a binding life experience. People tend to trust what they know. Family members may be disagreeable and even unreliable, but family members may know when not to trust Uncle Bud when he criticizes a particular political person or party. The same holds true for friends whom we may trust even if we disagree. 

The troubling part about the Morning Consult findings, which echo other similar findings, is that people largely distrust every other source of political information. A significant percentage of Americans believe news outlets publish inaccurate or biased stories. A low opinion of corporations, political parties and political institutions such as Congress have been acknowledged for some time, and the lack of trust in them continues to decline.

Ironically, this is the ferment that breeds “strong men” who constantly poke and mock the news media and political opponents. In an atmosphere where people have few people they trust, someone who says they are right not to trust the news they read or what politicians say can somehow appear trustworthy.

The Morning Consult poll reveals low regard for Trump’s tweets, yet the President retains an unshakable base of support that trusts what he says, even if they dislike how he says it.

One of the best explanations for the epidemic of distrust among Americans is the continuing culture war, which itself reflects changing demographics and evolving political attitudes. Increasingly, people don’t trust information from the news media or the mouths of politicians with which they disagree. It’s like Rudy Giuliani famously said, “Truth isn’t truth.” If you believe homosexuality is a lifestyle choice, you won’t trust information or political views that talk about it as an innate orientation.

Which brings the conversation back to the trust in family and friends. People apparently weigh their personal relationships with family and friends higher than agreement or disagreement with their views. You trust your brother-in-law because he takes care of your sister and their family, not because you agree or disagree with his political view. You might think he is a political dolt, but he is your family’s political dolt.

It’s no surprise then that one of the most popular shows on Fox News is named Fox & Friends.

 

Polling for All Seasons, Tastes and Political Stripes

If the blizzard of polls overwhelms you, one solution is to tune into FiveThirtyEight, which summarizes recent polls, aggregates multiple polls to see trends and covers a wide range of topics from politics to sports to culture.

If the blizzard of polls overwhelms you, one solution is to tune into FiveThirtyEight, which summarizes recent polls, aggregates multiple polls to see trends and covers a wide range of topics from politics to sports to culture.

Election season means leaves change color and political polls fall like rain. Keeping track of all the polls and making sense out of them is beyond the capability of most of us. Thank goodness for FiveThirtyEight. 

FiveThirtyEight, named after the number of electors in the US Electoral College, launched in 2008 as a polling aggregation site. The idea was and remains that looking collectively at polls is more useful than focusing on a single poll, which can be influenced by the skill and methodology of an individual pollster. The fivethirtyeight.com website was acquired last April by ABC News.

In a weekly roundup of polling, called Pollapalooza, the site reports on the “Poll of the Week” and provides a quick reference and links to a wide range of political polls. This week’s Pollapalozza blog centers on polling that FiveThirtyEight shows support for President Trump flagging while support for Robert Mueller’s Russian interference investigation rising. 

The blog started with findings from a CNN poll that shows 61 percent of respondents believe the Mueller investigation is serious and should continue, up 6 points from a month ago. Poll findings indicate 72 percent of respondents believe Trump should testify under oath (+4 points since June) and 47 percent think Trump should be impeached (+5 points since June).

The latest poll by Quinnipiac, which has a slight tilt toward the right, produced complementary results. Respondents by a 55-32 margin said the Mueller investigation is fair, up 4 points from a Quinnipiac poll conducted a month ago.

FiveThirtyEight is the brainchild of  Nate Silver , who brings a statistician’s eye to everything from political races to baseball sabermetrics. He has steered his informative and sometimes provocative blog through transitions that included the New York Times, ESPN and now ABC News. His statistical approach to politics and other subject areas has drawn a large following and earned him the label of ‘disruptive’ of status quo thinking.

FiveThirtyEight is the brainchild of Nate Silver, who brings a statistician’s eye to everything from political races to baseball sabermetrics. He has steered his informative and sometimes provocative blog through transitions that included the New York Times, ESPN and now ABC News. His statistical approach to politics and other subject areas has drawn a large following and earned him the label of ‘disruptive’ of status quo thinking.

Numbers were different, but the margins were similar in a YouGov poll, which indicated respondents approved of the Mueller investigation by a 49 percent to 30 percent margin. 

