Ill Communication: President Obama's Misguided Health Care Strategy
In 1998 I ran communications for one of the most stunning political victories of the '90s: Jordan Roberts' upset win as the first-ever woman Senator from the State of Confusion. The campaign was a simulation, part of an intensive five day campaign boot camp, but even though Roberts was fake (I had to play her in drag -- that's for another time) I learned the basic axioms of communication strategy:
1. You start with a goal (50 percent plus 1 vote) which reveals the target audience you need to achieve that goal (soccer moms from Sycamore and young voters throughout the State of Confusion).
2. Then you settle on a compelling message to sway that audience (Jordan Roberts will fight sprawl, preserve open space and is opposed to the dastardly Sycamore mine).
3. Then you win them over with tactics that reinforce that message. (We targeted community newspapers, canvassed every grocery store and built Roberts something called a "Web site")
Communications strategy is an art, and it follows the same formula for issues (environment, women's rights) as it does for elections.
I thought about Jordan Roberts while I watched President Obama's health care press conference. Obama is running a full court press to win health care reform, but the White House isn't following the formula. Surely there's a a strategy, but as I looked over the headlines from the presser the next day -- and at the wavering public support for health care -- I couldn't suss it out. Is health reform falling victim to lackluster messaging and a poor campaign? Are there better alternatives? Let's play strategist! Here's what we're looking at:
Goal: This should be easy -- the goal is to win House and Senate passage of health care for all Americans. But the White House is starting with one hand behind their back: "Health care" reform isn't written yet. There are drafts. There are committee proposals. But the details are in flux, so the White House is out hustling for a plan that doesn't yet exist.
Ezra Klein wrote a great piece today in The Washington Post about how the Obama administration's approach to health care reform has been to just do the opposite of what Bill Clinton did. In 1993, Hillary (and the White House) wrote ClintonCare. In 2009, the actual bill has been outsourced to Congress, which has left President Obama out there campaigning for an unfinished bill that someone else wrote. Where is the helpful WhiteHouse.gov Q&A that could assuage concerned voters? There isn't one, because there aren't any "A's" yet. It's a mess.
Audience: This is tricky. Because health care is something that impacts every American, you have to explain to every American what it is and how it will work. But the real audience is simple: You need to convince independent and centrist voters in conservative/center-leaning districts to raise a total shitstorm if their Representatives vote against health care. These are the people who are represented by "blue dog" conservative Democrats in Congress; it's also some of those pesky working class white voters that we thought would be racist against Obama but weren't. There are some signs that President Obama may be honing in on this audience (see message below) but the sense I get is that they are not yet pushing an aggressive strategy to pressure wavering legislators.
Message: A campaign "message" is the reason why people should support something, and Obama is pretty consistent here: We have to reform health care because we can't afford not to. He has tied his message to the economic crisis, and to the staggering costs of health care. If you go back to our audience, it's smart: the target audience is worried about the economy -- so the message responds to that.
The problem, of course, is that "Reform health insurance now because we can't afford not to" isn't exactly "Yes, We Can." (A message isn't as focused as a slogan, but you get my point -- there's no Will.I.Am video coming out of the conceptual need to reduce the tripling of health insurance premiums.) It's also not very "I feel your pain," and it's hampered because there isn't a plan on paper yet. So the message is muddled by fears of massive government spending. It's also a little Bush-ian, even though it's true: we have to do this or else.
Is there something better?
One of the few times during the presidential debates that I actually staggered up out of my chair and cheered was when Candidate Obama asserted that health care is a human right. I wonder if there isn't a bolder, higher-calling messaging platform that appeals to a moral framework as well as an economic one. Cost is important, but doesn't "we're Americans, we're heroes, we care for our seniors and our children and our neighbors, and so there are certain rights we all have in this country" trump "deficit reduction by 2017?" You can wrap in the economy -- health care has always been a right, now it's a necessity. It's a moral and economic imperative.
Tactics: Here's where I find some real fault with the Obama administration.
