Voters and Health Care in the 2006 Election
http://www.100md.com
《新英格兰医药杂志》
The U.S. House and Senate elections in November 2006 have generated intense interest both in this country and abroad.1 One reason this election is seen as important is that the Republican and Democratic positions on many key policy areas, such as health care, are currently far apart. A substantial body of research by political scientists has shown that in recent years the positions of the two parties in Congress have diverged increasingly on almost all major policy issues.2,3,4,5,6 This trend has also been reflected in congressional legislation on issues such as the future of the Medicare prescription drug program, the lack of health care coverage for a segment of the population, Medicaid, health care costs, and stem-cell research, as well as priorities for health care expenditures.7
What role, if any, will health care issues play in determining the outcome of this congressional election? Two factors limit our ability to answer this question fully. First, stands on issues are an important reason why voters select candidates in elections, but not the only one. Other reasons are the voters' political philosophy, their party loyalty, and the perceived character and experience of individual candidates.8,9,10 Second, to a degree that is difficult to measure, this particular election may be more of a general referendum on President George W. Bush and the Republican Congress than a vote on specific issues.
Recognizing these limitations, we attempt in this report to provide a picture of the overall role of health care in the upcoming congressional election. Specifically, we address six questions: How important is health care as an issue in this election, and how does voters' ranking of its importance compare with the rankings in the congressional elections of 2002 and 1998? What are the most important health care issues for voters in 2006, and how do these priorities vary among demographic groups? How satisfied are potential voters with the Bush administration's handling of health care issues? Finally, which party do voters think would be better at addressing major health policy issues in the future?
Methods
Sources of Data
The data presented here are from 11 national opinion surveys. One of these surveys, designed and analyzed by the Kaiser Family Foundation and the Harvard School of Public Health, was the principal source of data.11 In this telephone survey, conducted by International Communications Research from September 13 through September 17, 2006, 1003 randomly selected registered voters were asked about their views on the role of health care as an issue in the 2006 congressional elections, which party they thought would be better at addressing health policy issues, and whether they approved or disapproved of the Bush administration's handling of health care.
We have also drawn on the results of seven surveys conducted by national media polling organizations between April and September 2006 (selecting the most recent data on each topic covered) and one survey conducted before the 2002 congressional elections by National Public Radio, the Kaiser Family Foundation, and the Kennedy School of Government at Harvard University.12 The results of these surveys were compiled from the Roper Center for Public Opinion Research in Storrs, CT, or from data provided directly by the organizations. Each of these polls involved telephone interviews with 800 to 1200 randomly selected, self-described registered voters.
The remaining two surveys were national exit polls conducted on election day in 1998 and 2002 by Voter News Service (a consortium that conducts exit polls for major television networks and newspapers).13,14 In these exit polls, questionnaires were distributed to randomly selected voters at election places throughout the country.15 Voters filled out the questionnaire after casting their ballots. The 1998 survey included 11,387 voters and the 2002 survey included 17,872 voters. These exit polls asked questions about the role of specific issues, such as health care, in voters' decisions in the 1998 and 2002 congressional elections.
Survey Questions
The first set of questions was designed to identify the issues that voters thought were most important in the congressional election. In the exit polls for the 1998 and 2002 congressional elections, voters were given a list of the campaign issues that had been widely covered in the media.13,14 In 1998 and 2002, the list included seven issues. In the exit polls, voters were asked to choose the one or two most important issues. In the 2006 ABC News–Washington Post and Gallup pre-election polls, registered voters were asked to rate the importance of a list of potential election issues (seven and six issues, respectively).16,17 In the 2006 NBC News–Wall Street Journal, CBS News–New York Times, and Los Angeles Times polls, registered voters were asked whether they approved or disapproved of how President Bush was handling his job.18,19,20
In the 2006 survey conducted by the Kaiser Family Foundation and the Harvard School of Public Health, registered voters were asked to identify, in their own words, the health care issues that were most important in deciding their vote in the upcoming congressional election. The results were used to assess the salience of these issues for various subgroups of voters.
The Kaiser–Harvard survey also asked registered voters two additional sets of questions. The first set was aimed at ascertaining whether the respondents approved or disapproved of President Bush's handling of health care issues. The second set asked registered voters which political party, the Democrats or Republicans, they trusted to do a better job of handling health policy issues in general as well as four specific issues.11
Statistical Analysis
Like all survey data, those included in this report were subject to sampling error and may therefore differ from the results that would have been obtained if the whole population of registered voters and other adults had been interviewed. For example, an analysis of a sample of 1000 persons will, with a 95% degree of confidence, have a statistical precision of approximately ±3 percentage points; for a sample of 10,000, the comparable precision would be ±1 percentage point.
