Elections matter. The 2008 presidential election of Barack Obama was historic. The 2010 Senate election of Scott Brown was less symbolic, but perhaps more substantive. President Obama should learn from last week's result. Massachusetts voters spoke loudly, and what they said bodes ill for the President's agenda of expanded government.

President Obama took office at a time of economic crisis. Americans wanted change, and a majority gave their votes to Barack Obama. But events haven't worked out as people expected: Americans haven't seen the change that they desired. That's why Scott Brown was elected to the Senate seat long held by Ted Kennedy: Massachusetts citizens overwhelmingly supported Barack Obama in November 2008; they voted for Brown in January 2010.

The President's State of the Union showed that he had gotten this message-in part. He knows that turning around the economy is paramount, and that voters are disgusted with Washington. Yet he needs to dig deeper to understand more. He might start by looking closely at the results of a poll conducted by our sister organization, the Independent Women's Voice, of Massachusetts voters. The results show that it will take more than new rhetoric to win back voters: voters are focused on issues and want real change in Washington.

The poll showed that health care was voters' most important concern. Nearly one-third of those polled put the current health care debate as their top priority. Another 57 percent ranked it in the top three. And even in liberal Massachusetts, voters don't back a government medical takeover. Of those who ranked health care as their number one concern, 51 percent opposed the leading congressional proposals.

The preferences of self-identified political independents are most telling: Independent men rejected the measure by a 57 percent to 35 percent margin. Independent women were opposed by a similar margin: 55 percent to 33 percent.

Voters want a fresh start on health care. Only 16 percent of respondents believed that health care negotiations should "keep going as it is," and nearly half thought it would be important to open the legislative process to the public.

In the State of the Union, President Obama said he was open to new ideas about how to fix health care. So are Massachusetts voters. And many of those polled back market-oriented reforms: allowing small businesses to band together to buy insurance (57 percent supported), helping individuals to buy insurance (50 percent), implementing malpractice reform (46 percent), and permitting insurance sales across state lines (36 percent).

Of course, health care wasn't voters' only concern. Nearly one-in-five said economic recovery was the most important issue; another 62 percent ranked it within the top three. And once again, Massachusetts voters rejected Obama administration policies. Forty-six percent of voters believed that increased government spending-the Obama Administration's preferred tactic during year one-is more likely to deter the economic recovery, while less than a third believed spending would speed it up. Four out of five said they believed small business tax credits would stimulate economic growth. A majority of voters also want the Bush income tax cuts to be reauthorized, and cuts in government expenditures to reduce government debt.

The Christmas Day attempted terrorist attack also put national security on people's minds. Nearly two-thirds of Massachusetts citizens said that it was "very" or "somewhat" important to their vote when Brown said: "In dealing with terrorists, our tax dollars should pay for weapons to stop them, not lawyers to defend them."

Brown's victory obviously was good news for the Republican Party. It shows that they can win elections even in the most liberal territory. Yet this election was not a vote for the Republican Party, which continues to lag behind the Democrats in public support among Massachusetts voters. Voters saw the election as a referendum on the Democratic policy agenda. They found the agenda wanting, so elected Scott Brown to send a message to Washington.

The message is clear: Massachusetts voters believe health care reform is important, but they want it done right. They don't like the Democratic plan, and they especially don't like the Democrats' attempt to railroad a bad plan into law. Instead, the people want real, bipartisan solutions. Voters believe the economy requires immediate attention. Yet even in liberal Massachusetts, voters want traditionally conservative solutions: spending cuts, tax reductions and less regulation.

Finally, Massachusetts voters emphasize the importance of protecting Americans from terrorism. That doesn't mean giving up the liberties which have made America great. But it does mean treating foreign terrorists different than domestic criminals.

Last year when Sen. Ted Kennedy died, no one imagined that the Massachusetts Senate election would turn out to be so important. But voters wanted to send Washington a message. If the President and Congress don't listen, they are likely to find that the voter revolution won't stop with one state.

Michelle D. Bernard is the president and CEO of the Independent Women's Forum (IWF) and an MSNBC political analyst. Bernard is a regular panelist with MSNBC's Hardball with Chris Matthews and The McLaughlin Group, and a political commentator for The Hill's Congress blog.