Better Messaging is the Key to Winning Health Care

In order to pass a robust health care bill, Democrats need to re-frame the debate with a strong, disciplined messaging campaign. They have the power, the truth, and public approval on their side, but they're slacking badly on messaging, and it's putting reform in jeopardy.

Republicans and industry groups, meanwhile, have permeated the debate with a flurry of disinformation and outright lies. They've somewhat succeeded in slandering the reform as anti-capitalist, blighting it with idioms like "big government," "socialism," "death panels," and so on.

The reaction among leading reformers has had a deer-in-the-headlights ring. It's odd that President Obama didn't see this coming because he usually knows his history, and these despicable tactics have been repeatedly used to kill health care reform for nearly a century, each time preying on people's political prejudices and limited knowledge.

But it's not too late, and Obama can still turn this around -- with better messaging.

Unhinged free-market worship, combined with an inexplicable paranoia for anything government, is what's driving the opposition. So Obama and Democrats need to re-frame this bill -- particularly the public option -- as one that embraces capitalism's best principles.

The central message should be that this bill will increase choice and competition in the marketplace, which would lower costs and extend coverage. This is language that Americans of all political persuasions understand, and it would considerably help quell the senseless fears among conservatives and some moderates about any kind of "government takeover" of the system.

A recent poll reveals that when told that the public plan is merely a "choice," a whopping 77 percent of Americans support it. The number shrinks when it's presented as the "Obama health care plan," which means the propaganda has been quite successful.

So, why not change the name of the bill? "Health Security Act" has no ring to it; call it the "Health Care Free Choice Act." That'll take the opposition to task and put them on the defensive.

A crucial point Democrats need to drive home is that inaction will lead to economic ruin for the country and financial insolvency for more and more individuals, families and businesses. It will. The out-of-control health care costs are the primary cause of the surging budget deficit, as well as bankruptcies, which are literally rising by the minute.

The GOP calls this reform plan an "experiment" -- nefariously suggesting that it could go very, very wrong. But the real experiment would be to embrace the status quo, simply to assume private insurers will shape up and fix the system without any real pressure. Democrats need to make this abundantly clear.

The main reason health care costs are skyrocketing -- and worsening the deficit -- is that insurance executives realized they can use their virtual monopoly power to make higher profits by refusing to provide care for sick customers even if they've fully paid their premiums. That's where much of the excessive costs are going.

Insurers insist that premiums have risen in proportion to provider costs. But this is glaringly dishonest -- insurer profits have risen alongside higher premiums, making it clear that the reason regular people are paying exorbitant prices is so insurance executives and shareholders can line their pockets.

A public option will keep this in check. It's the ideal market-oriented solution that would bring down costs, extend coverage, increase quality and improve efficiency. It would motivate private insurers to clean up their act and realize that profits should be based on providing quality services at reasonable prices -- not shady boardroom tactics that fleece people.

The New York Times says the public plan is "not indispensable," that stronger insurance regulations can solve most of these problems. But this sounds like icing a broken leg that needs surgery. Insurers might behave themselves for a while, but eventually they'll sneak in loopholes to derail those rules, and return to their old ways.

And that's why a public option is critical if Democrats want a real, substantive victory for health care, rather than merely a shallow political victory. The tell-all as to how badly the negotiations are going so far is the insurance industry's reaction to them: "Hallelujah!"

Make no mistake, there is no such thing as worthy reform that doesn't infuriate insurance executives.

It's sad that this is so tough, that Democrats continue to get bullied by Republicans despite thrashing them in the last two elections. But their silver lining is the sheer silliness of most Republican talking points on health care. By positioning the public option as a market-based solution to the system's problems, the opposition can be defeated on its own turf.

Now, with much of America's economic and health future riding on this bill, let's see if Democrats can rise to the challenge and be effective champions for truth and common sense.

Listen to Sahil Kapur's recent radio interview on Talk 1410AM about the health care battle.