National polling organizations that engage in pre-election surveys of voters do not release the rates of response, nor in many cases do they calculate them, because this single measure, in their view, is not the best way to evaluate the accuracy of the poll. Surveys conducted over a short period (such as those reported here) yield lower response rates but more up-to-date information than surveys conducted over a long period.21 In attempts to forecast voters' choices, the use of outdated information may introduce more errors into predictions of the results than low response rates do.22 Independent studies have shown that the results of statistical reweighting of the data to compensate for low response rates in opinion surveys conducted over a short period are similar to the results of an analysis based on higher response rates in surveys of longer duration.23,24,25,26,27,28 The results of the surveys presented here were statistically reweighted to reflect the actual composition of the United States, calculated on the basis of data from the Census Bureau, according to age, sex, educational level, region, race or ethnic background, household size, and number of household telephone lines.29 We compared responses among subgroups or between years by testing for differences in proportions of respondents, taking into account the effect of the design of the study.30
Results
Health Care as an Issue in 2006
Health care was ranked as one of the six most important issues in the 1998 and 2002 congressional elections and in the 2006 pre-election polls. In national media polls conducted in September 2006, health care, including Medicare and prescription drugs, ranked fourth or fifth among issues that registered voters saw as most important in deciding their vote for Congress. The economy, the war in Iraq, and terrorism led the list of issues affecting voters' choices in the election (Table 1).13,14,16,17
Table 1. Most Important Issues for Voters in the Congressional Elections of 1998, 2002, and 2006.
In each of these elections, health care was ranked below a few other major issues that played a greater role in affecting voters' choices. In both 2002 and 2006, national security issues (Iraq and terrorism taken together) have been a more prominent concern among voters, along with continued concern about the economy. In 1998, when national security was not a top-ranking issue, five other domestic issues were more important to voters than health care.
Top Health Care Issues
When asked to say in their own words which health care issues were the most important in their congressional vote, no more than 22% of registered voters in 2006 agreed on any particular issue (Table 2). The two most frequently cited health care issues were costs, including the cost of prescription medicines (22%), and the problem of lack of coverage or lack of access to care (20%), followed by issues concerning Medicare (12%) and insurance companies (4%).11
Table 2. Most Important Health Care Issues for Registered Voters in the Congressional Elections of 2002 and 2006.
The main difference between 2002 and 2006 is that in 2002 there was a large gap between the first-ranked issue, health care costs, including the cost of prescription medicines (cited by 37% of respondents), and the second-ranked issue, Medicare (14%) (Table 2). In 2006, health care costs (including the cost of prescription medicines) and the problems of lack of coverage or lack of access to care were cited by nearly equal proportions of registered voters (22% and 20%, respectively). In addition, the proportion of registered voters who named any health care issue as an important factor was smaller in 2006 (58%) than in 2002 (71%).11,12
Among the registered voters who participated in the surveys, Democrats were significantly more likely than Republicans or Independents to name at least one health care issue that was important to their vote (Table 3). Specifically, Democrats were more likely than Republicans and Independents to cite lack of coverage or lack of access to care as the most important issue. Registered voters under the age of 65 years were more likely to view the problem of lack of coverage or lack of access to care as most important, whereas those who were 65 or older were more likely to consider Medicare the most important issue.11
Table 3. Most Important Health Care Issues for Registered Voters in the 2006 Congressional Election, According to Demographic Characteristics.
Ratings of Health Care Issues
As shown in Table 4, only a minority of registered voters (28%) currently approve of President Bush's handling of health care.11 The proportion of registered voters who approve of his handling of health care is lower than the proportion who approve of his overall performance, which ranged between 37% and 44% in September 2006.18,19,20
Table 4. Registered Voters' Views on the Handling of Health Care Issues, 2006.
