Multiple polls have shown that cost, not universal coverage, is the driving concern when it comes to health care. It is a major, increasing expenditure that seems to gobble up most of their paychecjs.

It is hardly surprising when, for example, the Monmouth poll finds, “Only 12% of Americans say that their family has benefited a great deal from recent growth in the U.S. economy and another 31% say they have received some benefit from the economic upturn. A majority, though, say they have been helped either not much (27%) or not at all (27%) from the nation’s macroeconomic growth.” And here is where health-care costs come in:

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When asked to name the biggest concern facing their families right now, the most commonly named problem is the cost of health care at 19%, which is up from 13% last year but down from 25% two years ago. This is followed by taxes at 9% (7% in 2018 and 4% in 2017), everyday bills such as groceries at 8% (12% in 2018 and 12% in 2017), job security and employment worries at 7% . . . . Among those who earn $50,000 or less, the top concerns are health care (21%), everyday bills (13%), and jobs (10%). Among those who earn between $50,000 and $100,000, the top concerns are health care (20%), everyday bills (9%), and taxes (9%). Among those who earn more than $100,000, the top concerns are taxes (14%), health care (13%), and immigration (7%).

It would seem Democrats would do far better in talking about the “economy” to stress that “take-home pay” or the “family budget” rather than the macro-economic numbers. Trump naturally wants to talk about the economy in the aggregate, but Democrats need to show that the family balance sheet is just as precarious as it has been for a decade or more.

Trump’s biggest error may have been in dropping economic populism for crony capitalism and tax cuts for the rich. “A majority of Americans (58%) say that wealthy families have benefited a lot from Trump’s policies, 22% say the wealthy have benefited a little, and just 9% say not at all.” When, for example, Sen. Kamala Harris (D-Calif.) or former vice president Joe Biden talk about reversing the tax cuts to increase teachers’ pay or to fund a public option, that’s music to the ears of a lot of voters.

From the standpoint of average voters, the economy may be doing well, but their financial situation isn’t getting the needed assistance. “Just 14% say that federal government actions have helped their family with their top concern [health care] over the past year while 42% say that the government’s actions have actually hurt their family in this area. Another 42% say the government has had no impact.”

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Democrats would be wise to keep in mind three points. First, gross domestic product is far less significant than the family’s credit card balance or the checking account. Don’t squabble over topline numbers for the national economy or root for a recession; talk about the economy of the household. Second, instead of Medicare-for-all or universal coverage, Democrats would do better to talk about reducing drug prices and putting caps on out-of-pocket expenses -- as they emphasize Trump’s desire to eliminate the Affordable Care Act and cut Medicare. Trump is taking away what little help they get; Democrats want to offer more help. Third, along with health care, “everyday bills” registers as a top concern. Harris has proposed in essence a vast expansion of the Earned Income Tax Credit of $500 a month for working and many middle-class families as well as a housing credit. Other candidates may find traction with this approach. The more times a Democratic candidate can say he or she will help with the “high cost of living,” the better.

In sum, the current formulation of the “economy” helps Trump. Democrats don’t have to argue the country’s economy at large isn’t strong; they need to make the case that Trump’s policies collectively make families’ costs go up and limit their wages. The result: Debt, credit card balances and plenty of stress. Speak to that and Democrats can take back the “economy” issue.

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