- Why did President Obama insist on a press conference, instead of an Oval Office address, which gave reporters a chance to parrot Republican talking points and put him on the defensive? An Oval Office address is usually reserved for foreign
policy, but this certainly rises to the occasion and fits nicely with a moral and economic imperative argument. Maybe he could have ended his address with some online questions? - Why is Vice-President Biden, the administration's point man on middle class issues, getting draped in medallions in Georgia and Ukraine instead of out campaigning for health care?
- Where is any useful shred of information about how your health care will be impacted at WhiteHouse.gov?
The biggest tactical concern I have, though, stems from how President Obama ran the general election. In 2008, they mastered the art of the "local" media hit. They talked under the national press, with local ads about issues that pertained to voters in specific states. Nuclear waste in Nevada, DHL outsourcing in Ohio, etc. Given that the entire objective here is to get a set of very specific legislators to support your bill, why isn't both the media and the online apparatus ramped up to put political pressure on those legislators? The lead "blue dog" reticent Democrat on health care is Congressman Mike Ross, from Arkansas' 4th District. So where is the Joe Biden sit down interview with Hot Springs Fox 16? Let's do it.
My guess is that the White House -- in an effort to look bi-partisan and not to stake the entire presidency on health care -- doesn't want to knock the heads of wavering legislators in their own districts and appear overtly political. But if health care really is that important, isn't this the time to do it? Senator Ben Nelson from Nebraska is the worst on health care. I'd love to see President Obama at the biggest church in Omaha -- where he was the first Democrat since 1964 to win an electoral vote -- launching his crusade -- yes, I said it -- for health care. Yes, we can.
The team that mastered "local" seems to have lost that page in the playbook.
So, What Would I Do? Well, I'm not David Axelrod, the president's chief political strategist. And I'm not on the treadmill everyday at 5 a.m. perfecting my rock-hard ass from years of ballet dancing like Chief of Staff Rahm Emmanuel. Maybe I should be. But if I were running communications on health care for the White House, here's what I would do:
1. Wait it out this week while the House hopefully (no given) passes a bill. Then I would take that bill and create a series of online and offline materials that explain succinctly how it would impact your health care. I want that Q&A. I want an awesome PSA that goes everywhere. If they can get Secretary of Health Kathleen Sebelius on the field with The Washington Nationals mascot to encourage flu vaccinations, they can get a 2 minute video outlining the basics of Obamacare.
2. Shift the message, from "do it now or the economy will tank" to the moral and economic imperative a can-do country has to provide first-rate health care argument. Launch the crusade.
3. Set out on a campaign-style, legislative-targeted barnstorming tour for health reform. Do events in Blue Dog districts. Put Joe Biden on NBC-Omaha. Get your best spokespeople. Michelle should be out there; Biden; Bill Clinton, maybe? In Cleveland on Friday we saw flashes of Candidate Obama. It's a good start.
(Also, except for Chelsea Clinton's wedding, President Obama needs to can the Martha's Vineyard vacation.)
4. Get all the advocacy groups on the same page with 1-3.
5. When we're back in September, give your Oval Office address and make it your best speech ever.
Also? We could use a little cultural currency around this. Shepard Fairey did an awesome windmill that MoveOn is pushing, but September means college and high school kids back on campus and looking for some way to get into trouble -- lets put them to work like it was 2008.
All that is easier said than done. I've run some winning campaigns since Jordan Roberts, but none as vexing as health care. And Jordan wouldn't have won if I didn't look so good in a dress. But as a student of campaign strategy, and an ardent progressive who wants to see a generation-defining health care plan up on the policy Mount Rushmore right next to Social Security, I am concerned that President Obama's communication strategy is not up to the task.
Health care is about sick people -- dying, suffering people, and also about healthy people -- thriving, vibrant people -- and not just about "get it done now to keep costs down" and muddled East Room pressers. The congressional recess this week is a chance for President Obama to regroup and reset his strategy. My hope is he hits the road with the urgency, passion and political (even partisan) communications savvy this issue deserves.
Note: This post first appeared at PinkoMag.com, which the author co-edits.