Similarly, when registered voters were asked which political party they trusted to do a better job of handling health care issues in general, prescription drug benefits for the elderly, the problem of lack of health insurance, health care costs, and stem cell research, Democrats held the lead on every issue (Table 4).11 Although President Bush and the Republican-led Congress were most directly responsible for enacting the new Medicare prescription drug law, 47% of registered voters who are 65 years of age or older think the Democratic party is better able to handle the issue of prescription drug benefits for the elderly; 30% of such voters prefer the Republican party's handling of this issue.11
Discussion
A careful analysis of the survey data suggests that although Americans are worried about the state of health care in the United States today and especially about the rising cost of their own health insurance, these concerns are not the top issues for voters in the midterm election.31,32 However, health care could still be a factor in some individual congressional races.
Health care ranks substantially below national security and the economy as issues likely to play a dominant role in determining the outcome of the 2006 congressional elections. Among issues related to health care, the problem of high costs is less salient to registered voters than it was in 2002, and lack of insurance is seen as more important, leaving the two issues essentially tied in voters' minds. This change between the two elections may reflect initiation of Medicare Part D drug coverage for people who are 65 years of age or older and an increase in the number of people who are uninsured.33 In addition, despite voters' positive perception of the Democratic Party's handling of health care, this issue is not likely to help the party substantially in the upcoming election because of its relatively limited overall importance as a voting issue.
Whichever party wins in the November congressional election, the margin of victory is likely to be small, and for this reason, the outcome of the election will have only a limited effect on the current direction of national health policy. The new leaders of the Congress will have to deal with the problems of scarce new federal revenues, a deep partisan division over the direction of health policy, and resistance by many conservative members to new plans for health care spending. In addition, as the presidential election of 2008 approaches, opposition by members of each party to the other's health care proposals will intensify. In this environment, important new health reform initiatives are unlikely, and the congressional focus will be on incremental policy changes.34,35
No potential conflict of interest relevant to this article was reported.
Source Information
From the Harvard School of Public Health, Boston (R.J.B.); and the Kaiser Family Foundation, Menlo Park, CA (D.E.A.).
Address reprint requests to Dr. Blendon at the Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Ave., Rm. 402, Boston, MA 02115, or at rblendon@hsph.harvard.edu.
References
Cook C. The coming impasse: Cook election preview. Natl J (Wash) 2006;:Suppl:3-3.
Bond JR, Fleisher R, eds. Polarized politics: Congress and the President in a partisan era. Washington, DC: CQ Press, 2000.
Layman GC, Carsey TM, Horowitz JM. Party polarization in American politics: characteristics, causes, and consequences. Annu Rev Polit Sci 2006;9:83-110.
Jacobson GC. Polarized politics and the 2004 congressional and presidential elections. Polit Sci Q 2005;120:199-218.
Poole KT, Rosenthal H. Congress: a political–economic history of roll call voting. New York: Oxford University Press, 1997.
McCarty N, Poole KT, Rosenthal H. Polarized America: the dance of ideology and unequal riches. Cambridge, MA: MIT Press, 2006.
Blendon RJ, Brodie M, Altman DE, Benson JM, Hamel EC. Voters and health care in the 2004 election. Health Aff 2005;5:86-96.
Niemi RG, Weisberg HF. What determines the vote? In: Niemi RG, Wiesberg HF, eds. Classics in voting behavior. Washington, DC: CQ Press, 1993:93-106.
Jackson JE. Issues, party choice, and presidential votes. Am J Polit Sci 1975;19:161-85.
Page BI, Jones CC. Reciprocal effects of policy preferences: party loyalties and the vote. Am Polit Sci Rev 1979;73:1071-1089.
Kaiser Family Foundation/Harvard School of Public Health poll. Storrs, CT: Roper Center for Public Opinion Research, September 13, 2006.
National Public Radio/Kaiser Family Foundation/Kennedy School of Government poll. Storrs, CT: Roper Center for Public Opinion Research, October 27, 2002.
Voter News Service. 1998 Election day exit poll. Storrs, CT: Roper Center for Public Opinion Research, November 3, 1998.
Idem. 2002 Election day exit poll. Storrs, CT: Roper Center for Public Opinion Research, November 5, 2002.
Mitofsky WJ. A short history of exit polls. In: Lavrakas PJ, Holley JK, eds. Polling and presidential election coverage. Newbury Park, CA: Sage Publications, 1991:83-99.
ABC News/Washington Post poll. Storrs, CT: Roper Center for Public Opinion Research, September 5, 2006.
Gallup poll. Storrs, CT: Roper Center for Public Opinion Research, September 15, 2006.
NBC News/Wall Street Journal poll. Storrs, CT: Roper Center for Public Opinion Research, September 8, 2006.
