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Tim James Up with First TV Ad

Candidate for Alabama governor Tim James is up with his first TV ad, which will start airing this week.  I’m surprisingly impressed with the ad and think it may be the best of the lot of TV campaign ads in this race so far, in terms of doing EXACTLY what the candidate needs to do at this point in the race.  I’ll be interested to see what his campaign comes up with next.

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Taking a Look at the Tim James Healthcare Plan

I strongly encourage gubernatorial candidates to come out with detailed policy proposals, something we can really sink our teeth into and something that gives a real window into how the candidate thinks about the issues we face.  So I was excited to take a look at what Tim James proposed today in Huntsville for healthcare.  From the campaign press release we get the following policy proposals:

  • Health Care Savings Accounts – Introduce health care savings accounts to state workers and teachers as an option to current plans now offered. This will provide people incentives to utilize health services more strategically, putting the decision-making with patients, not insurance companies.
  • Incentives for Healthy Living – Offer smoking cessation treatment, exercise classes, nutrition instruction to those enrolled in state-funded health care plans.
  • Greater Flexibility in Medicaid Plans – Shift Medicaid from a one-size-fits-all plan of 40 years ago to different levels of care to fit the needs of the 700,000 Alabamians served by the federal-state health care program for low income families.
  • Limit Medicaid Prescriptions – Move from unlimited prescriptions for Medicaid patients to five per month, saving the State of Alabama millions in taxpayer dollars.
  • Emergency Rooms for Emergencies Only – Restrict emergency rooms for medical emergencies for those enrolled in state-funded health care programs, saving taxpayers millions and taking an unnecessary burden off of hospital ERs. Clinics can accommodate the non-emergent care patients, and at a much lower cost.
  • Statewide Health Awareness – Bring Get Healthy Alabama’s message to schools, communities and families statewide in a comprehensive communications program utilizing all media, including the Internet.

Let’s take these one at a time.  First, we have Health Savings Accounts…which must be paired with high-deductible health insurance programs (HIDPs), sound great in concept, and can work well for young healthy people.  But they can also exacerbate many issues we are already experiencing with our healthcare system.  As Dr. Sara Collins of the Commonwealth Fund testified before Congress in 2006,

  • The EBRI/Commonwealth Fund Consumerism in Health Care Survey found in 2005 that people enrolled in HSA-eligible HDHPs were much less satisfied with many aspects of their health care than adults in more comprehensive plans.
  • People in these plans allocate substantial amounts of income to their health care, especially those who have poorer health or lower incomes.
  • Adults in HDHPs are far more likely to delay or avoid getting needed care, or to skip medications, because of the cost. Problems are particularly pronounced among those with poorer health or lower incomes.
  • Few Americans in any health plan have the information they need to make decisions. Just 12 to 16 percent of insured adults have information from their health plan about the quality or cost of care provided by their doctors and hospitals.

I’m interested to know what Mr. James is looking at or who he is listening to that is refuting this information.  The last bullet is particularly concerning, one of the key assumptions about HSA’s is that people will be able to make “informed decisions”, but that is not how they have worked in reality.

Next, we have Incentives for Healthy Living…no problems I can see with the vague statements offered here.  Though I’m not sure what Mr. James is proposing that is different from the existing State Employee’s Insurance Program Wellness Initiative.

Third, he proposes Greater Flexibility in Medicaid Plans…this one is extremely vague and I’m really not sure what this will entail.  We already have a number of different Medicaid waiver programs that offer differing services…so what is he proposing to change?  I would be very interested in if there is another state he is looking to model our program after or if this is something completely different than any of the other 49 states are doing.

Limiting Medicaid Prescriptions…the five prescription limit was put on the table by the current Alabama Medicaid commissioner in December and there is a bill currently bouncing around the legislature that would enact a similar restriction.  Here is a link to an FAQ on the current Medicaid prescription limits.  Before we take this kind of action, it’s extremely important to gather information on those that are currently over the five prescription limit that is being proposed.  Are we saying that if someone needs six prescription drugs to function effectively, we’re going to say, “No, you can only have five.  You have to chose.”  I understand we have to set limits, but it’s impossible for anyone to know whether the limit proposed is reasonable unless we know the types of clients we are talking about who get more than five prescriptions now.

Emergency Rooms for Emergencies Only…this one may simply be illegal.  The Emergency Medical Treatment and Active Labor Act clearly states that any hospital that accepts Medicare must provide services to anyone, regardless of ability to pay.  So, while the state may be able to deny payment for services rendered in an emergency room that are not deemed to be “emergency” through Medicaid or SCHIP (though I question whether we can even do that), the patients who are seeking the services cannot be told they can’t receive the services.  So, we’re left with an unenforceable regulation that will leave hospitals potentially providing even more services for which they will not receive payment.

And finally statewide health awareness…Mr. James has his own catchy slogan.  I’m just not sure his program will be leaps and bounds more successful than any of the myriad initiatives that the Alabama Department of Public Health is already responsible for…like “Scale Back Alabama”.

I’m interested in what other readers thought of these proposals and what I may have missed.