Follow Ben Wyskida on Twitter: www.twitter.com/wyskida
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Thanks Ben! We desperately need this kind of communications emphasis to win any victory, not just on health care. I wish there were a non-profit organization out there solely devoted to PR/framing
Wyskida’s “goal:” To win “50 pecent plus one vote.” This is like saying that the goal of Budweiser is to sell beer.
And this is not even an election we're talking about. The real goal is to persuade lawmakers to vote a certain way, which does not always depend on constituent opinion, and certainly not on producing a majority consensus in an electorate (think logrolling, party discipline, coddling “important” constituents like business leaders and donors, and other factors, like technical analyses the people or press don't understand but that would make a politician vote a particular way — and, amazing as it may sound, political norms).
A lot of questions need to be asked before proposing an outreach strategy on health care reform. Like what, exactly is motivating the "swing votes" in Congress? Might be constituent opinion, might not. If it is, then see what’s motivating voters in specific areas. But reaching voters still might not be the solution to changing the votes of representatives and senators. Might be reaching opinion leaders, or simply exposing a politician’s position which may not be well known. Or, it might be all about positioning health care reform in a way that’s more acceptable to everyone. Which is a whole ‘nother strategy — requiring a knowledge of what different target groups on both sides of the issue want. This is the "message" part.
Mr. Wyskida's strategy is way too general and assumes too much.
No no - sorry the writing wasn't clear. 50 percent plus one vote was the goal of the simulated senate campaign I was working on at a campaign planning/training program I was part of. The goal of the simulation was to learn ruthless politics and to hustle for votes.
I was trying to walk through the basic principles (goal, audience, message, tactics) of a communications plan and then explain how they were or were not being executed in Obama's health care push.
Sorry it wasn't clear. Health care, as I wrote, is not a 50% + 1 proposition - it's an issue campaign about getting a good bill through.
Actually, your writing was reasonably clear — I put too much emphasis in my comment on the "50%+1 vote" statement (which is still too general an objective for a campaign strategy). You stated that the goal is to "win House and Senate passage of health care for all." Again, I'd argue that this is way too general. What's missing is a situation analysis identifying persuasion opportunities and challenges and navigating these things for maximum effect. Also, I think your strategy leaves out way too many "touchpoints" in the process. Constituent pressure is just one element in the decision making process of members of Congress. Party discipline, expert opinion, logrolling, etc. figure in big — and these are at least somewhat manageable.
If this were affirmative action to get health care for black citizens I would say go for it. It is also a payoff to the Clinton's for the hand-off as well as an official green-light to Media-giant, General Electric who holds the promised contracts for implementation. The language is from the U.N. as are all of the Obama initiatives.
Appreciate all your comments - thanks so much! Also Pacifist2, great lead. How final is that PDF? I'm trying to find a real, actual final bill.
Good stuff, this is what I've been thinking the past week.
Another approach: Obama could have a press conference aimed at the press. He needs to call them out for not doing their job. For instance when many in the MSM focused on the Gates arrest instead of the health care part of his speech.
And what about reporting on details? I'm tired of even Rachel, Keith, and ED constantly analyzing the political opposition to reform. How about analyzing the policy details being debated in these bills? ED had a caller the other day who said it had taken him only 2 1/2 hours to read about 250 pages of the House bill. ED could have seized upon this and asked for a group of citizen volunteers to comb through the legislation and report back to ordinary Americans about the policy details.
The media needs to be talking about things like the cost to an individual of buying into the public option, etc. Obama needs to focus the MSM on the policies, I think a national press conference aimed at the press itself would sink into the pervasive Groupthink that's crippling the national debate.
Anyone who wants to educate themselves to the nuts and bolts of the best draft of the House bill should read this:
http://ene
If you want some guidance about how to get involved via the internet come on over to firedoglak
Thank you.....wi
So many great cpmments on a good post! As a 40 year veteran of the healthcare "System" I know a few things. We do not HAVE a system-we have a corporate takeover that has reduced quality of care while jacking up costs out of all proportion. The only stakeholder" that provides NO actual healthcare service is the insurance industry. The Congress is unable to legislate coherently on this complex issue and the President is wimping out. We should all start pushing for the following: lower the eligiblility age for traditional Medicare by ten years every six months untill everyone is eligible. Nobody is forced to change, but anybody could. We need to end SEPARATE AND UNEQUAL healthcare in the name of justice and rationality both.
