Less than 1 month before the nation goes to the polls, the 2012 presidential race remains so competitive as to defy many predictions. Although a majority of Americans have a favorable view of President Obama,1widespread skepticism over his handling of the economy and his accomplishments as president indicates he might struggle to win a second term.
Obama’s signature piece of legislation—the Affordable Care Act—continues to divide the country, with 40% viewing the law unfavorably and 41% viewing it favorably.2 Only 36% of Americans believe the economy is headed in the right direction under President Obama; 35% believe the president’s policies are taking the country in the wrong direction.3
Overall, 47% approve of Obama’s job performance, with 48% of the electorate voicing their disapproval. In contrast, George W. Bush and Ronald Reagan stood at 51% approval at a similar point in their presidencies, and Bill Clinton was at 55% approval.
Unemployment remains stubbornly high, even as the private sector continues to add jobs, according to monthly reports from the Bureau of Labor Statistics. As political pundits keep reminding us, no president since World War II has won reelection with an unemployment rate above 7.4%.4
Yet national polls show the president neck and neck with his Republican challenger, former Massachusetts Governor Mitt Romney. Even more importantly, deeper analysis suggests that the Obama campaign is developing a lead in key swing states.
Why Is the Race So Close?
The power of incumbency is obviously a factor; the weight and gravitas of the office itself improves President Obama’s perception among voters and his ability to raise money. Access to Air Force One, for example, does his reelection campaign no harm.
The passion and fervor that swept Obama to office in 2008, although weakened, remains evident across the electorate, with the president showing strong leads among minority populations and women voters.5
Romney’s campaign has struggled to ignite the levels of excitement among Republicans that Obama has enjoyed among his base. Romney’s high-profile campaign gaffes have helped deflect attention from the president’s economic woes and have forced the former governor to waste valuable time and resources trying to clarify his positions on key issues rather than building support among undecided voters and energizing his base.
Familiarity is also proving to be a challenge for Romney. An increasingly polarized electorate means that less than 10%3 of likely voters were undecided a full 6 months out from the election, which leaves Romney with little room for error as he works to unseat a resilient, if somewhat diminished, incumbent.
State-by-State Polls
With 538 Electoral College votes up for grabs, the winner will require at least 270 to secure the presidency. Polling indicates that President Obama can count on at least 251 votes (142 from states considered “solid,” 37 “likely,” and 72 “leaning”) versus Governor Romney, who can expect at least 181 votes (76 solid, 74 likely, and 31 leaning). This leaves 106 Electoral College votes from states labeled “toss-ups,” where the race is considered too close to predict. These are from Nevada (6 Electoral College votes), Colorado (9), Iowa (6), Wisconsin (10), Ohio (18), Missouri (10), Florida (29), North Carolina (15) Virginia (13), and New Hampshire (4).
State-by-State Poll Summary—October 5, 20126
Colorado (9)
Obama: 47.2%
*Romney: 47.7%
Florida (29)
Obama: 47.3%
*Romney: 48%
Iowa (6)
*Obama: 48.6%
Romney: 45.4%
Missouri (10)
Obama: 43.8%
*Romney: 49%
Nevada (6)
*Obama: 49.5%
Romney: 46%
New Hampshire (4)
*Obama: 50%
Romney: 44%
North Carolina (15)
Obama: 46.2%
*Romney: 49.2%
Ohio (18)
*Obama: 48.5%
Romney: 46.8%
Virginia (13)
*Obama: 47.8%
Romney: 47.5%
Wisconsin (10)
*Obama: 50.8%
Romney: 44.2%
Election Summary
There’s not much that Democrats and Republicans in Washington agree on these days, but few dispute that the 2012 presidential election will be agonizingly close. Romney’s assured performance in the opening debate was met almost immediately with good news for the Obama campaign with the announcement of the September jobs report and reports of the unemployment rate having fallen below 8% for the first time since February 2009.
In the final weeks of the race, the Romney campaign appears to be finding the momentum it struggled to build after the announcement of Congressman Paul Ryan as running mate and the Republican Convention in August. Yet Romney is considered gaffe-prone and still struggles to connect with the voters whose support he desperately needs.
The Obama campaign was bruised by the president’s lackluster debate performance, but it may retain an advantage in Electoral College math. Perhaps October will produce a surprise that will fundamentally dictate the outcome of this race.
H.R. 6413 Medicare Transitional Care Act of 2012
On September 14, 2012, Rep. Earl Blumenauer (D-OR) introduced H.R. 6413, the Medicare Transitional Care Act of 2012.
