ROBERT SIEGEL, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.
MELISSA BLOCK, host:
And I'm Melissa Block.
The war in Iraq, national security and the economy are the dominant issues in this year's midterm elections but they're not the only ones that will determine which party controls Congress. A study in this week's New England Journal of Medicine finds that voters who want lawmakers to do something about healthcare could play a pivotal role in some close races.
NPR's Julie Rovner reports.
JULIE ROVNER: You have to pay pretty close attention, but just about every candidate for Congress this year makes sure to say something about healthcare. In New Hampshire, where Republican Congressman Charlie Bass is fighting to keep his seat, Democratic challenger Paul Hodes used a debate question about medical malpractice to make a more populist point.
Mr. PAUL HODES (Democratic Congressional Candidate, New Hampshire): Doctors do need relief from their medical malpractice premiums. It's going to take a congressman who's willing to stand up to the big insurance companies. You're not going to get that from Charlie Bass and George Bush. I will.
ROVNER: And on Meet the Press last Sunday, Maryland Democratic Senate candidate Ben Cardin said he'd work to improve the new Republican backed Medicare drug benefit by allowing Medicare to negotiate lower drug prices, something that's currently banned.
Mr. BEN CARDIN (Democratic Senatorial Candidate, Maryland): Well Medicare, we can save a lot of money by just taking on the prescription drug issue. Let's have a fair price for prescription medicines in this country. We pay three times what we should.
ROVNER: It's no surprise that candidates are going out of their way to talk about healthcare issues. While healthcare is not at the top of voter concerns the way it was in the early 1990s, it's been creeping back of late.
Paul Fronstin of the Employee Benefit Research Institute says that showed up dramatically in his organization's annual survey of healthcare consumer confidence released last week.
Mr. PAUL FRONSTIN (Employee Benefit Research Institute): Dissatisfaction with the healthcare system is up. You have twice as many people ranking the healthcare system as fair or poor as ranked it fair or poor nine years ago.
ROVNER: Fronstin says for a significant portion of voters, healthcare is the top issue.
Mr. FRONSTIN: The Medicare population, the 46 million people who are uninsured, the additional population that's underinsured, even the population that has good coverage is very concerned about losing that coverage or what's going to happen to the cost. So while healthcare may not be a top tier issue for everybody, it's definitely a top tier issue for somebody.
ROVNER: One out of every eight somebodies, according to a separate study in this week's New England Journal of Medicine. Bob Blendon, a polling expert at the Harvard School of Public Health, is one of the study's authors. He says with so many close House and Senate races this year, that small group of voters could make a big difference.
Mr. BOB BLENDON (Harvard School of Public Health): When we talk about it nationally, we say well, healthcare's this second level issue. It cannot in anyway compete with people's concerns about Iraq and the economy. But when you look at specific races and how close they're going to be, you realize that in some of these districts, people's stands on healthcare will determine whether or not they'll return to the Congress.
ROVNER: That' particularly true of Medicare, whose new drug benefit was supposed to be an electoral plus for Republicans. Here's President Bush touting it at a campaign swing through Georgia yesterday.
President GEORGE W. BUSH: As a result of legislation that I signed, 33 million seniors have more choices and access to prescription drugs. But more importantly, the days of poor seniors having to choose between food and medicine, they're over.
ROVNER: But Blendon says most polls show seniors preferred Democrats on the Medicare issue.
Mr. BLENDON: There're things that need to be fixed in Medicare in the future and more older voters think the Democrats are likely to fix it than the Republicans. So if it shows up in a race and there are a lot of seniors, it will give probably the Democratic candidate a small lead and sometimes that could be critical in determining the outcome.
ROVNER: The effect of Medicare is also magnified by the fact that seniors are the group most likely to turn out to vote in midterm elections, and the fact that seniors already represent one of every four voters is not lost on any candidate from either party.
Julie Rovner, NPR News.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.