If you tire of reading about the Russian investigation, Pollapalozza offers a guide to other recent research. For example: 

  • 58 percent of Americans want the senior Trump official who wrote an anonymous op-ed published by the New York Times to identify himself or herself. (CNN poll)

  • A plurality of respondents say it’s “not very important” or “not important at all” for a political candidate to have strong religious beliefs. (Associated Press-NORC Center for Public Affairs Research)

  • “Two-thirds of Americans rely on social media to get at least some of their news, but more than half of those people expect the news on social medial to be largely inaccurate.” (Pew Research Center)

  • “Among Americans who lost trust in media, 7 in 10 say that trust can be restored.” (Gallup and Knight Foundation)

If politics isn’t your thing, the FiveThirtyEight website serves up the latest news in sports, science & health, economics and culture.

In the culture category, the site’s blog, called Significant Digits, reported the results from a Washington Post survey of 50 cities that found police departments with lower caseloads of homicides have higher arrest rates while the opposite is true for cities with higher caseloads. “Major police departments that are successful at making arrests in homicides generally assign detectives fewer than five cases annually,” according to survey findings as reported in the newspaper under the headline, “Buried under bodies.”

The sports section is peppered with stories such as why the NFL, reputedly a passing league, doesn’t throw enough passes or a piece pitting “old-school stats” versus “fancy-pants analytics” in Major League Baseball.

FiveThirtyEight is pretty much like having your cake and political polling, too. It is worth some clicks.

 

Chinese Retaliatory Tariffs ‘Shrewdly’ Designed to Hurt Rural America

Axios has posted an interactive map that shows the localized effects of  Chinese retaliatory tariffs if President Trump acts on his threat to impose another $200 billion on tariffs on Chinese exports to the United States.

Axios has posted an interactive map that shows the localized effects of  Chinese retaliatory tariffs if President Trump acts on his threat to impose another $200 billion on tariffs on Chinese exports to the United States.

 

Axios.com has posted a story with an interactive map showing areas of the country destined to feel the greatest pain from retaliatory tariffs spurred by President Trump’s trade policies.

“Industries affected by the brinksmanship are mostly concentrated in rural, deeply red, already-struggling parts of the country, with political consequences for Trump and Republicans in 2018 and beyond,” according to the Axios analysis. 

The analysis drew on data from the Brookings Institution, US Chamber of Commerce, US Census Bureau and Bureau of Labor Statistics.

Axios posted the map after a public comment period ended last week on Trump’s threat to quadruple tariffs on Chinese goods to $200 billion. China has said it will retaliate with $60 billion in tariffs on US exports.

“That's on top of 25 percent and 10 percent tariffs enacted, respectively, on steel and aluminum imports from Canada, China, Mexico and the European Union, and by those countries against the United States,” Axios reported.

US farmers, manufacturers and consumer groups have been bracing for the blowback. The Axios map helps to localize where the most severe impact could be felt. For example, it identifies six industries in Douglas County that would be affected by retaliatory tariffs, which is 95 times more concentrated impact than the the national average. The map identifies 35 affected industries in Clackamas County.

“Employment in rural and low-population counties can be exceptionally vulnerable to gyrations in the global economy,” Mark Muro, a senior fellow at the Brookings Institution, tells Axios. "In a small county, a single meatpacking establishment can provide hundreds of jobs and make up a large share of that county's total employment.”

Muro  and a colleague wrote a previous report anticipating the impact of retaliatory Chinese tariffs with this observation: “Trade diplomacy can often seem an international and faraway activity. However, when it comes down to specific lists of tariffs on particular products that Americans produce, from ginseng to airplanes, the high-level posturing of Washington and Beijing suddenly gets more real.”

He added: “Our top line estimates suggest while the total number of jobs potentially disrupted by an all-out trade war remains modest, the count encompasses a diverse and shrewdly chosen ‘hit list’ of hallmark American industries – one that appears well-calculated to scare both red and blue America.”

Trump has assured his supporters, especially in the Farm Belt, his take-no-prisoners approach to international trade can produce positive results for US workers, businesses and farmers. In response to immediate-term impacts on soybean growers and other farm interests, Trump proposed a one-time $4.2 billion subsidy. It has met with opposition and disappointment by congressional Republicans and recipients of the aid.

 

Poll Shows Polarization Affects Brand, Media Views

Recent polling reveals political polarization has spilled over into net brand favorability ratings, with sharply disparate views of everything from Trump Hotels to the NFL to Starbucks. Some of the most notable partisan differences are on media outlets.

Recent polling reveals political polarization has spilled over into net brand favorability ratings, with sharply disparate views of everything from Trump Hotels to the NFL to Starbucks. Some of the most notable partisan differences are on media outlets.

Voters in America are polarized and that polarization has spilled over onto brand favorability, according to Axios.

