By Jason Szep - Analysis
BOSTON (Reuters) - Democratic presidential contender Barack Obama often says his rival Hillary Clinton would force people into buying health care "whether they could afford it or not."
But pollsters and health industry experts say a steep U.S. economic slowdown or recession could help Clinton's battle with Obama for the U.S. presidential nomination by playing to one of her perceived strengths: that she would be better than Obama at controlling surging health care costs.
Health care and other economic issues gave Clinton an edge in Ohio's primary on March 4 when the New York senator, who would be America's first female president, beat a surging Obama, the Illinois senator who would the first black president, exit polls showed.
Many of the same forces are at work in the Pennsylvania contest on April 22, the biggest remaining fight in the Democratic race. Her campaign hopes to repeat her success in Ohio, in part by focusing on her $110 billion universal health care plan as the U.S. economy stumbles.
"When voters say they are worried about the economy, health care is what an awful lot of them are really worried about," said Clay Richards, an assistant director at the Quinnipiac University Polling Institute in Connecticut.
"They see Clinton as the candidate with far more experience in the field," he said.
'ALMOST PARADOXICAL'
But that experience, he noted, includes Clinton's dramatic failure in 1993 to reform U.S. health care, which many Americans felt overstepped the role of first lady.
"It's almost paradoxical that she had a plan that failed and that she is seen as more experienced and the better candidate on health care," he said.
A Quinnipiac survey of Pennsylvania released on Tuesday showed Clinton widening her lead from 6 to 12 percentage points over Obama. Democrats in the state preferred Clinton on health care by a 56 percent to 38 percent margin, it said.
"Pennsylvania has traditionally had an older female electorate which is the number one group of voters for Clinton, number one group of voters for health care, and the number one group of voters who tend to think Clinton is better on health care," said Celinda Lake, a Democratic pollster not affiliated with either candidate.
But Lake and other experts question whether health care or any single issue will dramatically alter the state-by-state race for delegates to the party's nominating convention in August, where the candidate for the November election will be chosen. Obama has led in the delegate count for weeks.
"Clinton would be in a worse position were it not for the rise of economic issues like health care," said Mark Mellman, a Democratic pollster who is not affiliated with a campaign. "But I don't think issues are going to decide this race."
At campaign stops, Clinton calls universal health care a core Democratic value.
"In order to be competitive we've got to have a health care system that covers everybody, doesn't leave anybody out and which begins to lower costs for everyone," she told a rally in Pennsylvania on March 10.
SURGING COSTS
Americans who have health insurance have seen double-digit increases each year for much of the past decade. The number who go without it has reached to nearly 47 million, or about 16 percent of the population, Census Bureau figures show.
People without insurance spend roughly $125 billion on health care annually, with about a third of that amount -- $40 billion -- going unpaid, a debt largely covered by the government, according to a Kaiser Family Foundation study.
Both Clinton and Obama would seek to make health insurance more affordable, and both aim for universal coverage. Both would require private insurers to offer policies to everyone regardless of medical history, and both would allow people to buy government-sponsored insurance.
But Clinton would mandate that everyone acquire health care coverage, just as all automobile drivers must carry insurance. Obama would require only children to be covered and says people will buy insurance if it becomes affordable.
"I don't think the public perceives an enormous difference between the two, though there are differences of course," said William Galston, a senior fellow at the Brookings Institute and a former policy adviser to ex-President Bill Clinton.
"Do I expect the Democratic nomination to turn on the issue of health care? No," Galston said.
But he expects "a resurgence in public debate once the general election is joined in earnest" because there are stark differences between the Democrats' health care plans and that of Arizona Sen. John McCain, the presumptive Republican candidate.
McCain's plan emphasizes containing costs rather than covering the uninsured, proposing a tax credit of $2,500 to low-income individuals and $5,000 to low-income families who obtain their own insurance.
"The cost of health care is unlikely to go away and is certain to figure prominently in the general election," Galston said.
