Bush has made it clear he’s got his agenda for America’s health care problems: capping medical malpractice awards. A newly-released poll by the Kaiser Family Foundation/Harvard School of Public Health makes it clear that this goal is only a minor part of the public’s health care agenda. In this poll, respondents were given a series of 12 health care reforms that they could rate as a top priority and reducing jury awards in malpractice suits came in 11th out of these 12 items. Just 26 percent said it should be a top priority, compared to these figures for the top three health care reforms: 63 percent said lowering the cost of health care and insurance should be a top priority, 58 percent said making Medicare more financially sound for the future should be and 57 percent said increasing the number of Americans with insurance should be.
The poll also finds that Bush’s signature accomplishment in the health care field, the Medicare reform bill that established a prescription drug benefit within that program, remains unpopular with the very group, seniors, who were the intended beneficiaries of the new benefit. Just 29 percent have a favorable impression of the new law and 70 percent believe lawmakers in Washington should work to fix the problems in the new law, rather than leave it as it is. The three key problem to be fixed are that the bill is too complicated for people on Medicare to understand (81 percent say this problem needs fixing), that it does not do enough to lower prescription drug prices (78 percent) and that it does not provide people on Medicare enough help with their prescription drug costs (also 78 percent).

So many polls, so little time. In the last several days, four more major public polls have been released, in addition to the four I previously discussed in “Pre-Inauguration Blues”, Part I and Part II. By and large, the tale told by these polls is quite consistent with the story I laid out in those earlier posts: we are a nation of unhappy campers at the beginning of Bush’s second term. And he has quite a challenge in front of him to win these unhappy campers over, given his relatively unpopular agenda and apparent contempt for the political center.
Here are some of the more interesting findings from these new polls:
New York Times/CBS News Poll
1. When asked whether things in the US are going better, worse or the same as five years ago, just 20 percent say better, 56 percent say worse and 21 percent say the same. Compare that to responses at the beginning of Poppa Bush’s term in 1989 (44 percent better/26 percent worse/23 percent same) and at the beginning of Reagan’s second term in 1985 (57 percent better/26 percent worse/11 percent same). Evidently Bush has a different coalition-building strategy than Reagan-era Republicans: make things worse!
2. The public is more likely to believe the next four years of Bush’s presidency will divide Americans (47 percent) than bring them together (44 percent).
3. Expectations of progress in other areas during Bush’s second term are minimal: only 17 percent think the US will be more respected in the world; 33 percent think the economy will be better than it is today; 29 percent think the US will be safer from terrorism; 24 percent believe the educational system will be better; 15 percent believe the price they pay for prescription drugs will be lower and just 9 percent think their taxes will be lower. Even on Iraq, only 38 percent believe there will be fewer troops there four long years from now. And 66 percent believe the federal budget deficit will be bigger.
4. Speaking of the deficit, almost four-fifths (78 percent) say it is not possible to overhaul Social Security, cut taxes and pay for the war in Iraq (all of which Bush proposes to do) without running up the budget deficit.
5. Another of Bush’s schemes is to maintain and extend the system where income from investments and interest is taxed less than income from wages and salaries. Only 28 percent endorse that approach, while 66 percent say investment income should be taxed either the same (54 percent) or more (12 percent).
6. By 50-45, the public says it is bad idea, rather than good idea, to allow “individuals to invest portions of their Social Security taxes on their own, which might allow them to make more money for their retirement, but would involve greater risk”. That’s the most negative judgement this poll has received on this question since they first started asking it in mid-2000. Moreover, support for this proposition drops to 22 percent, when it is posited that establishing personal accounts would reduce the guaranteed benefit by as much as a third.
As for whether they would be likely to actually invest in the stock market through these personal accounts, just 39 percent say they would be likely to do so. And that figure drops to 30 percent, when it is pointed out that the personal accounts would be accompanied by a drop in the guaranteed benefit.
And in terms of Bush’s motivations in seeking changes to the Social Security system, 50 percent say he primarily trying to help Wall Street investment companies, compared to 40 percent who think he is trying to help average Americans.
7. On Iraq, the number saying we did the right thing in taking military action against Iraq is down to 45 percent, tied for the lowest ever. And for the first time, a majority (53 percent to 41 percent) say that the war in Iraq will not have been worth the costs if we never find weapons of mass destruction there.
A majority (52-41) also believes that it is not possible for the US to create a stable democracy in Iraq and that Bush is making the situation in Iraq today sound better than it really is (55 percent). Just 15 percent believe violence in Iraq will decline after the election and a mere 18 percent believe Bush has a clear plan for dealing with the situation in Iraq (down 20 points from before November’s election).
In terms of the war’s effect on terrorist threats against the US, less than a fifth (19 percent) think such threats have been decreased, while 33 percent say they’ve increased and 47 percent think they’ve stayed the same.
Like I said, a nation of unhappy campers.
More on unhappy campers tomorrow…..