Health care has an unlimited demand associated with it and a limited supply.
Those that think health care is a right fail to understand or acknowledge that it has unlimited demand.
Visit a nursing home, look at the monthly bill of the patients there.
Health care is being rationed now. The people that are not getting full care are those with tubes stuck down their throat and are semi-conscience. They are not complaining because they can't.
The next group that will get " rationed" care are those without the resources to have lobbyists in Washington to represent them.
The only unlimited demand I see in our current situation is the greed of those who have found various ways of siphoning off huge profits from a system that clearly is not reaching many people. Health care is not an unlimited demand; rather, it seems at present to be an unlimited opportunity for those whose only concern is unlimited profit. It is a right in the sense that any citizen cannot really fulfill their duties as citizen unless they are freed from the concern and pain of being ill. Our current "system" is clearly already a victim of rationing-shall we have food or medical care this week? Lobbyists work for the insurance companies to make sure that the political will to change this mess is constantly weakened and confused.
We are told it will cost one trillion dollars over 10 years fot universal health care. Meanwhile, we are wasting close to one trillion dollars THIS YEAR ALONE on "defense/national security".
Where is the limit on war spending? Why does war spending increase while caring for our own citizens gets short shrift? In spite of stopping the obsolete F-22, Obama's "defense" budget is an increase of 4% over Bush's last war budget, not including the "supplemental" for our three wars in the Middle East and Central Asia.
Let's talk morality: why are we so willing to spend hundreds of billions to kill people than to care for them?
Let’s score this SECRET, KEY and GAME CHANGER first, CBO !
The House leaders reached a deal on Medicare payments: A "Pay for Value" reimbursement system that rewards doctors and hospitals that achieve the best outcomes at the lowest cost. As a result, The House gained a lot of votes, a lot of people who were withholding support.
The federal Medicare program insures some 44 million elderly and disabled Americans at an annual cost of $450 billion, almost one-fifth of total U.S. health care spending.
Supporters of the agreement say it could save the Medicare System more than $100 billion a year and improve care, that means $1trillian over a decade. (Please visit http://www
The Times in a July 7 editorial argued “As much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients,” Thus the remaining $239 billions over a decade do not matter. And private insurance, too, will be greatly influenced by this change with the focus on value over volume. !
Dr. Armadiosays, "If we got rid of that stuff, we save a third of all that we spend and that is 2.5 trillion dollars on health care. A third of that and that is 700 billion dollars a year. That covers a lot of uninsured people."
The House leaders reached a deal on Medicare payments: A "Pay for Value" reimbursement system that rewards doctors and hospitals that achieve the best outcomes at the lowest cost. As a result, The House gained a lot of votes, a lot of people who were withholding support.
The federal Medicare program insures some 44 million elderly and disabled Americans at an annual cost of $450 billion, almost one-fifth of total U.S. health care spending.
Supporters of the agreement say it could save the Medicare System more than $100 billion a year and improve care, that means $1trillian over a decade. (Please visit http://www
The Times in a July 7 editorial argued “As much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients,” Thus the remaining $239 billions over a decade do not matter.
No one can disagree with this best outcome / evidence-based system, and private insurance, too, will be greatly influenced by this change with the focus on value over volume. !
Dr. Armadio says, "If we got rid of that stuff, we save a third of all that we spend and that is 2.5 trillion dollars on health care. A third of that and that is 700 billion dollars a year. That covers a lot of uninsured people."
Health care is in crisis. America in a crisis does not always or rarely react in the best interests of its citizens. The usual response of the government is to take away or rationalize away rights. I believe that the message of health care as a right has been so maligned and vilified by the republican talking points, that it is not even on the average persons radar today. What I find striking is the absence of attacking the talking points by anyone in the press, or the Democratic party. I think any strategy needs to re-direct attention to ones individual situation, which is not being done.
Unfortunately, I think this is a come from behind campaign that is going to take every communication and political tactic in the book. I hope someone who can make a difference in developing a campaign reads your article.
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