Lessons from Super Tuesday: Health Care in the Deep South

The Democratic Presidential race has changed radically since the South Carolina Primary.  As a Bernie Sanders supporter I was so hopeful for him to have a strong showing.  The outcome was very sobering.  I thought I would take a look at the exit poll data from SC and other states from Super Tuesday on the issue of Sanders' Medicare for All (M4A) proposal.

SC	Support	Oppose	AL	Support	Oppose	VA	Support	Oppose
	49%	46%		51%	43%		52%	45%
Biden	44%	55%	Biden	50%	76%	Biden	42%	67%
Sanders	29%	12%	Sanders	27%	5%	Sanders	33%	12%
TN	Support	Oppose	NC	Support	Oppose	TX	Support	Oppose
	53%	43%		55%	41%		64%	33%
Biden	32%	51%	Biden	34%	54%	Biden	25%	46%
Sanders	38%	9%	Sanders	36%	12%	Sanders	39%	13%

South Carolina and the five southern Super Tuesday states are summarized in the above tables.  The numbers right below "Support" and "Oppose" are the percentage of primary voters who either support or oppose the statement "How do you feel about replacing all private health insurance with a single government plan for everyone?"  

In South Carolina, it was favored by 49% to 46%.  Biden beat Sanders 44% to 29% of those who support M4A.  Biden beat Sanders 55% to 12% among those who oppose M4A.  Similar patterns were found in Alabama and Virginia.  In Tennessee, North Carolina, and Texas, Sanders did slightly better than Biden among those who support M4A and was trounced by Biden among those who did not.  Texas had the strongest support for Sanders proposal but he only bested Biden by 14 points among those who do.

It is also known that older African American voters overwhelmingly supported Biden.  The exit poll does not state whether they were more or less likely to support Medicare for All.  

MA	Support	Oppose	CA	Support	Oppose	VT	Support	Oppose
	50%	45%		55%	36%		73%	23%
Biden	23%	46%	Biden	14%	35%	Biden	14%	42%
Sanders	41%	13%	Sanders	48%	14%	Sanders	62%	25%
Warren	27%	14%

Three of the states outside of the deep south where Sanders fared better against Biden are shown above: Massachusetts, California, and Vermont.  In Massachusetts the 69% who supported M4A favored Sanders over Biden by 41% to 23%.  Warren received 27% among those who do.

In California and Vermont, Sanders had strong support among those who support M4A.  Biden won among those who did not.  The lesson from these primaries and the 2016 and 2008 elections is that it is almost impossible to win the Democratic party nomination for president without substantial African American support.  It would be interesting to look at what role support for M4A plays in this.

**Update**

Biden has now won Mississippi, Michigan, and Missouri.  In Mississippi 60% of voters support M4A but 75% of those voted for Biden.  In the video below, Biden said he would veto any M4A bill that came to his desk as president.  In Missouri and Michigan those supported M4A preferred Sanders.

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Medicare for All is a "Top/Important Priority" in Pennsylvania

I saw this article by a Julian Routh of the Pittsburgh Post-Gazette where he reports on a survey by the Kaiser Family Foundation and the Cook Political Report of voters in the states of Pennsylvania, Michigan, Minnesota, and Wisconsin called The Blue Wall Project.  He highlights their responses to questions on implementing a Medicare for All System and on banning fracking as warning signs for progressives.  He sites that 57% of PA voters believe that an outright ban on hydraulic fracturing or fracking is a "bad idea."  Also he says that 56% of swing voters believe that Medicare for All is a bad idea.

I went back to look at the raw results for the survey to see where he found those numbers.  For starters this was a long survey administered by telephone (8%), computer assisted telephone interviewing or CATI (6%), and online (86%) with 3,222 respondents.  752 respondents were in Pennsylvania.  They were offered $2 as a pre-incentive.  Hispanics were offered an additional $10 for completing the survey.  There were 36 questions followed by demographic questions.

The items that Routh cites were items 23g and 23f for fracking and Medicare for all respectively.  Survey item #4 asked respondents what the top priority should be for Congress in the upcoming year.  Item 4d asked: "Implementing a national Medicare-for-all plan, in which all Americans would get their insurance from a single government plan."  For Pennsylvania, 54% of all respondents said that this was either a top priority (26%) or an important (28%) thing.  

The length of this suggests that their may be a fatigue effect.  Also the wording of the question may bias the result.  Respondents were paid to encourage them to complete the survey.  

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A look at the Freshman Democratic Congress, Gender, Ethnic Background and Healthcare Contributions

In my two previous posts I looked at Freshman Democratic Congressman their support for single payer or Medicare for All, and their ethnic background on how they effect campaign contributions from the healthcare industry.  I found that there nonwhite freshman who supported single payer received less money than white freshman who did.  I also looked at their gender and found no specific pattern.  For this post I will look at their gender and ethnic background to see if there was a difference in the healthcare campaign contributions that they received.

The graph above shows that nonwhite female freshman congress members overall and from the four healthcare sectors in Tarbell's dataset.  It shows that the most generous donors to freshman Democrats were healthcare professionals and that nonwhite female freshman consistently received less healthcare money.  According to the Analysis of Variance or ANOVA, hospitals gave more to white freshman ($15871) than nonwhite freshman ($7,985, p=0.031).  For total healthcare there was a significant interaction between gender and ethnicity (p=0.034) and a significant main effect for ethnicity (p=0.048) with nonwhite freshman receiving an average of $37,469 less.  The interaction was also present for health professionals (p=0.040) but not the other three sectors.  One would expect that more money from HMOs, Hospitals, and Pharma was given to freshman Republicans.

HMOs, Hospitals, and Pharma may have more rigid rules for donating than healthcare professionals who can give to anyone they want.  Nonwhite congressman may also represent districts with fewer healthcare professionals.  Also when donors are free to give as they choose their cultural biases may become more apparent.

Support SP	Nonwhite		White
	#	%	#	%
No	7	37%	23	56%
Undecided	2	11%	8	20%
Yes	12	63%	10	24%
Total	21	100%	41	100%

Ethnicity and support for single payer are confounded with each other as the table below shows with nonwhite freshman being more likely to support it than white ones.  In my last post I showed that the interaction between support for single payer and  the freshman's ethnic background was present for donations from Health Professionals, HMOs and Hospitals. This indicates that support for Medicare for All and ethnicity is a stronger factor for healthcare donations than the gender of the freshman democrat.

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