By Alan Abramowitz
Peter Beinart in his recent Washington Post op-ed blames the Iowa caucuses for the Democrats’ failure to nominate more moderate, security-conscious candidates in recent years. But while Iowa’s Democratic caucus-goers are clearly not representative of the overall Democratic electorate, they have not been particularly friendly to left-wing candidates. In 1976, southern moderate Jimmy Carter’s victory over several northern liberals in the Iowa caucuses helped propel him to the Democratic presidential nomination. Four years later, Ted Kennedy’s attempt to challenge Carter from the left failed badly in Iowa. In 1988, Missouri moderate Dick Gephardt finished first in Iowa and in 2000, Al Gore easily dispatched Bill Bradley. Finally, Howard Dean’s collapse in Iowa in 2004 was due in no small part to widespread concern among Democratic caucus-goers that Dean’s strident anti-Bush and anti-war rhetoric would make him unelectable in November.
The fact is, the presidential candidates nominated by the Democratic Party in recent years, including John Kerry in 2004, have accurately reflected the liberal views of rank-and-file Democratic voters across the nation. If California, New York, or Illinois had held their primaries before Iowa held its caucuses in 2004, it is very unlikely that Joe Lieberman or another centrist candidate would have had a better chance of winning the Democratic nomination.

The public’s got those mean old pre-inauguration blues. That’s the message of four polls released over the Martin Luther King holiday weekend.
1. The first poll to be released was a Pew Research Center poll, their annual assessment of the public’s policy priorities. Here’s the lead paragraph of their report on the poll, succinctly titled “Public’s Agenda Differs from President’s“:

George W. Bush begins his second term with considerably less popular support than other recent incumbent presidents after their reelection. He also is proposing a second-term policy agenda that differs in several key respects from the public’s. Health care, aid for the poor, and the growing budget deficit are all increasingly important public priorities, while limiting lawsuit awards, making recent tax cuts permanent and tax simplification rank near the bottom of the public’s agenda.

On the public’s exceptionally weak support for Bush at the start of his second term, the report notes that their current poll has Bush at 50 percent approval, while their analagous poll in January, 1997 had Clinton at 59 percent approval. And earlier Gallup polls had Reagan at 62 percent in January, 1985, Nixon at 59 percent in December, 1972, Johnson at 71 percent in January, 1965 and Eisenhower at 73 percent in January, 1957.
On who will gain and lose influence during Bush’s second term, the public is quite pessimistic about “people like yourself”, with just 22 percent saying this group will gain influence and 34 percent saying they will lose influence. That’s down from four years ago, at the beginning of Bush’s first term, when, by 35-26, the public felt people like themselves would gain, rather than lose, influence. The public is also pessimistic about whether older people (29 percent), blacks (26 percent), poor people (20 percent), union leaders (18 percent) and environmentalists (18 percent) will gain influence during a second Bush administration. All of these figures are significantly down from where they were four years ago.
In fact, the only groups the public is more optimistic about than four years ago are Washington lobbyists (up from 35 to 40 percent in terms of gaining influence) and conservative Christians (up from 51 to 54 percent). But the groups the public is most optimistic about today are the still same two groups that topped this list in 2001: the military and business corporations.
On prospects for the economy, fewer people today than at any time since 2001 say they believe economic conditions will be better a year from now. Only 27 percent express this optimistic viewpoint, 18 percent believe they will be worse and most (52 percent) believe they will remain the same.
On Social Security, 49 percent say the system needs major changes or to be completely rebuilt. But that’s much less than the 71 percent who say the health care system has problems of this magitude or the 62 percent who have the same viewpoint about the educational system. And, while the poll finds support (54-30) for the very general idea of having private investment accounts within Social Security (the typical finding when no tradeoffs or costs are mentioned), the poll also finds overwhelming support for the priority of “keeping Social Security as a program with a guaranteed monthly benefit based on a person’s earnings during their working life” (65 percent) rather than “letting younger workers decide for themselves how some of their own contributions to Social Security are invested, which would cause their future benefits to be higher or lower depending on how well their investments perform” (29 percent).
More on “Pre-Inauguaration Blues” tomorrow, including much more on Social Security and and a great deal about Iraq.

