November 4, 2008, brought to a close the longest, costliest, and most eagerly anticipated presidential election in history.

The campaign itself was historic – both because of the vast sums of money spent by both sides and the presence of a minority candidate and a woman on the Democratic and Republican tickets, respectively.

Yet history continued to be made on election day. Senator Barack Obama’s victory meant that, for the first time, an African American candidate was elected president of the United States – an event that, for many, represented what The New York Times termed, “a new era in a country where just 143 years ago, Mr. Obama, as a black man, could have been owned as a slave.”¹

With almost 130 million ballots cast nationwide, the 2008 presidential elections had the highest levels of participation in history as well as the highest turnout: the percentage of registered voters was up – 61% of registered voters made it to the polls on election day, a number that has hovered between 50% and 60% since 1968 and even dipped below 50% in 1996.²

The extent of Barack Obama’s victory, although not historic, is certainly notable. Obama won 365 Electoral College votes to Senator McCain’s 173 and carried 28 states to McCain’s 22. Obama swept the traditional “battleground” states of Ohio, Pennsylvania, and Florida and made inroads in the Southwest with victories in Colorado and New Mexico. Obama surprised many by winning the former southern Republican strongholds of Virginia and North Carolina; Obama even carried Indiana – a state that favored President George W. Bush by more than 20 percentage points in 2004.³

Commentary

Because it was so historic, the 2008 presidential election will likely be debated and analyzed for years. Voters were clearly dissatisfied with the Bush administration (with which McCain was closely associated) and with a Republican party that appeared to be out of touch with its core values. In addition, the energy, enthusiasm, and passion surrounding the Obama campaign transformed Obama from an inexperienced outsider going into the primaries to the strong favorite approaching election day.

There were several steps along the campaign trail that defined the two campaigns and could been seen as determining factors in the outcome.

Vice Presidential Picks

Biden vs. Palin – If anyone could challenge the star power generated by Barack Obama, it was Sarah Palin – Republican Governor of Alaska and Senator John McCain’s choice for running mate.

John McCain surprised almost everyone when he catapulted the previously unknown former mayor of Wasilla (population 10,000) onto the national stage. Although some pundits sneered at her lack of experience, Palin’s appearance at the Republican National Convention in St. Paul showed her to be everything the McCain team hoped for – articulate, witty, and the darling of the Republican base that needed to be energized.

Yet during the course of the campaign, the Palin gloss wore off – in the eyes of many voters at least. Her awkward interview with Katie Couric raised doubts about her suitability for the office – especially given Senator McCain’s age and medical history. In addition, her own lack of experience served to negate that particular charge against Barack Obama. Inexperience was an obvious flaw in Obama’s resumé given that he had only been in the U.S. Senate in 2004.

Meanwhile, Obama himself nominated Delaware Senator Joe Biden as his running mate. Biden failed to generate much momentum around his own bid for the Democratic nomination for president, but given his experience (first elected to the Senate in 1972) and foreign policy credentials (chairman of the Senate Foreign Relations Committee), Biden’s presence on the ticket did far more to help Obama than hurt him.

The Change Message

The unprecedented appeal of Barack Obama can be attributed to his ability to capitalize on President Bush’s low approval ratings and a general, nationwide sense of dissatisfaction with the politics of the past 8 years. Although his rhetoric was often short on details, Obama made “change” and “hope” key themes during his campaign and used this mantra to carry him through a hotly contested primary and all the way to the White House.

McCain made the most of his “maverick” status, his track record of working across party lines to pass legislation, and his nomination of Sarah Palin – a Washington outsider. However, his close association with the unpopular Bush administration was ultimately an insurmountable hurdle for many voters.

Given Obama’s focus on “change,” some noted the irony in his early appointments as president-elect. His chief of staff – Rep. Rahm Emanuel –not only was an incumbent Congressman but also worked as a Hill staffer and an advisor to the Clinton White House and to Richard M. Daley’s victorious campaign for mayor of Chicago in 1989. An unusual choice, some might say, to bring change to Washington.

Subsequent Cabinet appointments read like a “who’s who” of the Democratic Party. Former Obama primary rival Senator Hillary Clinton was announced secretary of state; former Senate Majority Leader Tom Daschle, Health and Human Services Secretary; and New Mexico Governor Bill Richardson, who served as UN Ambassador for the Clinton White House, Commerce Secretary.