The bill would cover transitional care services for high-risk patients (those with chronic conditions, mental or cognitive impairment, or multiple hospitalizations) provided by transitional care clinicians (including pharmacists) to facilitate the safe transition of Medicare patients from one level of care, care setting, or provider to another.
The bill provides for payment to qualified clinicians who are affiliated with certain entities (e.g., hospitals or long-term care facilities), and payment would be linked to outcomes-based performance metrics. The bill would also allow additional payments to incentivize the use of health information technology in care coordination.
The bill currently has five cosponsors: Rep. Thomas Petri (R-WI), Rep. Allyson Schwartz (D-PA), Rep. Jan Schakowsky (D-IL), Rep. Jason Altmire (D-PA), and Rep. David Loebsack (D-IA).
H.R. 6413 Background
Insufficient communication among older adults, family caregivers, and health care providers during transitions from one care setting to another contributes to poor continuity of care, inadequate management of complex health care needs, medication errors, and preventable hospital readmissions. These failures create serious patient safety, quality of care, and health outcome concerns.
Transitions of Care Services Include:
- A comprehensive assessment of the individual before the individual’s transition from one care facility to another care facility or home, including an assessment of the individual’s physical and mental condition, cognitive and functional capacities, medication regimen and adherence, social and environmental needs, and primary caregiver needs and resources.
- Development of a comprehensive, evidence-based plan of care for the individual developed with the individual and the individual’s primary caregiver and other health team members, identifying potential health risks, treatment goals, current therapies, and future services for both the individual and any primary caregiver.
- Development of a comprehensive medications management plan that ensures the safe use of medications and is based on the individual’s plan of care. Such management plan shall include the following:
- Identification of the individual’s medications in use (including prescription and nonprescription medications).
- Assessment and (if needed) consultation with key medical providers to ensure medications are necessary, appropriate, and free of discrepancies.
- Assessment of the individual and family caregiver’s health literacy regarding the ability to properly follow medication instructions.
- Individual and family education and counseling about medications.
- Teaching and counseling the individual and the individual’s primary caregiver (as appropriate) to ensure adherence to medications and other therapies and avoid adverse events.
Definition of Qualified Provider of Services:
The definition of the term transitional care clinician includes a nurse, case manager, social worker, physician assistant, physician, pharmacist, or other licensed health professional who:
- has received specialized training in the clinical care of people with several chronic conditions (including medication management) and communication and coordination with multiple providers of services, suppliers, patients, and their primary caregivers; and
- is supported by an interdisciplinary team in a manner that ensures continuity of care throughout a transitional care period and across care settings (including the residences of qualified individuals).
Although it is unlikely that H.R. 6413 will be enacted in the lame duck session of Congress expected after the November elections, ACCP anticipates the introduction of similar legislative language in the 113th Congress and will support its passage. Click here for more information on the Medicare Transitional Care Act of 2012.
ACCP Political Action Committee (ACCP-PAC) and the 2012 Elections
The upcoming November elections will allow ACCP to help elect members of Congress who share our vision for the roles of clinical pharmacists in an evolving health care delivery system.
Beyond the 2012 elections, ACCP is committed to a targeted legislative strategy designed to achieve recognition and payment for comprehensive medication management services provided by clinical pharmacists in the evolving Medicare program.
We also remain focused on developing, advancing, and positioning clinical pharmacists through a variety of public and private initiatives, including the Patient-Centered Primary Care Collaborative (PCPCC).
As health care delivery continues to evolve, it is more vital than ever that we help elect congressional leaders who understand and value the role of the clinical pharmacist as part of a patient-centered, multidisciplinary team.
ACCP-PAC Fundraising Challenge
The success of the ACCP-PAC depends entirely on the support of ACCP members. Although several PACs represent various segments of the pharmacy profession, ACCP has the only PAC dedicated to advancing the practice of clinical pharmacy.
Unlike the contributions to the Frontiers Fund, the ACCP-PAC cannot accept contributions from PRNs. All PAC contributions must be made by individuals from personal funds.
With more than 12,000 members eligible to contribute to the PAC, ACCP is in a position to become one of the most prominent pharmacy PACs in Washington. To do this, we need the widespread support of our membership.
If each ACCP member contributed just $25, the ACCP-PAC would raise $300,000.
All ACCP members should consider making a donation of at least $25 to the ACCP-PAC. CLICK HERE to support your PAC today!