Follow Sahil Kapur on Twitter: www.twitter.com/Sahil_Kapur

Comments

[jbatch]

I believe the reason we are in danger of losing a debate that shouild be a cake walk (at the start, more than 70% of Americans wanted single-payer, universal care) is precisely because we have failed to take on the twin myths of Reagan -- big gubmin' can't do anything right; the private sector can't do anythng wrong.

Your reccomendation plays right into that meme.

[smarti]

Agreed. A large part of the problem has been the failure to personalize the issue to the 80% who are currently insured in some form. They don't see themselves as the "uninsured" so getting them to seriously think about major reforms for an abstract group of "them" doesn't work. Instead, Dem's need to frame the debate to those who are insured: they need to drag out charts and graphs that show costs of premiums in relation to wages, and charts showing changes in employer provided insurance. They need to hear from business owners about the burden of employer based care, and how that is translating into decreased wages and job losses. They need to be made to face the reality that in the near future, their insurance will eat up ever larger chunks of their income while their incomes will rise much slower. They will also need to face up to the reality that their coverage, at the same time, will decrease, and it will happen as they get older and need more care. They will need to examine a future in which their employer will consider either their care, or their job, expendable, in the face of ballooning costs.

[smarti]

All of these are issues the 80% of the insured are going to be facing real soon if they don't get on board. They are also much more difficult for right wing media and industry advocates to spin away and distort. Dem's have spent too much time defending against lies and half truths and fighting people's hot button ideologies (illegal aliens, constitutionalism, taxes) and not enough time getting the majority to face the problem.

[BruceHNV]

I have to buckle down and get some work done, so I'll see you guys.

I want to thank those on my right, as well as the others here, for keeping it civil and arguing actual ideas and not personalities or point-scoring.

I'll check back in later.

[tompoe]

The private insurance industry has failed to carry out the obligation of the government to deliver on our RIGHT TO HEALTH CARE. The financial industry has failed to carry out the obligation of the government to deliver on our RIGHT TO PURSUIT OF HAPPINESS. The free market has failed miserably in both instances. We need SINGLE PAYER health care.

[BruceHNV]

What free market would that be? There's no such thing. We in America suffer under a captive market, owned lock stock and barrel by a financial and social elite.

[cadsuch]

If we were using capitalism's best principles we wouldn't be compelled to reform health care. For that matter, an industrial community that was using capitalism's best principles wouldn't need unions. A banking and investment community wouldn't have melted down and froze its credit system, if they were using capitalism's best principles. Heck, we probably wouldn't even need a Democratic party. But we need Democrats and we need unions and we need medical reform, because we are human. All except for those bad actors at those town hall meetings.

[BruceHNV]

Capitalism's best principles require ENLIGHTENED self interest and social conscience - neither of which are natural to the human condition.

[BruceHNV]

WilliamBradford:

"We are individuals who seek for ourselves and our families first and then for others if, and when, it serves our needs."

Your concept defies the definition of society. It typifies the modern conservative mindset perfectly, but that it is a contra-survival pattern is proven by the recent economic crash. It is also proven by the fact that "looking out for one's self" as the template for our capitalization of medicine has produced an unsustainable status quo - where the holders of the monopoly on the the right to treat have priced their services beyond the ability of their customers to pay, and the holders of the monopoly on the financing of medicine have likewise priced their service beyond the ability of the market to bear.

And yet prices continue to escalate, beyond all logic.

The inability of a population to afford a necessity of life is evidence that countervailing pressures against the result of the "free market" have become necessary. This was how we got anti-trust legislation, labor unions, voting rights and equal rights laws, etc. etc. Self-interest as practiced by those with a monopolistic hold on monetary or social power proved (as it is proving now) destructive to society, and hence its members.

[fwgarvin]

"Society" is to the left as "God" is to the right...

They are both constructs that that no human can see, hear, smell, touch, or taste, that are both far too abstract to be comprehended in totality by the human mind, and the justification for the existence of each is measured only in personal anecdote and/or faith, but which nonetheless impose moral duties in the non-abstract workings of day-to-day life that usually involve the oppression of those who do not agree.