Brands such as the NFL, Starbucks, Chick-fil-A and Trump Hotels are viewed differently through a polarized lens. Some of the most disparate political favorability ratings attach to media companies.

“The only media outlets preferred by Republicans over Democrats are Fox, Fox Business and Breitbart,” Axios reported. “Most entertainment outlets listed, like Comedy Central, HBO and MTV, are much more widely favored by Democrats.”

The net brand favorability gaps between partisans are based on polling by Morning Consult of adults taken from last October through January 2018.

Not surprisingly, the largest gap is for Trump Hotels, with Democrats and Republicans split on their views by 80 percentage points. Democrats give Trump Hotels nearly a 50-point negative rating.

CNN has the second largest gap, with Republicans giving it a negative favorability rating of 15 percent while Democrats rate it favorably at more than 50 percent.

The gaps are significant, but it is equally interesting to note that only 11 of the 30 brands have any negative rating, and most of those are relatively minor.

For example, Starbucks, which has provoked conservative angst, enjoys a nearly 50 percent favorability rating by Democrats and a 25 percent rating by Republicans.  Cabelas, known for selling guns, has a better than 50 percent favorability rating by Republicans and around 30 percent by Democrats. Chick-fil-A, which has faced pushback from LBGTQ advocates, enjoys a Republican favorability rating around 60 percent and a Democratic favorability rating of 30 percent.

While there are stark differences of opinion about well known media brands, overall the ratings are favorable, even for Fox News. Republicans give it more than a 50 percent favorability rating, but Democrats are basically neutral on the network.  The New York Times, which is frequently targeted in Trump tweets, received a 50+ percent favorability rating from Democrats and a slightly positive rating from Republicans.

The biggest negative ratings from Democrats, in order, were for Trump Hotels (40+ percent), Breitbart (20+ percent), Halliburton (15 percent) and Koch Industries (10+ percent). The biggest negative ratings from Republicans, also in order, were for CNN (15 percent) and the NFL (12 percent). The Washington Post, HuffPost, MSNBC and BET had negative ratings of 5 percent or less from Republicans.

 

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Poll Shows Americans Dubious about Tariffs, Trump Trade Policy

President Trump is poised to impose a 25 percent tariff on steel imports and a 10 percent tariff on aluminum  imports as early as this week, despite vocal opposition by congressional Republicans and business groups. A new poll shows Americans aren’t too keen on tariffs and even less so about prospects of inciting a trade war

President Trump is poised to impose a 25 percent tariff on steel imports and a 10 percent tariff on aluminum  imports as early as this week, despite vocal opposition by congressional Republicans and business groups. A new poll shows Americans aren’t too keen on tariffs and even less so about prospects of inciting a trade war

As President Trump prepares to impose tariffs on steel and aluminum imports to the United States, polling results show tariffs are unpopular with Americans and Trump’s notion that trade wars are good is unbelievable.

A Quinnipiac University poll published March 6 revealed 50 percent of respondents opposed tariffs proposed by Trump. Sixty-four percent disagreed with Trump’s claim that a trade war would be good for America

“Poll results suggest Americans disapprove of steel and aluminum tariffs proposed by President Trump out of fear they can raise consumer prices, invite trade retaliation and put US jobs at risk in a trade war."

“Poll results suggest Americans disapprove of steel and aluminum tariffs proposed by President Trump out of fear they can raise consumer prices, invite trade retaliation and put US jobs at risk in a trade war."

“Every listed party, gender, education, age and racial group oppose steel and aluminum tariffs, except Republicans, who support tariffs by a lackluster 58 - 20 percent and white voters with no college degree, who are divided with 42 percent supporting tariffs and 40 percent opposed,” according to the poll.

"Tariff, smariff, say voters who believe punishing other countries on imports will do more harm at home," said Tim Malloy, assistant director of the Quinnipiac University Poll. 

“American voters disapprove 54 - 34 percent of the way President Trump is handling trade. Only Republicans and white voters with no college degree approve his handling,“ poll results show. The strongest disapproval rate is by Democrats. Eighty-five percent disapprove of Trump’s handling of trade and 73 percent oppose the steel and alumni tariffs. Sixty-eight percent of black respondents disagree with the tariffs. There is a sharp divergence between college-educated respondents who strongly oppose tariffs and non-college respondents who lukewarmly support them.

The same poll asked about the National Rifle Association and its influence on gun violence legislation. In response to a question about whether Republicans in Congress are afraid of the NRA, 70 percent of GOP respondents said “no” and 83 percent of Democrats said “yes.” Older Americans and African-Americans were much more likely to view congressional Republicans as fearful of the NRA and its grassroots political power.