Although these members of the Obama team may be inconsistent with his message of “change,” the challenges our nation faces regarding the economic crisis, the threats to the fundamentals of our manufacturing base, and the ongoing conflicts in Iraq and Afghanistan all point to the urgent need for experience, leadership, and continuity at this time. Furthermore, the tragic death of Clinton Deputy White House Counsel Vince Foster serves as a reminder of the extreme pressure the incoming administration will be under and the importance of effective management through the complicated transition of power.

The Economy

Although former Clinton advisor James Carville coined the phrase, “It’s the economy, stupid,” in 1992, 16 years later, that sentiment remains true. Although many voters were skeptical about Obama’s lack of foreign policy experience and were impressed with McCain’s record in office, service to his country, and commitment to American values, it was the collapse of the stock markets and the global financial crisis that, many argue, helped tip the scales in Obama’s favor.

McCain’s close association with the Bush administration ultimately hurt him on economic issues – after all, the global credit crunch and subsequent meltdown occurred on Bush’s watch. Thus, as stock markets tumbled and banks failed during September, Obama’s message of change began to resonate with voters more than ever. At the same time, Obama was able to portray McCain – with his 20 years or more in the Senate – as offering up “politics as usual,” an accusation voters began to pay attention to as their retirement accounts evaporated and their home prices continued to plummet.

McCain’s offer to “suspend his campaign” and cancel a nationally televised debate to return to Washington to legislate on the bank bailout was a move that made him look erratic and willing to resort to cheap political stunts at a time when Obama appeared confident and in control.

Times of crises often favor the experienced candidate over the newcomer, incumbent over challenger. Bush’s portrayal of himself as a wartime president was an important factor in his decisive victory over Senator John Kerry in 2004. Yet, in 2008, fears about our crumbling financial systems, housing market collapse, shrinking manufacturing sector, and deteriorating infrastructure swayed voters to embrace the change offered by Obama over the experience offered by McCain.

Overview: The House and Senate

While eyes across the world were focused on the outcome of the U.S. presidential race, control of the House and Senate were also up for grabs on November 4. Since regaining control of both legislative chambers in 2006, the Democratic Party held only the slimmest majority in the Senate (49 Democrats to 49 Republicans, with 2 Independents caucusing with the Democrats) after 12 years in the minority following Newt Gingrich’s 1994 “Republican Revolution.”

Two years later, a strong showing allowed the Democrats to extend their margin, although it fell short of the 60 seats they needed for a filibuster-proof majority. This time, the Democrats picked up a net of seven seats (with one yet undecided – the Minnesota race between comedian Al Franken and incumbent Republican Norm Coleman).

Democrats in the Senate retained all of the seats they were defending, won open seats in Colorado and Virginia, and defeated Republican incumbents in New Hampshire, Oregon, North Carolina, and Virginia to hold 56 seats (+2 independents) to the Republicans’ 41.

Memorable Moments from the Battle for the Senate

Connecticut: Joe Lieberman – Despite not even appearing on a ballot (Senator Lieberman was elected to a 6-year term in 2004), the controversial Connecticut senator remained in the spotlight thanks to his surprising endorsement of Senator McCain for president. Democrats were outraged when Lieberman – Al Gore’s running mate in 2000 and candidate for the Democratic presidential nomination in 2004 – threw his support behind McCain and campaigned energetically for him, including a keynote appearance at the Republican National Convention.

When Obama emerged victorious, there was a great deal of speculation over what would become of Lieberman – an Independent who caucuses with the Democrats after losing the Democratic primary in 2006. But a series of “clear-the-air” meetings proved successful, and Lieberman will continue to caucus with the Democrats and will retain the chairmanship of the Homeland Security and Governmental Affairs Committee.

Alaska: Ted Stevens – With Governor Sarah Palin running for vice president, Alaska gained unusual prominence in the 2008 election. But the state also received some unwelcome attention when long-term Senator Ted Stevens was indicted by a federal grand jury on corruption charges.

No stranger to controversy, the senator vowed to continue his fight, but on October 27, 2008, barely 1 week before the election, Stevens was found guilty on all seven counts. It is a testament to the popularity of Senator Stevens in Alaska that, even after his conviction, he almost won reelection. Nevertheless, after a nail-biting recount, it was announced on November 18 that Stevens had lost his reelection bid to Democrat Mark Begich. Stevens had served in the Senate since 1968.

North Carolina: Elizabeth Dole – Having served in the Nixon, Ford, Reagan, and Bush Sr. administrations and run for president in 2000, the wife of former senator and 1996 Republican presidential nominee Bob Dole was expected to enjoy a successful career as a legislator after her election to the Senate in 2002. However, mistakes made during her campaign for reelection in 2008 ultimately cost her dearly, and Senator Dole was defeated by outsider Kay Hagan, a state senator from Greensboro. With Obama aggressively targeting North Carolina, Dole ran a negative advertisement accusing Hagan of taking donations from a group that advocates for the rights of people who do not believe in God. Hagan, a former Sunday school teacher, dismissed the charges and won the support of voters turned off by Dole’s negative tactics.