People have faught and died for both... but both are mere figments of the flawed human psyche.

[BruceHNV]

Were it not for the protections, benefits and obligations of the society of which you are a member, you would not by typing here. The computer which you are using would never have been invented. The collective resources which evolved into its existence would have never been pooled.

Tell a sociologist that "society" is a figment of his imagination.

Granted, owing to the infinite variety of character and characteristics of humans, "society" as a subject can be so deep and changeable that no one can ever understand it in its totality.

But the basic of society, collective survival, is not mysterious and is not in question. It is as real as your keyboard and, ultimately, much more valuable.

[fwgarvin]

BruceHNV,

The economic crash was created by government, in the form of the Fed - who offerred free money - and Fannie Mae and Freddie Mac who underwrote and securitized 80% of all mortgage transactions.

Basically, the government gave out free money to the lenders and then insured them against loss.

At the same time, on November 15, 2007, FAS 157 passed - forcing the non-underwriters (holders of the securities) to mark down trillions in asset value.

What caused this was the combination of government intervention (via monetary policy), governement welfare (in the form of laying off risk), and government regulation (in the form of a ridiculous accounting rule) - yes, and with the actual exectution of the utterly perverse incentives created by government in the marketplace (the "greedy banks").

The true "contra-survival pattern" is having any trust of people who have no incentive to perform one way or another (the government) - and should have us all out in the streets with torches and pitchforks riding the politicians and beareaucrats out of Washington on a rail.

The "free market" in health care - and the escalation of costs - was not created by the free market but by a large myriad of factors - nearly each one of which is tied to a government intervention, regulation and/or the structure of the laws.

Don't even try to tell me that health care is a free market... or I'll have to force you to read the collective 60,000 pages of federal

[BruceHNV]

Your understanding of the crash is limited to libertarian talking points, and I'd have to write a book to set you straight. Needless to say, Krugman would have you for breakfast on that score.

In fact, the more I read it, your entire comment is libertarian talking points.

You are right, that government intervention (licensing physicians and prohibiting wage increases during WWII) were the triggers for our current health care debacle - but human greed, monopolization of finance and services, a captive consumerate, and the "free market" (a fairy tale if ever there was one), leveraging off the controls in place, brought us to where we are now.

[BruceHNV]

Society: A grouping of people forming a working whole, of which the parts cooperate for certain *public ends.*

A number of individuals of a species, organized as a community or group, and outlined by the bounds of *functional interdependence.*

A society enables individual members to fulfill needs, aims or desires that they could not fulfill separately, and enables the fulfilling of group needs, aims or desires.

In other words, the purpose of society is to operate in a fashion which promotes and enhances the survival of the members thereof, as well as of the society as a whole.

If we are a society, we owe the necessities of survival, including health care, to our members.

[hoosier96]

Yes, a society exists for the good of everyone, but when a government starts taking from Peter to give to Paul then you are usurping one person's property to redistribute it to others. That is an obvious denial of my rights.

Why should I work my tail off to be successful so that someone else can have the fruits of my labor? How does that motivate me to continue to be successful?

Paying taxes for the common good, such as national defense, infrastructure, and commerce is one thing. Taxing someone so you can give entitlements to someone else is something completely different.

[BruceHNV]

You admit society exists for the good of everyone, but then proceed to argue that the common good imposes no duty on the members of the society, and further that the common good is something different from the common good.

Societies pool resources. It is not a taking, it is a commons.

Pooling resources (via insurance) is what you are doing now, in order to pay for a service which, insulated from market pressures, has become too expensive for you to bear alone in a crisis. The chief problems are two: 1) healing has been monopolized by conventional medicine, which is therefore partly insulated from price pressure, and 2) your pooled resources are being stolen and used against you by the persons you entrusted to manage the pool - further, these same embezzlers are in collusion with the monopolistic medical professionals to artificially support prices.

A "Public Option" or even a single payer is a scheme to pool resources fairly rather than criminally.