CBS News/New York Times poll. Storrs, CT: Roper Center for Public Opinion Research, September 15, 2006.
Los Angeles Times poll. Storrs, CT: Roper Center for Public Opinion Research, September 16, 2006.
Brady HE, Orren GR. Polling pitfalls: sources of error in public opinion surveys. In: Mann TE, Orren GR, eds. Media polls in Americans politics. Washington, DC: Brookings Institution, 1992.
Mosteller F, Hyman H, McCarthy PJ, Marks ES, Truman DB. The pre-election polls of 1948. New York: Social Science Research Council, 1949.
Polls face growing resistance, but still representative: survey experiment shows. Washington, DC: The Pew Research Center for the People and the Press, April 20, 2004. (Accessed October 12, 2006, at http://people-press.org/reports/display.php3?ReportID=211.)
Keeter S, Miller C, Kohut A, Groves RM, Presser S. Consequences of reducing nonresponse in a national telephone survey. Public Opin Q 2000;64:125-148.
Curtin R, Presser S, Singer E. The effect of response rate changes on the Index of Consumer Sentiment. Public Opin Q 2000;64:413-428.
Blendon RJ, Benson JM, Desroches CM, Weldon KJ. Using opinion surveys to track the public's response to a bioterrorist attack. J Health Commun 2003;8:Suppl 1:83-92.
Traugott MW. Assessing poll performance in the 2000 campaign. Public Opin Q 2001;65:389-419.
Blendon RJ, Altman DE, Benson JM, Brodie M. Health care in the 2004 presidential election. N Engl J Med 2004;351:1314-1322.
Voss DS, Gelman A, King G. Pre-election survey methodology: details from nine polling organizations, 1988 and 1992. Public Opin Q 1995;59:98-132.
Daniel WW. Biostatistics: a foundation for analysis in the health sciences. New York: John Wiley, 1991:225-6.
Harris Interactive poll. New York: Harris Interactive, April 2006.
Kaiser Family Foundation poll. Storrs, CT: Roper Center for Public Opinion Research, August 3, 2006.
DeNavas-Walt C, Proctor BD, Lee CH. Income, poverty, and health insurance coverage in the United States: 2005. Current population reports no. P60-231. Washington, DC: Government Printing Office, 2006. (Accessed October 12, 2006, at http://www.census.gov/prod/2006pubs/p60-231.pdf.)
Cohen RE. If they win. Natl J (Wash) 2006;38:26-29.
Serafini MW. A dose of pragmatism. Natl J (Wash) 2006;38:54-55.(Robert J. Blendon, Sc.D.,)
What role, if any, will health care issues play in determining the outcome of this congressional election? Two factors limit our ability to answer this question fully. First, stands on issues are an important reason why voters select candidates in elections, but not the only one. Other reasons are the voters' political philosophy, their party loyalty, and the perceived character and experience of individual candidates.8,9,10 Second, to a degree that is difficult to measure, this particular election may be more of a general referendum on President George W. Bush and the Republican Congress than a vote on specific issues.
Recognizing these limitations, we attempt in this report to provide a picture of the overall role of health care in the upcoming congressional election. Specifically, we address six questions: How important is health care as an issue in this election, and how does voters' ranking of its importance compare with the rankings in the congressional elections of 2002 and 1998? What are the most important health care issues for voters in 2006, and how do these priorities vary among demographic groups? How satisfied are potential voters with the Bush administration's handling of health care issues? Finally, which party do voters think would be better at addressing major health policy issues in the future?
Methods
Sources of Data
The data presented here are from 11 national opinion surveys. One of these surveys, designed and analyzed by the Kaiser Family Foundation and the Harvard School of Public Health, was the principal source of data.11 In this telephone survey, conducted by International Communications Research from September 13 through September 17, 2006, 1003 randomly selected registered voters were asked about their views on the role of health care as an issue in the 2006 congressional elections, which party they thought would be better at addressing health policy issues, and whether they approved or disapproved of the Bush administration's handling of health care.
We have also drawn on the results of seven surveys conducted by national media polling organizations between April and September 2006 (selecting the most recent data on each topic covered) and one survey conducted before the 2002 congressional elections by National Public Radio, the Kaiser Family Foundation, and the Kennedy School of Government at Harvard University.12 The results of these surveys were compiled from the Roper Center for Public Opinion Research in Storrs, CT, or from data provided directly by the organizations. Each of these polls involved telephone interviews with 800 to 1200 randomly selected, self-described registered voters.
