In 1993, William Kristol wrote a now-famous memo advising Republicans that their ticket to power was blocking health care reform no matter what it looked like. Newt Gingrich followed that advice, and the rest - as they say - is history.
Taking a page from that history, Republican message maestro Frank Luntz told the Republican House conference this week - shrunk back to its 1993 size - that "You're not going to get what you want, but you can kill what they're trying to do."
Luntz's prescription for Republicans is to replay the 1993-1994 Republican playbook of attacking "government" health care: "government rationing care...Washington bureaucrats...government takeover..." You get the picture.
Only this time it won't work. And the reason that Luntz's recycled prescription won't cure Republican's political ailments is revealed in another one of Luntz's remarks to the Republican House members: "...because the American people blame the insurance companies more than almost anybody else for why health care is such a mess in this country right now."
The attack on government health care falls flat when confronted by the everyday experience of Americans with private health insurance. As New York Senator Charles Schumer said on Tuesday at the Senate Finance Committee roundtable, "Well, let me tell you, the American people have some problems with the government. But they have a lot more problems with private insurers."
HHS Secretary Kathleen Sebelius made the same point at a Ways and Means Committee hearing the following day: "I know there's a lot of talk about not having bureaucrats make health decisions, but I think it's equally important not to have private insurance companies make health decisions, overruling protocols recommended by health providers."
The Senator's and Secretary's observations should give some encouragement to those who worry that Democrats will be cowed by the retreaded, anti-government rhetoric from the right. This is a fight that we have prepared for and welcome. We at Health Care for America Now anticipated the fear-mongering attacks that Luntz is promoting and found that if we respond aggressively, we win the argument hands down.
Several rounds of research done for Health Care for America Now and others confirm that Americans take a dim view of the health insurance industry and believe that government is needed to fix the health care mess. We tested many descriptions of the health insurance industry - some favorable and others not - and here's the one that voters affirmed by four-out-five voters (78%): health insurance companies put profits before people.
We also tested a number of message frames, and here's what worked the best:
We need an alternative to the harsh and unfair practices of the health insurance industry. The right approach recognizes that we are all part of the solution. We need a guarantee of quality, affordable health care for all of us. We need government to be an advocate for us and set and enforce the rules so insurance companies put our health care before their profits. We need to be able to keep the health care that we have, and we need the choice of a public health insurance plan so we're not left at the mercy of the same private insurance companies that have gotten us into this mess.
Earlier this year we threw many of the right-wing arguments - "rationing", "government bureaucracy", "losing private health insurance and being dumped into a public plan" - against the choice of a public health insurance plan, and we found that in every case, the public favors the pro-public health insurance option. In fact, in most cases, they prefer it by margins of better than two-to-one.
In his one nod to policy prescriptions, Luntz says Republicans should support "more access to more treatments and doctors... with less interference from insurance companies and Washington politicians and special interests." But the only policy solutions favored by Republicans call for pushing more people into unregulated private insurance. Republicans have a real ideological dilemma when the popular solution is to regulate private markets.
Luntz's focus on quality in understandable because where Republicans really lose is on Americans' top concern about health care: cost. In exit polls after the election last November, people said their number one personal economic concern was health care costs. Our research shows that the fact most compelling to people is the following: health insurance premiums have gone up six times faster than wages in the past nine years. Asked about health care, the first thing volunteered is that "we are paying more and getting less." People see health care taking a bigger chunk of their paychecks everyday. They are paying higher deductibles and co-pays themselves, and at the same time, they understand employers are being drained by the skyrocketing costs of health care too.
There is a reason that everyone on both sides of the debate - including Health Care for America Now and our arch-enemy America's Health Insurance Plans - all agree on the same core message: "quality, affordable health care for all." Americans want both: quality and affordability. But trying to rile up the public against health care reform by scaring them about government takeovers and rationing won't work as long as we emphasize the following three points over and over again. One, you can keep your insurance if you like it. Two, the health insurance industry is making you pay more for less. Three, we need government to advocate for us and give us a choice.
Now is the time we can be stronger and louder than the special interests and influence Washington in a way that works for us - not the health insurance companies. We're now at a place in time when the Frank Luntz's of the world - and his Republican protégés - have run out of steam. The public is angry at the excesses of private, corporate greed and exhausted by political bickering and petty partisan gamesmanship. We have a unique opportunity, and a President committed to, thinking big, ushering in real progress, and restoring the reputation of our government as a balancing force for fairness and progressive change.