[smarti]

This conservative persecution crap is really getting annoying. Do you have any concept of how insurance works? As BruceHVN so elegantly stated, you are pooling your resources, eg paying for Paul, and eventually Paul will pay for you. One of the problems with our system is the cost of the uninsured is also factored into your premiums and the fees for services charged by providers. And, since uninsured tend to have more expensive conditions (no preventative care) and are forced into more expensive providers (ER's) they cost you more. So guess what, you're already paying for someone else, and you have no say so about it. Additionally, without your say so, your insurance company skims the cream off your premiums for their costs and of course, their profits, none of which benefit you one iota. Also without your say so, they can drop you at any time or raise your premiums. But.. but.. you say in a "free market" you can drop the bad company and get a better one right? Really? First off, if it's employer provided good luck with that. Second, if you're in the individual market, chances are you now have some pre-existing condition (you know, that condition your insurance company dropped you for getting) so good luck getting that other company to pick you up. Guess you could pay out of pocket, now you can sell your house and liquidate your retirement. Gotta love that freedom of the free market right!

[STILJON]

Amen!! It was so refreshing to find your piece today especially since I have been so surprised that the seemingly obvious has been slipping by the supposedly smart party. How can the opponents of healthcare reform say no to something that is designed specifically to combat the fears they are raising. Another aspect to consider is the fear of government control especially in regards to this death panel argument which is simple to combat. Democrats and a few Republicans included a living will provision that would demand insurance pay for patients to decide their own end-of-life care. Republicans used lies and baseless fears targeted at the most vulnerable they are claiming to protect which actually resulted in the protections of this provision for the elderly being stripped from the bill so now patients have to pay out of their own pocket. The overwhelming majority of impartial medical professionals believe comprehensive effectiveness research is critical to fixing our healthcare system and despite the opponents lies this is the best way to protect us from government control and profit-based industry control. Right now private insurance decides management of care based on profit considerations so instead of this or government deciding healthcare management, the current health care reform proposals include independent advisory boards made up of impartial medical experts who will increase quality care while decreasing wasteful spending. I hope your work on better messaging spreads like wildfire.

[hoosier96]

"The central message should be that this bill will increase choice and competition in the marketplace, which would lower costs and extend coverage. This is language that Americans of all political persuasions understand, and it would considerably help quell the senseless fears among conservatives and some moderates about any kind of "government takeover" of the system."

Nice plan Mr. Johnny Come Lately. They've been pushing this lie. It ain't working.

[smarti]

Hoosier96, stop talking in abstractions and right wing victimization talking points. Admit the facts: health insurance premiums have risen over 3x faster than wages over the last 10 years. Studies indicate the trend will continue. Do you foresee your wages tripling over the next 10 years? How about your health insurance? If you have employer provided insurance, at what point do you think your employer will dump or reduce your health plan .. or dump your job and take it overseas to worker who doesn't require employer health insurance? If left unchecked, how many times do you see this situation repeating itself across America, decimating our already low employment economy.
This is not about taking from the productive and giving to the non-productive. Stop recycling that Atlas Shrugged fantasy and letting it blind you to reality. This is about an unsustainable cost that will cost the productive much more than the non-productive in the near future in terms of a much larger percentages of your income feeding health insurance troughs and declining coverage that you will need as you age. Unless you're one of the super rich 1% which I doubt, this WILL be your problem before you know it and you will regret that you allowed arrogance and ideology to facilitate your own undoing.

[WilliamBradford]

So, the secret to getting health care reform passed is... for the administration to lie more. Hmmm.

If this were just about providing a "choice", why hasn't it been done already? Why can't one of the larger private non-profit organizations set it up? Just start offering low-cost insurance to the high-risk people who need it. Then any excess revenue can be used to offer coverage to the needy. As long as it self-sustaining, why does this have to be a government venture?

The argument that somehow a "public option" will lower health care costs still is not clear. The author seems to be saying that health care is expensive because insurance companies make money. That doesn't work, logically. If the public plan will use price-fixing to drive costs lower, that might work in the short run, but that is not very "market-oriented" nor will it be without effect on the market as a whole.

