How "Harry and Louise" Could Still Take Down Health Care Reform

After more than a decade of academic, media, and popular analysis, the failure of the Clintons' 1993 health care proposal is still best captured by this old Harry and Louise ad in which a white middle-class couple sit down at their kitchen table "sometime in the future" and lament the good ol' days before the bureaucratic government took over their health care system and eliminated their ability to control their own care (my words).

Paid for by the powerful Health Insurance Association of America, this ad galvanized public opposition to health care reform -- confirming the widespread notion that interest groups and media experts can easily manipulate a susceptible public in order to benefit their own bottom line. Of course, this media strategy is found on both sides of the debate. In fact, during the Democratic and Republican conventions this summer, a set of pro-reform interest groups (American Cancer Society Cancer Action Network, Families USA, etc.) aired a new multi-million dollar ad campaign in which the same Harry and Louise return to lament out-of-control health care costs and urge the next president and Congress to put health care reform at the top of their political agenda.

Now, we see a new "Bulldozer ad" from Conservatives for Patent's Rights. In it we watch a bulldozer labeled "Government Run Insurance Plan" rush forward while hearing that Congressional reform proposals "could crush all your other choices, driving them out of existence."

Among others, Newsweek quickly posted a fact check memo pointing out holes in this ad's argument, most notably the fact that for most Americans choices are already incredibly constrained. But, despite the "truthiness" (a la Colbert) of this type of ad, it remains powerful by effectively evoking emotional, rather than rational, responses from viewers. In short, it does not matter if you're really being bulldozed; only if you feel like you are.

It is easy to dismiss this ad effect as superficial smoke and mirrors generated by well-compensated media types manipulating an apathetic and ignorant American public. Instead, it represents something much more fundamental -- and hence, much more powerful.

The fact that we can be swayed, scared, and moved by a minute or two of well-staged political rhetoric illustrates the deeply-conflicted and emotional nature of American public opinion. Rather than simply adopting a liberal or conservative ideology, most Americans embrace a broad set of deeply-held moral beliefs about justice, fairness, freedom, and opportunity. Our problem is not apathy or ignorance, but the complexity of our social problems that requires making really hard trade-offs among values that we really do not want to trade-off.

These tensions were illustrated in the recent June health tracking poll from the Kaiser Family Foundation, in which respondents were provided with counter-arguments after expressing their initial position on aspects of health reform. Not surprising, like political ads, these counter-arguments had a big impact on public preferences. For example, although 71% of respondents favored requiring an individual mandate, the vast majority of these respondents changed their mind when asked, "What if you heard that this could mean that some people would be required to buy health insurance that they find too expensive or did not want?" Additionally, among those opposing the individual mandate, 78% changed their mind when asked, "What if you heard that without such a requirement, insurance companies would still be allowed to deny coverage to people who are sick?"

Kaiser concludes that public support for reform is "somewhat fragile." And that much is clear. But, this fragility does not stem from indifference and confusion as many assume. It stems from the inherent conflict we all face in maximizing conflicting goals, such as broad coverage for the sick and disadvantaged and our desire to make our own choices for how we care for our health. These are not pedestrian concerns for most Americans; but represent deeply-emotional and powerful notions of what is right and wrong -- for themselves, their families, and for others. Harry-and-Louise-Style ads are powerful, not because they tell ignorant Americans what to worry about, but because they remind well-meaning Americans of what could be lost in the name of progress.

When considering the power short TV ads hold to shift public preference, reform proponents may be tempted to talk down to the American public, to focus-group-test even more sound bites, and to sweep complexities under the rug in an effort to hold together the "somewhat fragile" support for reform. But, real efforts to counter this style ad campaign require just the opposite: acknowledging the trade-offs that will occur and leveling with the American public about why they are so necessary.

Elizabeth Rigby, Ph.D. is an Assistant Professor of Political Science at the University of Houston and a Research Associate at the National Center for Children and Families at Columbia University. Her research examines the politics of health, education, and welfare policy making in the US.

Comments

[upton]

The problem is that all those republicans are too dumb to understaned how this will benefit them!

We have to stop these ads getting on air. ABC seems to be on board - the other networks need to be 'encouraged' to follow their lead. It probably all comes back to the fairness doctrine. If we could get that passed we could get Fox off the air and this would all be much easier.

[cathybee]

Please people. Find out the agenda of who is spouting the rhetoric that you are accepting as gospel.
I don't remember the gentleman's name but he was a Canadian spouting that our system was like North Koreas on some sort of infomercial . The interviewer on CBC was able to get him to retract his comments because she knew the truth and could counteract his info. It was also noted that he was being paid by hospitals in the US to get people using there services. He had an agenda...t­he more people he could get down there, the more money he would make.
Next time you see a European, Canadian or any country tourist ask them what they think of their healthcare system. They will tell you their truth because they have no agenda

[BrighterStar]

The person being most untruthful about healthcare is Obama. He knows the people in this country do not want socialized medicine so he is trying to get it passed by trying to make it look like something else.

[Gdebs]

That old crap just don't hunt anymore.

[Ken Jackson]

Got news for you folks. Universal Health Care is as dead as Marley's ghost. Internal warfare among democrats killed it. Whatever chance they had has been squandered, proving yet again that democrats are their own worst enemy. Now, the republicans will sit back and watch and laugh, secure in the knowledge that they didn't need to do a thing.

[USCitizenShareHolder]

Now the GOP says that Health Care Reform is moving to fast and that there needs to be a slow down.

I guess they are saying to sick people or people who may get sick.

Just wait and die because we are going to try to delay health care reform long as possible

That way, my insurance friends can continue to get as rich as possible and pass along some of that money to me.

When you are sick, slow is not an option.

The slower you get treated, the quicker you die.

[Elizabeth Rigby - Huffpost Blogger]

After posting this last night, I just came across this great video spoofing the "Be Afraid, Be Very Afraid" messages coming from reform opponents.

http://www.youtube.com/watch?v=AzDwXr9szxw

Note: It doesn't quite embrace my post's message that these ad strategies are powerful because they tap something very real, not just because they manipulate ignorant Americans. However, I still had to post it since it was so funny!

[raker]

We didn't have Harry and Louise ads here in Massachusetts. But if we know anything, it's that with advertising, people can be made to do or think anything. You can even convince sick people who've been dropped by their health insurance and will soon lose the house to vote against universal health care. Fear trumps all other forms of desperation in America.

[longtalldrink]

Yes, tv ads, just level with us. We might surprise you with what we know. We are not all sheep, easily led around.

[cdub1991]

The response to those ads is that we are now living in the future that Harry and Louise supposedly inhabited and things have gotten worse rather than better. The future is always worse, if you don't change to meet it.

[Elizabeth Rigby - Huffpost Blogger]

Good point!

[kd1s]

I wish we could cut through the political bovine effluent and just shift to a single payer national health care system in the U.S. Of course since the political is so thoroughly polluted by the corporate, and by corporate I mean the insurance industry, that' will never happen.