Latest Social Media Poll Results and Updating the Twitter Scorecard

The latest TWAY poll results are in.  This time, the question we asked was “Which gubernatorial candidate is running the most effective online campaign?”  Our completely unscientific (but still interesting) results are:

Bradley Byrne 33%

Artur Davis 28%

Tim James 20%

Bill Johnson 9%

Ron Sparks 6%

Roy Moore 2%

Robert Bentley 1%

Kay Ivey 1%

James Potts <1%

I also wanted to check-in once again with some objective numbers (and subjective analysis) on the use of social media by the candidates for Alabama governor.  Let’s look at the number of Facebook “fans”, Twitter “followers” and You Tube “subscribers”.

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We last visited the usage of Twitter by candidates in December.  While the number of pieces of information flowing on Twitter have changed quite dramatically, there is still a key piece of what social media is all about missing, interaction.  While there is now much interaction between surrogates (including campaign staff) and the general public, there is still very little to no interaction from the candidates themselves.  We receive assurances that most if not all of the candidates are now producing their own tweets (which I still find suspect), but few questions are being answered or posed from those accounts.

As I did in December, I looked at the results from Twitalyzer, which is an application that provides a way to score your impact in the Twitter universe.  Here is how the candidates shake out (with their December scores in parentheses):

@ArturDavis: 3.4 (1.8)

@Bradley Byrne: 1.6 (1.4)

@TimJames2010: 1.5 (0.9)

@Moore2010: 1.5 (0)

@Bentley2010: 0.9 (0.1)

@TeamJohnson2010: 0.5 (0.9)

@KayIvey: 0.4 (0.5)

@RonSparks2010: 0.3 (0.2)

Congressman Davis continues to expand his lead over the field by this measure, almost doubling his score from December.  Roy Moore made the next biggest move, followed by Rep. Bentley, then Tim James and Bill Johnson.  Kay Ivey and Ron Sparks actually regressed since December.  From my own experience with following these accounts, I once again believe this objective measure to coincide with my subjective opinion of what is happening.  I am impressed with the engagement of the James campaign on social media, and their use of it in getting out their message.  I still believe Davis’s apparatus has been superior, but the gap is closing.

Latest Poll Shows Byrne leads in Republican Primary, but Many Undecided

Some really interesting numbers out today from Public Strategy Associates and pollster Mike Baselice.  These numbers look very realistic, first because of the high number of undecided voters identified.  The reality is a large number of Republican primary voters haven’t sorted through this field yet and if a pollster pushes them to pick one candidate over another, name ID is going to drive the decision more than who they will ultimately choose to support (explaining some of the previously high numbers we’ve heard about for Former Alabama Supreme Court Chief Justice Roy Moore).

This poll revealed that 46% of those polled are undecided, which is good and bad news for candidates in the race.  They still have a lot of work to do.  Some of them have been at this for almost a year, and only about half of the primary electorate has made up their minds.  That could be a little disheartening, but also a big opportunity for all of the candidates in the race. 

The poll also show how difficult it is going to be for anyone to get a majority of the vote and avoid a run-off.  If you look at those voters who have made a decision, about a third are going for former two-year college chancellor Bradley Byrne, a third for Roy Moore and businessman Tim James leading in the remaining third.  I thought the numbers when you combined first and second choice made it even more apparent that, right now, it is a three-person race:

Byrne – 1st Choice of 20%, 2nd Choice of 7% = 27%

Moore – 1st Choice of 17%, 2nd Choice of 7% = 24%

James – 1st Choice of 8%, 2nd Choice of 8% = 16%

That means that half of those who have made up their minds like Byrne enough to make him their first or second choice.  Almost half feel the same about Moore.  In fact, I was surprised at the number of folks who picked Moore and Byrne as their 1-2 selection in one order or the other, seems like a strange pair to be torn between to me.  Tim James doubles his support when you look at second choice, which makes him a player as well, if the field thins or the front-runners stumble.

I was also impressed with Byrne’s strong showing across the ideology spectrum.  I would have thought he would be trailing Roy Moore even more amongst those who consider themselves “very conservative”, considering most view Byrne’s biggest deficit as the perception that he is too moderate.  However, these numbers show different.  Byrne runs a strong second to Moore’s 24%, with 18%, amongst those who label themselves “very conservative”.  As expected, Byrne has strong leads amongst less conservative members of the Republican electorate and Moore falls back to the rest of the pack in those categories (which do not make up the majority of the electorate in a Republican primary).

Byrne must remain competitive (within 5-7 points) with the “very conservative” 55% of the primary electorate, but he doesn’t have to win that group to win the race.  That’s the balancing act he faces, appealing to enough of these voters to get through the primary, while still leaving himself in a position to gain independent and Democratic support in the general election.  Moore’s strategy is more straightforward, shore up as much of the “very conservative” base as possible and mobilize them actively both through the primary and a potential general election, because his baggage with less conservative voters is substantial.

The breakdown by gender was also a bit surprising in that State Treasurer Kay Ivey didn’t see any bump in her support amongst women.  She polled at 3% both among males and females.  That has to be disheartening to her (as if polling at 3% isn’t disheartening enough).

Big thanks to Public Strategy Associates for conducting the poll and I am interested in your comments and thoughts below.

**UPDATE:  National Journal had some comments and quotes on the poll here.