Dole lost by a wider-than-expected margin, taking only 44% of the vote to Hagan’s 53% – the widest margin for a Senate race in North Carolina in 30 years and the largest margin of defeat for an incumbent senator in the 2008 cycle.

House of Representatives – Election Overview

In the U.S. House of Representatives, Democrats picked up 21 seats for a 257 majority to the Republicans’ 178.

Notable House Races:

• Illinois’ 14th Congressional District: When former House Speaker Dennis Hastert (R) resigned November 26, 2007, Bill Foster (D) caused a major upset when he defeated Jim Oberweis (R) in a special election on March 8, 2008. When the two faced each other again in November, Foster won again, this time by a wide margin.
• Connecticut''s 4th Congressional District has been represented by Chris Shays (R) since 1987. However, he lost his 2008 bid for reelection to Democrat Jim Himes. From 2006 until 2008, it was the only district in New England represented by a Republican – there are now no Republican-held House seats in New England.
• Virginia''s 5th Congressional District: The swing in Virginia from a red state to a blue can be attributed to shifting demographics, especially in the Northern Virginia suburbs of Washington, DC. Yet changes were witnessed in the heartland of Virginia as well. Incumbent congressman Virgil Goode lost reelection to Tom Perriello, who has been certified the winner of the 2008 election to the 111th Congress by a margin of 745 of more than 316,000 votes cast.
• Texas’s 22nd District: In a rare, positive moment for the Republican party, Democratic incumbent Nick Lampson was defeated by Republican Pete Olson. The 22nd district was formerly held by House Speaker Tom Delay, who was forced to resign before the 2006 election over ethical questions relating to the Jack Abramoff scandal. Because of Texas election law, Republicans missed the deadline to name an alternative candidate, and Rep. Lampson won the seat in 2006. In an interesting twist, Lampson had previously lost his seat in 2004 after a Tom Delay–led redistricting effort.

Outlook – New Administration, New Congress

President-elect Barack Obama defied expectations and made history by winning the 2008 presidential election. Now, some say he has the job no one wants. With the conflicts in Iraq and Afghanistan still unresolved and the nation facing its greatest financial crisis since the Great Depression, Obama faces unprecedented challenges amid runaway anticipation and expectation. Immediate priorities include implementation of the $700 billion bank bailout recently approved by Congress and development of effective responses to the potential collapse of the Detroit auto industry and the ongoing subprime mortgage crisis. At this tumultuous time, campaign promises of health care reform and changes to our energy policy may slip downward on the list of priorities. Yet conversations with congressional leaders on the Hill suggest that health care reform remains very much alive in the 111th Congress. As Bill and Hillary Clinton found out – an issue such as health care reform depends more on support and initiative from the Congress than the White House.

Update – Leadership for Medication Management

ACCP and our partner organizations in the Leadership for Medication Management (LMM) continue to lobby on Capitol Hill on behalf of our proposal to improve medication therapy management (MTM) under Medicare Part D and expand access to the patient-care services of pharmacists under Medicare Part B.

At this stage, it is important that all ACCP members to review the legislative proposal and supporting materials (http://www.accp.com/govt/advocacyResources.aspx).

In addition, we have prepared a letter on our Legislative Action Center Web site (http://capwiz.com/accp/home/) for all members to send to their federal lawmakers, introducing the legislative principles and offering opportunities for further discussion of the proposal.

Please also forward the link to the Legislative Action Center to friends, colleagues, and other clinical pharmacy stakeholders. As Congress formulates proposals to reform our nation’s health care delivery system, it is important to continue to remind lawmakers of the widespread support for our issue throughout the pharmacy profession and of the benefits pharmacists can bring to health care delivery and patient care.

Our chances for advancing our agenda depend on your active participation in the political process. For more information on ACCP’s work in Washington, DC, contact John McGlew at (202) 756-2227 or [email protected].

References

1. The New York Times. Obama wins election; McCain loses as Bush legacy is rejected. November 4, 2008. Available at http://www.nytimes.com/2008/11/05/us/politics/05campaign.html.
2. National Voter Turnout in Federal Elections: 1960–2008. Available at: http://www.infoplease.com/ipa/A0781453.html.
3. Real Clear Politics. Available at http://www.realclearpolitics.com/epolls/election_2008/presidential_final_results.html.