The remaining two surveys were national exit polls conducted on election day in 1998 and 2002 by Voter News Service (a consortium that conducts exit polls for major television networks and newspapers).13,14 In these exit polls, questionnaires were distributed to randomly selected voters at election places throughout the country.15 Voters filled out the questionnaire after casting their ballots. The 1998 survey included 11,387 voters and the 2002 survey included 17,872 voters. These exit polls asked questions about the role of specific issues, such as health care, in voters' decisions in the 1998 and 2002 congressional elections.
Survey Questions
The first set of questions was designed to identify the issues that voters thought were most important in the congressional election. In the exit polls for the 1998 and 2002 congressional elections, voters were given a list of the campaign issues that had been widely covered in the media.13,14 In 1998 and 2002, the list included seven issues. In the exit polls, voters were asked to choose the one or two most important issues. In the 2006 ABC News–Washington Post and Gallup pre-election polls, registered voters were asked to rate the importance of a list of potential election issues (seven and six issues, respectively).16,17 In the 2006 NBC News–Wall Street Journal, CBS News–New York Times, and Los Angeles Times polls, registered voters were asked whether they approved or disapproved of how President Bush was handling his job.18,19,20
In the 2006 survey conducted by the Kaiser Family Foundation and the Harvard School of Public Health, registered voters were asked to identify, in their own words, the health care issues that were most important in deciding their vote in the upcoming congressional election. The results were used to assess the salience of these issues for various subgroups of voters.
The Kaiser–Harvard survey also asked registered voters two additional sets of questions. The first set was aimed at ascertaining whether the respondents approved or disapproved of President Bush's handling of health care issues. The second set asked registered voters which political party, the Democrats or Republicans, they trusted to do a better job of handling health policy issues in general as well as four specific issues.11
Statistical Analysis
Like all survey data, those included in this report were subject to sampling error and may therefore differ from the results that would have been obtained if the whole population of registered voters and other adults had been interviewed. For example, an analysis of a sample of 1000 persons will, with a 95% degree of confidence, have a statistical precision of approximately ±3 percentage points; for a sample of 10,000, the comparable precision would be ±1 percentage point.
National polling organizations that engage in pre-election surveys of voters do not release the rates of response, nor in many cases do they calculate them, because this single measure, in their view, is not the best way to evaluate the accuracy of the poll. Surveys conducted over a short period (such as those reported here) yield lower response rates but more up-to-date information than surveys conducted over a long period.21 In attempts to forecast voters' choices, the use of outdated information may introduce more errors into predictions of the results than low response rates do.22 Independent studies have shown that the results of statistical reweighting of the data to compensate for low response rates in opinion surveys conducted over a short period are similar to the results of an analysis based on higher response rates in surveys of longer duration.23,24,25,26,27,28 The results of the surveys presented here were statistically reweighted to reflect the actual composition of the United States, calculated on the basis of data from the Census Bureau, according to age, sex, educational level, region, race or ethnic background, household size, and number of household telephone lines.29 We compared responses among subgroups or between years by testing for differences in proportions of respondents, taking into account the effect of the design of the study.30
Results
Health Care as an Issue in 2006
Health care was ranked as one of the six most important issues in the 1998 and 2002 congressional elections and in the 2006 pre-election polls. In national media polls conducted in September 2006, health care, including Medicare and prescription drugs, ranked fourth or fifth among issues that registered voters saw as most important in deciding their vote for Congress. The economy, the war in Iraq, and terrorism led the list of issues affecting voters' choices in the election (Table 1).13,14,16,17
Table 1. Most Important Issues for Voters in the Congressional Elections of 1998, 2002, and 2006.
In each of these elections, health care was ranked below a few other major issues that played a greater role in affecting voters' choices. In both 2002 and 2006, national security issues (Iraq and terrorism taken together) have been a more prominent concern among voters, along with continued concern about the economy. In 1998, when national security was not a top-ranking issue, five other domestic issues were more important to voters than health care.
Top Health Care Issues
When asked to say in their own words which health care issues were the most important in their congressional vote, no more than 22% of registered voters in 2006 agreed on any particular issue (Table 2). The two most frequently cited health care issues were costs, including the cost of prescription medicines (22%), and the problem of lack of coverage or lack of access to care (20%), followed by issues concerning Medicare (12%) and insurance companies (4%).11
Table 2. Most Important Health Care Issues for Registered Voters in the Congressional Elections of 2002 and 2006.
