The Republican presidential candidates avoided talking about healthcare issues in any detail in Iowa because it did not register as a high-impact issue for voters. So no one wanted to put themselves out front architecting their view of solutions, engaging in discussion about it or even visiting healthcare facilities, said Matt Eide, managing partner at Eide & Heisinger in Des Moines, Iowa.
"I think they feared the questions that could come," he said, adding that "it's better to stay with the global view that Obamacare is bad, it's too expensive."
Eide represents some healthcare organizations, including Iowa Medical Group Management Association (IMGMA) and Genesis Health System, a large provider in Iowa, and provided some after-caucus insights.
Q: What do the results of Iowa caucuses mean through the lens of healthcare issues?
A: You get the global sense in dealing with some of the candidates that they tried to bash Romney on his prior healthcare law in Massachusetts. There was not a lot of traction in their attempt to cast a negative light on him and lower his percent in the polls. I think they got all that they could out of it early. The important issues were about jobs and the economy and some social issues from parts of our state.
Q: How did the candidates react to healthcare issues?
A: We tried on behalf of my healthcare clients to get any and all candidates to visit a large healthcare system in eastern Iowa, the largest employer in that county, with personal invitations, letters, went to campaign headquarters, many of the staff whom I know.
I found that no one wanted to go there or be associated with the healthcare issues. I think they feared the questions that could come. My interpretation is, I knew Romney wouldn't want to go there and open himself up. He was very cautious and conservative with his appearances and the questions. I thought we might be able to get Gingrich, Santorum and Bachmann, people who might need platforms to perhaps go after Romney.
[Related Q&A: In Iowa healthcare is yardstick of federal overreach.]
I think there was avoidance on the part of a number of front-runners not to engage in the healthcare debate. I think they all looked at the polling for the importance of issues to Iowans and the influence health care was going to have on their selection was very low. It was hovering around 13 percent as an impact issue. Very little was said on health care except for those big broad statements about Obamacare. The candidates cater their message to what they think the voters were interested in, and health care wasn't one of them.
Q: How do you anticipate health care being treated in the coming primaries?
A: I can't speak to where it ranks with those in New Hampshire or South Carolina. I would surmise it's probably going to be similar with what it was here in Iowa. There isn't anything special about our state's healthcare views. Every vote is going to be fought for. There just wasn't a lot of traction here on health care. I would guess that health care is not going to be a driving issue in the next state primaries.
In my opinion, it's better for candidates to stay with the global views that Obamacare is bad, it's too expensive and it imposes on our freedom and get what you can off of that than trying to be an architect in a primary or caucus state about how you're really going to do it.
Q:Will health care become important at some point in the election process?
A: I have no doubt that it's going to be elevated once we get to the general election.
Q: When the candidates do come up with some ideas, might they use some that were in the health reform law since many were once Republican-generated concepts?
A: Exactly, they get their political points saying bad things about it. But I don't anticipate seeing a lot of detail on how to roll back Obama's health law. Some are going to admit that parts of it are probably good, and outside of the rhetoric and piecemeal changes, that's going to be a real challenge for whoever has to govern.