The latest Gallup poll has Bush’s approval rating at 52 percent, slightly above his average 49 percent rating in polls in the last month. That 52 percent rating for a re-elected president on the eve of his inauguration is quite poor by historical standards.
Bush’s popularity ratings in specifically areas also indicate Bush is receiving no political boost from his re-election and impending inauguration. His highest rating is in the terrorism area where he receives a 58 percent rating, just a point above his worst rating in this area in this poll.
His next-best rating is in the education area, where he receives a 52 percent rating, his worst ever in this area in this poll, followed by the economy, where he gets a 50 percent approval/48 percent disapproval rating. His other ratings are all below 50 percent and, with the exception of health care, are all the worst Bush has ever received in these areas in the Gallup poll: the environment, 49 percent approval/45 percent disapproval; taxes, 49/47; foreign affairs, 47/49; the situation in Iraq, 42/56; Social Security, 41/52; health care policy, 40/54; immigration, 34/54 and the federal budget deficit, 32/63.
Bush’s poor rating on Iraq is underscored by several other findings from the survey. For the first time in this poll, more people (50 percent) think the US made a mistake sending troops to Iraq than don’t (48 percent). In addition, about three-fifths (59 percent) think things in Iraq are going badly for the US, the same number feel it is unlikely a democratic form of government will be established in Iraq in the next year and even more (71 percent) believe it is unlikely peace and internal security will be established in Iraq in the next year.
Not much help for Mr. Popularity there. Perhaps he expects his Social Security scheme to overcome his Iraq problems. That seems highly unlikely given how his idea is apparently playing with the downscale constituencies Bush relies upon politically (see yesterday’s post) and the fact that his Social Security approval rating (see above) is actually lower than his anemic Iraq rating.

What’s holding back the Democratic party? Here are three nominations, as advanced by three different observers in recent articles.
1. Clintonism. Chuck Todd, editor of the Hotline, argues in the new Atlantic that Clinton’s strategy of triangulation–neutralizing troublesome issues by “splitting the difference”–had great success rehabilitating some negative parts of the Democrats’ image and, combined with Clinton’s great skills as a politician was a successful formula for a limited time at the Presidential level. But Clintonism did little to build the Democrats as a party (indeed the Democrats’ Congressional majority was lost in the heyday of Clintonism) and, as applied by less skillful politicians in a changed environment, has contributed to the deadly perception that Democrats don’t really stand for anything and have no core values.
2. Consultants. Amy Sullivan argues in her entertaining new article, “Fire the Consultants“, in The Washington Monthly that the Democrats’ tendency to employ the same losing consultants–who are so inbred with the Democratic establishment that they wind up, in essence, assigning themselves work–over and over again ensures that the same losing strategies are employed in campaigns over and over again. No market discipline on these consultants (in fact, it seems more like a form of crony capitalism) means no progress for the Democrats.
3. Character. Jill Lawrence argues in USA Today that Democrats keep nominating men of sterling character (Gore, Kerry) whose character the Democrats’ inexlicably fail to defend against a deliberate Republican strategy of character assassination. She suggests that Democrats’ just don’t take character seriously enough and think they can deflect these attacks by talking about “issues”.
What do I think? I think there’s truth to all three of these critiques, though each of them overstates their thesis. It seems reasonable to me that Clintonism did not perform particularly well either in party-building or in building a positive image of Democrats’ core values and convictions among constituencies like white working class voters who no longer “got” what Democrats were about. Perhaps that was inevitable given the other problems that Clintonism had to solve first, but it seems silly to deny that these were real failures of Clintonism. (See Ed Kilgore over at NewDonkey, however, for a stout defense of Clintonism against Todd’s critique.)
It would also be silly to deny that rewarding those consultants that fail (all shall have prizes!) with more and more work is flat-out dumb as a strategy and stands in depressing contrast to the Republicans’ ability to promote new talent and reward winners. And who could deny that Democrats have handled character attacks poorly in the last several elections and need a more aggressive appoach to beat them back?
But none of these critiques add up to a silver bullet for Democrats’ electoral fortunes. Let’s take the elements of truth in each of them, without getting dogmatic about any of them. That’s the “Newer Democrat” way–or the “Vince Lombardi Democrat” way, to use a term coined by Rahm Emanuel, the new head of the DCCC. The last thing we need is a new orthodoxy about what’s wrong with the Democratic party. Instead, let’s be pragmatic and take only the elements of these critques that may help us win and discard the rest.

