The American political apparatus imploded as the primary season kicked off in Iowa this February. Many wonder how things could have gotten so bad…but then again, many of us are wondering the same thing about the health care system.  In this show, I will describe some of the problems that arose in Iowa and draw some comparisons about what’s going on in health care. Specifically, I will discuss the importance of primary voting versus polling, the racial composition of Iowa’s audience and the mis-appropriation of funds that led to the Caucus’s technology disaster.
Key Citations

* Cancer rates in the U.S.: Centers for Disease Control and Prevention
* Health care dollars are spent on administrative costs: Annals of Internal Medicine

Transcript
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Welcome to The Powers Report Podcast. I am your host, Janis Powers. The show brings you candid, unique and data-driven perspectives on the health care industry. I believe that any solution that is going to positively impact the American health care system has to satisfy two major criteria: financial viability and behavioral incentive alignment. In other words, access to high quality care can only be achieved if we can afford it, and if we behave in ways that optimize our health. Please subscribe to our show on iTunes or on your preferred podcasting platform and connect with us on social media. Again, this is Janis Powers, and welcome to The Powers Report Podcast.
The most notable event of the 2020 presidential election season has already happened. The Debacle of Des Moines, the Meltdown in the Midwest, call it what you want. It took the Democratic Party in Iowa days, not hours, to identify a winner of the Iowa Caucuses. Given the scale of reported mismanagement, from precincts reporting more votes than they had been allotted to, of course, the massive technology glitch, results are being reviewed. It doesn’t matter. The damage has been done.
The 2020 Iowa Caucuses have given us plenty of opportunity to reflect on how to better run campaigns and elections. Interestingly, I think a lot of those lessons apply to what’s going on in health care. We can all agree that the industry is in dire need of help. Maybe looking at some of its problems through the lens of the political apparatus will make us think a little differently about what needs to change in health care and why.
First let’s talk about the importance of being first. Millions of dollars were invested by the candidates and their parties to make a big splash in Iowa for a reason. On the night of the Caucuses, theoretically, all the polling that went on beforehand becomes irrelevant. Someone’s going to win. Winners get delegates. Candidates need delegates to earn the party’s nomination.
Polling influences voters. Let’s say I can’t decide between Bernie Sanders and Tom Steyer. I hear repeatedly that Steyer is polling near the bottom while Sanders is at the top. Why throw away my vote on someone who’s not going to win? Those polling numbers are going to influence my choice to vote for Sanders.
Polling is a numbers game.  Results depend on who’s asking the question; how questions are asked; who’s being polled; where the polling is conducted; how many people are in the poll; when the poll takes place, etc.
For example, taking a national poll on a subset of voters pitting two candidates against each other for president – like Hillary Clinton versus Donald Trump – is pointless. That kind of poll adds up the number of people who want one candidate or the other. Presidents don’t win elections based on the popular vote.