The main difference between 2002 and 2006 is that in 2002 there was a large gap between the first-ranked issue, health care costs, including the cost of prescription medicines (cited by 37% of respondents), and the second-ranked issue, Medicare (14%) (Table 2). In 2006, health care costs (including the cost of prescription medicines) and the problems of lack of coverage or lack of access to care were cited by nearly equal proportions of registered voters (22% and 20%, respectively). In addition, the proportion of registered voters who named any health care issue as an important factor was smaller in 2006 (58%) than in 2002 (71%).11,12
Among the registered voters who participated in the surveys, Democrats were significantly more likely than Republicans or Independents to name at least one health care issue that was important to their vote (Table 3). Specifically, Democrats were more likely than Republicans and Independents to cite lack of coverage or lack of access to care as the most important issue. Registered voters under the age of 65 years were more likely to view the problem of lack of coverage or lack of access to care as most important, whereas those who were 65 or older were more likely to consider Medicare the most important issue.11
Table 3. Most Important Health Care Issues for Registered Voters in the 2006 Congressional Election, According to Demographic Characteristics.
Ratings of Health Care Issues
As shown in Table 4, only a minority of registered voters (28%) currently approve of President Bush's handling of health care.11 The proportion of registered voters who approve of his handling of health care is lower than the proportion who approve of his overall performance, which ranged between 37% and 44% in September 2006.18,19,20
Table 4. Registered Voters' Views on the Handling of Health Care Issues, 2006.
Similarly, when registered voters were asked which political party they trusted to do a better job of handling health care issues in general, prescription drug benefits for the elderly, the problem of lack of health insurance, health care costs, and stem cell research, Democrats held the lead on every issue (Table 4).11 Although President Bush and the Republican-led Congress were most directly responsible for enacting the new Medicare prescription drug law, 47% of registered voters who are 65 years of age or older think the Democratic party is better able to handle the issue of prescription drug benefits for the elderly; 30% of such voters prefer the Republican party's handling of this issue.11
Discussion
A careful analysis of the survey data suggests that although Americans are worried about the state of health care in the United States today and especially about the rising cost of their own health insurance, these concerns are not the top issues for voters in the midterm election.31,32 However, health care could still be a factor in some individual congressional races.
Health care ranks substantially below national security and the economy as issues likely to play a dominant role in determining the outcome of the 2006 congressional elections. Among issues related to health care, the problem of high costs is less salient to registered voters than it was in 2002, and lack of insurance is seen as more important, leaving the two issues essentially tied in voters' minds. This change between the two elections may reflect initiation of Medicare Part D drug coverage for people who are 65 years of age or older and an increase in the number of people who are uninsured.33 In addition, despite voters' positive perception of the Democratic Party's handling of health care, this issue is not likely to help the party substantially in the upcoming election because of its relatively limited overall importance as a voting issue.
Whichever party wins in the November congressional election, the margin of victory is likely to be small, and for this reason, the outcome of the election will have only a limited effect on the current direction of national health policy. The new leaders of the Congress will have to deal with the problems of scarce new federal revenues, a deep partisan division over the direction of health policy, and resistance by many conservative members to new plans for health care spending. In addition, as the presidential election of 2008 approaches, opposition by members of each party to the other's health care proposals will intensify. In this environment, important new health reform initiatives are unlikely, and the congressional focus will be on incremental policy changes.34,35
No potential conflict of interest relevant to this article was reported.
Source Information
From the Harvard School of Public Health, Boston (R.J.B.); and the Kaiser Family Foundation, Menlo Park, CA (D.E.A.).
Address reprint requests to Dr. Blendon at the Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Ave., Rm. 402, Boston, MA 02115, or at rblendon@hsph.harvard.edu.
References
Cook C. The coming impasse: Cook election preview. Natl J (Wash) 2006;:Suppl:3-3.
Bond JR, Fleisher R, eds. Polarized politics: Congress and the President in a partisan era. Washington, DC: CQ Press, 2000.
Layman GC, Carsey TM, Horowitz JM. Party polarization in American politics: characteristics, causes, and consequences. Annu Rev Polit Sci 2006;9:83-110.
Jacobson GC. Polarized politics and the 2004 congressional and presidential elections. Polit Sci Q 2005;120:199-218.
Poole KT, Rosenthal H. Congress: a political–economic history of roll call voting. New York: Oxford University Press, 1997.