As many readers of this blog are no doubt aware, the labor movement is in the process of a vigorous internal debate about its future and how to rectify the obvious weaknesses of the movement (see this article by Thomas Edsall, “AFL-CIO Chief Facing Challenges From Labor’s Left: Critics Say That Under Sweeney, Group’s Political Influence, Percentage of Workforce Have Waned” for the basic parameters and dramatis personnae of this debate).
But what you may not know is that there are a couple of places on the web where you can access the key documents in this debate and evaluate for yourself the arguments different parts of the labor movement are now making.
1. SEIU has relevant documents and proposals plus a blog on the Unite to Win part of their site.
2. The AFL-CIO site has relevant documents and proposals on the Stregthening Our Union Movement for the Future part of their site.
Definitely worth a look.

An interesting variant on the exurban argument (which I critiqued on Monday and in other posts) is the white families with kids argument. This argument contends that exurbs are busting at the seams with white married households with children who have moved there for more land, bigger houses and a safer, more traditional and (let’s face it) less racially diverse environment for their kids. Since these kind of voters naturally tend to favor the Republicans, and since the exurbs are fast-growing, this must give the Republicans a big edge over the demographically stagnant Democrats. This argument popped up recently on The New Republic website in an article “Parent Trap” by Joel Kotkin and William Frey. The same basic argument is developed in more detail by political analyst Steve Sailer in his article “Baby Gap” in The American Conservative.
I have already had much to say about the problems with the fast exurban growth part of this argument. But the white families with children argument has another, deeper problem: white married households with children are not only declining relatively, as a percentage of households, they are also declining absolutely–that is, the number of these households is actually falling over time. Between 1990 and 2000, for example, the number of white married households with children declined by almost 7 percent. This is true even in the NCEC-designated “exurban” counties (or “Republican-leaning suburban counties” [RLSCs] as I prefer to call them} I discussed on Monday: white families with kids declined by 1 percent in RLSCs between 1990 and 2000. And in NCEC-designated rural counties, they decreased by 9 percent.
That makes the whole white families with children argument sound pretty weak. Aren’t there any areas where these households are at least growing in absolute terms? Sure there are, but to find them you have to adopt a fairly strict definition of exurbs like the one I’ve used in the past (fringe counties of large metro areas). If you do that, it turns out that these exurban counties had 11 percent growth in white married households with children in the 1990s. But these exurban counties are also just 4 percent of the population and contain only 6 percent of the nation’s white families with children. In other words, the only category of counties that remotely fits the white families with children argument is too small to have the big political impact the argument alleges.
It’s also interesting to note how slowly the distribution of these households is changing. Using the NCEC categories, in 1990, 34 percent of white families with children were in “exurban” (or RLSC) counties compared to 35 percent in 2000. In rural counties there was no change (24 percent in both years). In NCEC’s “suburban” counties (many of which are not really suburban and are selected so that they tend to lean Democratic), there was a slight increase, from 20 to 21 percent of white families with children over the decade. And in NCEC-designated urban counties, which are typically in only the largest urban areas with the heaviest minority populations, there was only a slight decline over the decade, from 21 to 20 percent of these housholds.
And even using my strict–and more accurate–definition of exurbia, the proportion of white families with children in this category of counties only rose from 5 percent in 1990 to the 6 percent mentioned above.
Thus, not only are the absolute numbers of these families declining almost everywhere, but the distribution of these families across different types of counties is actually changing very slowly–in fact hardly changing at all.
In short, the attempt to construct a dynamic, demographic argument around white people with kids just doesn’t hold water. Of course, the basic observation that white people with kids do tend to vote Republican remains true, but the attempt to gussy up this fact with “parent traps” and “baby gaps” should be taken with an entire cellarful of salt.

By Alan Abramowitz
Based on the findings of the Abramowitz, Alexander and Gunning paper (see yesterday’s post), in 2006 Democrats would be wise to target Republicans representing high-risk districts: districts that lean Democratic in presidential elections. Such districts account for a disproprtionate share of incumbent defeats and party turnover in House elections. For example, in 1994, 32 percent of Democratic incumbents in high-risk districts were defeated compared with only 7 percent of Democratic incumbents in all other districts. Although only 34 percent of all Democratic seats in 1994 were in high-risk districts, 70 percent of Democratic seat losses occurred in these districts.
So where are these high-risk Republican districts? There are currently 25 such GOP districts: Colorado 7; Connecticut 2, 4, and 5; Delaware AL; Florida 10 and 22; Illinois 10; Iowa 1 and 2; Kentucky 3; Nevada 3; New Hampshire 2; New Jersey 2, 3, and 4; New Mexico 1; New York 3, 13, and 25; Pennsylvania 6, 7, 8, and 15; and Washington 8.
There are certainly vulnerable Republicans in other districts, but the GOP Representatives in these high-risk districts deserve special attention. In order to maximize their gains in the 2006 midterm election, Democrats need to recruit strong challengers in these high-risk GOP districts and make sure that these challengers have the funds needed to wage competitive campaigns. That will take a lot of money, but Democrats showed in 2004 that they can compete financially with Republicans. We only need to gain 15 seats to regain control of the House. With a major effort and a little help from a Bush Administration that seems determined to cut social security benefits for future retirees, it should be possible.