ACCP-PAC Governing Council
The ACCP-PAC is directed by the PAC Governing Council, which provides oversight and strategic leadership for the operations of the ACCP-PAC.
The ACCP-PAC Governing Council consists of the following ACCP members:
Chair: Leigh Ann Ross, Pharm.D., BCPS
Treasurer: Gary R. Matzke, Pharm.D., FCP, FCCP
Secretary: Michael S. Maddux, Pharm.D., FCCP
Member: Anna Legreid Dopp, Pharm.D.
Member: Terry Seaton, Pharm.D., FCCP, BCPS (Board of Regents Liaison)
ACCP funds the administrative expenses associated with operating the PAC, so all member contributions go directly to support pro-clinical pharmacy candidates.
CLICK HERE to support your PAC today!
2011–2012 ACCP-ASHP-VCU Congressional Healthcare Policy Fellow Program
Derek Griffing, Pharm.D., MPH, of Cicero, Illinois, currently serves as the 2012–2013 ACCP-ASHP-VCU Congressional Healthcare Policy Fellow. The fellow program, which is now in its sixth year, provides pharmacists with unique insights into health care policy analysis and development.
Dr. Griffing earned a Pharm.D. degree from Midwestern University School of Pharmacy in 2010 and a master’s degree in public health with a concentration in health systems and policy from Johns Hopkins University, Bloomberg School of Public Health, in 2011. He currently practices as an oncology pharmacist at The Johns Hopkins Hospital in Baltimore.
Dr. Griffing began his fellowship on September 1. After a structured orientation to Congress from the VCU faculty and the Brookings Institute, Griffing spent 1 month with the ASHP government affairs and policy team and 1 month with the ACCP government and professional affairs staff. In November, he will begin working as a policy fellow on a congressional committee or with the personal staff of a U.S. senator or representative.
About the ACCP/ASHP/VCU Pharmacy Policy Fellow Program
The initial month of the program consists of an orientation curriculum put on by faculty of the VCU and the government affairs staff of ACCP and ASHP. Fellows then spend 1 year on Capitol Hill as part of the staff of a congressional committee or the personal staff of a U.S. senator or representative.
The program provides a unique health care policy learning experience that allows the fellow to make practical contributions to the effective use of scientific and pharmaceutical knowledge in government decision-making.
The fellow is also expected to undertake a wide array of responsibilities in the congressional office where he or she serves, including researching and writing briefs on health care issues, assisting with policy decisions, drafting memoranda, and planning, organizing, and contributing to the management objectives of the office.
Applications for 2013–2014 Pharmacy Healthcare Policy Fellow Program
Interested candidates should visit the Pharmacy Healthcare Policy Fellow Program’s website for more information and instruction on submitting and applying.
Contact Us! For more information on any of ACCP’s advocacy efforts, please contact:
John K. McGlew
Associate Director, Government Affairs
American College of Clinical Pharmacy
1455 Pennsylvania Avenue NW
Suite 400
Washington, DC 20004-1017
(202) 621-1820
[email protected]
References
1Washington Post article. Obama Remains More Popular than Romney Before the Conventions. Available at http://www.washingtonpost.com/politics/polling/obama-remains-popular-romney-conventions/2012/08/08/19caa396-e10e-11e1-8d48-2b1243f34c85_page.html. Accessed October 15, 2012.
2Kaiser Health Tracking Poll, March 2012. Available at http://www.kff.org/kaiserpolls/upload/8285-F.pdf. Accessed October 15, 2012.
3Purple Strategies. April 2012 Edition PurplePoll. Available at http://www.purplestrategies.com/wp-content/uploads/AprilPurplePoll_v9.pdf. Accessed October 15, 2012.
4Washington Post article. President Obama’s Troubling Trend Line on Jobs. Available at http://www.washingtonpost.com/blogs/the-fix/post/president-obamas-troubling-trend-line-on-jobs/2012/07/06/gJQAWDHhRW_blog.html. Accessed October 15, 2012.
5Wall Street Journal article. Poll: Women, Minorities Give Obama an Edge. Available at http://blogs.wsj.com/washwire/2012/04/19/poll-women-minorities-give-obama-an-edge/. Accessed October 15, 2012.
6Real Clear Politics. Electoral College Map. Battle for the White House. Available at http://www.realclearpolitics.com/epolls/2012/president/co/colorado_romney_vs_obama-2023.html. Accessed October 15, 2012.