McCarty N, Poole KT, Rosenthal H. Polarized America: the dance of ideology and unequal riches. Cambridge, MA: MIT Press, 2006.
Blendon RJ, Brodie M, Altman DE, Benson JM, Hamel EC. Voters and health care in the 2004 election. Health Aff 2005;5:86-96.
Niemi RG, Weisberg HF. What determines the vote? In: Niemi RG, Wiesberg HF, eds. Classics in voting behavior. Washington, DC: CQ Press, 1993:93-106.
Jackson JE. Issues, party choice, and presidential votes. Am J Polit Sci 1975;19:161-85.
Page BI, Jones CC. Reciprocal effects of policy preferences: party loyalties and the vote. Am Polit Sci Rev 1979;73:1071-1089.
Kaiser Family Foundation/Harvard School of Public Health poll. Storrs, CT: Roper Center for Public Opinion Research, September 13, 2006.
National Public Radio/Kaiser Family Foundation/Kennedy School of Government poll. Storrs, CT: Roper Center for Public Opinion Research, October 27, 2002.
Voter News Service. 1998 Election day exit poll. Storrs, CT: Roper Center for Public Opinion Research, November 3, 1998.
Idem. 2002 Election day exit poll. Storrs, CT: Roper Center for Public Opinion Research, November 5, 2002.
Mitofsky WJ. A short history of exit polls. In: Lavrakas PJ, Holley JK, eds. Polling and presidential election coverage. Newbury Park, CA: Sage Publications, 1991:83-99.
ABC News/Washington Post poll. Storrs, CT: Roper Center for Public Opinion Research, September 5, 2006.
Gallup poll. Storrs, CT: Roper Center for Public Opinion Research, September 15, 2006.
NBC News/Wall Street Journal poll. Storrs, CT: Roper Center for Public Opinion Research, September 8, 2006.
CBS News/New York Times poll. Storrs, CT: Roper Center for Public Opinion Research, September 15, 2006.
Los Angeles Times poll. Storrs, CT: Roper Center for Public Opinion Research, September 16, 2006.
Brady HE, Orren GR. Polling pitfalls: sources of error in public opinion surveys. In: Mann TE, Orren GR, eds. Media polls in Americans politics. Washington, DC: Brookings Institution, 1992.
Mosteller F, Hyman H, McCarthy PJ, Marks ES, Truman DB. The pre-election polls of 1948. New York: Social Science Research Council, 1949.
Polls face growing resistance, but still representative: survey experiment shows. Washington, DC: The Pew Research Center for the People and the Press, April 20, 2004. (Accessed October 12, 2006, at http://people-press.org/reports/display.php3?ReportID=211.)
Keeter S, Miller C, Kohut A, Groves RM, Presser S. Consequences of reducing nonresponse in a national telephone survey. Public Opin Q 2000;64:125-148.
Curtin R, Presser S, Singer E. The effect of response rate changes on the Index of Consumer Sentiment. Public Opin Q 2000;64:413-428.
Blendon RJ, Benson JM, Desroches CM, Weldon KJ. Using opinion surveys to track the public's response to a bioterrorist attack. J Health Commun 2003;8:Suppl 1:83-92.
Traugott MW. Assessing poll performance in the 2000 campaign. Public Opin Q 2001;65:389-419.
Blendon RJ, Altman DE, Benson JM, Brodie M. Health care in the 2004 presidential election. N Engl J Med 2004;351:1314-1322.
Voss DS, Gelman A, King G. Pre-election survey methodology: details from nine polling organizations, 1988 and 1992. Public Opin Q 1995;59:98-132.
Daniel WW. Biostatistics: a foundation for analysis in the health sciences. New York: John Wiley, 1991:225-6.
Harris Interactive poll. New York: Harris Interactive, April 2006.
Kaiser Family Foundation poll. Storrs, CT: Roper Center for Public Opinion Research, August 3, 2006.
DeNavas-Walt C, Proctor BD, Lee CH. Income, poverty, and health insurance coverage in the United States: 2005. Current population reports no. P60-231. Washington, DC: Government Printing Office, 2006. (Accessed October 12, 2006, at http://www.census.gov/prod/2006pubs/p60-231.pdf.)
Cohen RE. If they win. Natl J (Wash) 2006;38:26-29.
Serafini MW. A dose of pragmatism. Natl J (Wash) 2006;38:54-55.(Robert J. Blendon, Sc.D.,)