In previous posts on this topic, I have argued that the term “exurban” has been used in a scandalously confused way, categorizing so much of suburbia as exurban that the term loses any meaning. In particular, I took a close look at the definition of exurbia used by the National Committee for an Effective Congress (NCEC), a leading Democratic targeting firm. Here is some of what I reported:

[NCEC’s original criteria] indicate that pretty much any suburban county that does not contain a large city can be designated as exurban, if it is relatively downscale in terms of occupation, income and education or if it falls below a certain density criterion. [Note: these original criteria also appear to categorize any non-rural county with a minority population over 50 percent as an urban county.]….
1. Some entire MSAs (metropolitan statistical areas) are designated exurban, like the Canton MSA in Ohio and the Pensacola and Sarasota MSAs in Florida.
2. In other MSAs, only the county containing the MSA’s main city is designated “urban-surburban” while every other county is designated exurban or even rural. For example, in the Columbus, OH MSA, only Franklin county is termed urban-suburban, while five other counties are designated exurban and two are considered rural. Similarly, all Ohio counties in the Cincinnati MSA are designated exurban except Hamilton county.
3. Medium-sized metro areas wind up being classified almost entirely as exurban or rural. In Florida, for example, there are 16 counties in medium-sized metro areas. Of these, just three are classified as either urban-suburban (1) or suburban (2), while 13 are classified as either exurban (11) or rural (2).
4. Almost no counties are simply designated “suburban”. In Ohio, there are only three (compared to 30 exurban counties); in Florida, just five (compared to 21 exurban counties)….
Collapsing all but the most urbanized parts of big metro areas, almost the entirety of medium-sized metro areas and outer suburbs everywhere into exurbia does considerable violence to the concept and clarifies little.

Arguably, what the NCEC criteria are really doing is categorizing all suburban counties where downscale white voters predominate as “exurban”. Not surprisingly, given recent voting trends among white working class voters, these suburban counties tend to vote Republican. But calling these counties exurban simply confuses the issue: why not call them Republican-Leaning Suburban Counties (RLSCs) instead? That would be clearer and more analytically justified (though less trendy).
I have now obtained a categorization of every county in the US on the basis of NCEC’s original criteria and have conducted some analysis using their categories. (Note: they appear to have modified their criteria slightly since their original criteria were elaborated, but I do not have access to these modified criteria.) This analysis produces some interesting results which further underscore, I think, the need for much more careful and selective use of the term “exurban”.
1. By NCEC’s definition, 581 counties in the US are exurban and just 131 are suburban.
2. By NCEC’s definition, 29 percent of the US poplation lives in exurbia and just 19 percent in suburbia (!). (If you’ve got a geographer friend, tell that one to him/her to get a good laugh.)
3. NCEC’s exurban counties provided 31 percent of the vote in 2004, 2 points over their population share of 29 percent. Note that these counties provided 30 percent of the vote in both 2000 and 1996, so the exurban share of the vote, even under NCEC’s peculiar definition, is increasing very slowly, not rapidly.
4. Once you adjust the increase in votes in these counties for population increase (see my earlier post on this subject), their adjusted rise in turnout in 2004 was actually less than in rural, suburban and urban counties, as defined by NCEC.
5. Republican domination of these counties is, as I argued previously, nothing new. Even under NCEC’s definition, Reagan carried exurban counties by 27 points in 1984, compared to just 15 points for Bush in 2004. In fact, Bush’s papa in 1988 actually did better than his son in these counties, carrying them by 17 points. The only area where Bush bested his papa was in rural counties (by NCEC’s definition), carrying them by 19 points, compared to 11 points for his father (though Reagan carried them by 24 points). And Bush did way worse than his father in NCEC’s suburban counties, losing them by 5 points, while his father carried them by 11 in 1988 (and Reagan carried them by 21 in ’84); he also did much worse in NCEC’s urban counties, losing them by 19 points, while his father lost them by only 5 points in ’88 (and Reagan actually carried them by 4 points in ’84). All this underscores the “Reagan lite” nature of Bush’s coalition.
Bottom line: we’re still looking for a definition of exurbia that clarifies more than confuses and adds real analytical value. I am in touch with some geographers who are trying to come up with a clear, tight definition rooted in standard practices in their field. I’ll report back when their efforts have (hopefully) borne some fruit.