Some interesting poll results emerged at the end of last week, the biggest story from which being the Louisiana mass public still hasn’t quite shaken itself from its populist heritage, and the implications that could have for some future political careers.
Commissioned by the Louisiana State Medical Society, the data
collected focus largely on views on health care issues. The group has a history
of supporting policy decisions that maximize the flow of taxpayer dollars to
state physicians, as evidenced (until it realized nothing could derail it) by
its past initial opposition to Medicaid reform that became known as Bayou
Health that scrutinizes more exactly doctors’ billing requests (by breaking the
fee-for-service mold in favor of patient premium support), and more recently by
its indirect support for the state’s acceptance in expanding Medicaid eligibility
under the money-goes-to-the-institution model rather than the more efficient
money-follow-the-patient paradigm.
The Gov. Bobby
Jindal Administration, quite
wisely, has rejected expansion under those terms, which would increase
demand for medical services under the old, inefficient model, and the survey
represented an attempt to demonstrate public support for expansion under those
terms as well as away from the Bayou Health model, which theoretically if the Pres.
Barack Obama
Administration would show any flexibility on the expansion model to allow that
model to be used would entice Jindal to accept. Perhaps to get the media
to bite on publicizing the results, it also included approval measures for the
Legislature and Jindal, as well as favorability ratings for him and Sens. Mary Landrieu and David
Vitter, Lt. Gov. Jay Dardenne,
and Treas. John
Kennedy.
As far as the issues went, a plurality of the sample did not know of
Bayou Health, but of those that did, a majority supported it. Barely more said
the existing charity hospital system worked well prior to recent changes to
move it away from government direct provision of health care than said those
changes needed to be made, within the margin of error. It should not shock that
Bayou Health is relatively unknown, nor despite the relative inefficiency of
the charity system that it should hold up so well in opinion, as it would be
surprising if even a tenth of Louisianans knew anything beyond the barest information
about them, and the vast majority of that proportion would utilize these
services or be providers of them. But it is interesting that among those with even
minimal awareness of Bayou Health that it enjoyed relatively strong support.
The agenda also got mixed reviews regarding the rather misnamed Patient
Protection and Affordable Care Act. While the sample lined up solidly against the
whole of Obamacare, a small majority favored one of its constituent parts, the
expansion. Again, neither result should surprise that much: while the public is
largely aware of the various merits and demerits of the entire law that was the
subject of massive discussion over two years, only a small segment understands
the implications of acceptance or rejection of the expansion, and where
knowledge is incomplete for many, populist instincts begin to kick in (all that
“free” money up for grabs!).
As in the case of feelings about the charity system, it’s not so much a
contradiction when understanding that the lack of information prompts falling
back on populism that still remains a potent part of Louisiana’s political
culture. But where things get really pertinent is in how these attitudes might
get reflected in evaluations of leading political actors.
The most identified with all of these issues, given the authorship of
his administration regarding, Bayou Health, reform to the charity system,
opposition to expansion, and in outspokenness against Obamacare is Jindal. And
while it’s hazardous to tie to opinion on health care matters to an evaluation
of Jindal’s performance or approval, as fewer than 15 percent declared health
care as the most important issue and fewer than 30 percent put it in their top
three issues, Jindal came out of it all in a wash.
On the approval scale, Jindal registered a slight negative, 46-48,
within the margin of error. On favorability, Jindal was slightly positive, the 49-46
gap also within the margin of error. Thus, despite an enormous amount of
controversial reform efforts, much bucking strongly established interests and
running against the populist impulse in the political culture, Jindal seems to
be holding his own, after having much higher ratings at times where he did
little risky policy-making beyond enforced budget reductions.
But perhaps more interestingly, on the favorability measure the figure
running the highest was for the one most identified with the minority view on
Obamacare, Landrieu at 59 percent, then followed by Vitter at 55 percent.
Again, this indicates how ingrained populism proves confusing to a conservative
mass public: with Landrieu being the key vote to have passed the entire package,
yet she is not punished for it, at least in terms of likeability.
Note also that likeability translates poorly into reelection chances.
Two years ago, right about the time Obamacare was in the final stages of being
jackknifed into law, Landrieu’s favorability was only a little lower than it is
now, yet of those who gave an opinion on the matter a majority
answered they would not vote to reelect her regardless of opponent. And if
there’s one thing you can count on in Louisiana politics, it’s if you do enough
unpopular things, a quality opponent will expose you, and there’s every sign
that the GOP is going to have one or more such candidates tie her Obamacare
approval around her neck that will serve as an anchor very difficult to prevent
her from sinking into retirement.
(As for the rest, the Legislature ranked 46-37 for approval, although
it’s also debatable how much people generally really know about what it’s done
lately, and while Kennedy ranked at and Dardenne just below Jindal’s
favorability, their proportion of unfavorable mentions were much lower with even higher proportions than for the
Legislature unwilling to rate them. Again, general lack of awareness of their
records or even anything beyond recognizing their names means it’s tricky to
read anything into this. Only Jindal, Landrieu, and Vitter had widespread name recognition.)
1 comment:
Let's see: Jindal's ratings drop into the negative range, and you declare that he "has weathered the largest sea change in state political history decently..."
From 64% to 46% in 15 months...some might (fairly, and accurately) characterize that differently than you do.
However, no one can say your response is unexpected.
And, now, you can add the Medical Society to your ever-increasing and lengthy list of people and entities you have had to demonize in apologizing for the Governor.
A continuing great job, Professor...........
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