Luckily, it looks like the American people can see through this propaganda, no matter how it is repackaged.

[BruceHNV]

Au contraire. The solution is to tell the truth more simply and more directly.

[WilliamBradford]

The truth that the "public option" is rooted in free market principles? Pants on fire.

[BruceHNV]

To give water to a man dying of thirst is not to be saintly - it is to be non-criminal. And so it is with another necessity of life - medical assistance.

If there is no reciprocal duty within society to care for each other, then there is no such thing as society. Even wolves recognize this. The pack cares for an injured member and nurses them back to health - for the good of the pack. They do not abandon their efforts until the injured wolf is well, or dead. To the very last moment, they will lick its wounds, bring it food, and stand guard over it. The hunt is not the only meaning of the pack. All aspects of survival are. Similarly with gibbons, howler monkeys and capuchins. For the society not to perish, its members must not perish.

Are we not better than beasts? Can we not see that if survival is a right, then care is a right? I submit that we are better, and that we can see.

There is a RIGHT to health care. Access to health care is a human RIGHT.

[BruceHNV]

Had we no duty in society to protect the lives of our fellows, then society, a cooperative arrangement to enhance our joint survival, would be without meaning and without value. The very existence of society is an acknowledgment that human interdependency exists - and it exists on the most basic level - the level of bare survival.

The right to life recognized in our founding documents is not merely a right not to be killed. It is an affirmative right to life. Its observance requires action by the members of society. We are called upon to defend the lives of others - and can be criminally prosecuted for failing to do so. If we have knowledge of a crisis, an emergency or a crime which threatens the life of another, our duty is to mitigate it, prevent it, and/or report it. To fail to do so can rise to the level of accessory, or criminally negligent homicide.

The absence of access to health care is a clear and present threat to life.

[hoosier96]

Wrong. The only ones who are ciminally liable for not preventing, reporting, or mitigating an emergency or crime are those who give an oath to preserve it. You can debate that they are morally obligated but it is not a legal obligation.

Right to life means the right to live your life as you see fit. To confiscate one mans property to give to another man (i.e. entitlements) is a transfer of rights from one man to another.

[BruceHNV]

"The only ones who are ciminally liable for not preventing, reporting, or mitigating an emergency or crime are those who give an oath to preserve it."

Don't really know much about the law, do you? Irrespective of "stop and render aid" or "good samaritan" laws, all jurisdictions criminalize failure to render aid under varying circumstances.

If it's a moral obligation, then it is an obligation. Laws codify moral obligations or they are illegitimate. "...morally obligate.." What do you think rights ARE if not moral obligations to one another?

No one exists in a vacuum. You may live your life as you see fit, only to the degree that you do so without harming others. Failing to act when aid is needed is just as wrong, in both legal and natural terms, as taking destructive action. To withhold the necessities of life causes harm.

If you don't like the benefits and obligations of society, then you are free to leave it.

[BruceHNV]

If there is no right to the necessities of life, then there is no right to life.

For this reason, we are constitutionally barred from withholding air, water, food, shelter and medical services from felons in our prisons.

Inmates forfeit their rights, including the rights to liberty and to the pursuit of happiness; and retain only the basic human right to life. Hence, anything they receive while in detention can be seen only as incidental to the right to life. We feed them that they may live. We treat their ills that they may live. We regulate temperature and provide bedding that they might not fall ill.

If the rights to nutrition, shelter and medical aid do not inhere in the right to life, then the right to life is without meaning.

The common worker, the impoverished and the marginalized have a right to affordable access to no less care than we provide to the worst among us.

We recognize our duty as a society to preserve the lives of our fellows by providing, if nothing else, sanitation, clean water, fire services and police services. At their root, these health and safety provisions are life-preserving measures. They protect the right to life.

[WilliamBradford]

The right to life is a protection. It makes clear that you have a basic right not to be killed by your government or by other citizens.

It is not a promise to be protected from fate, or nature, or your own mistakes in order to ensure that you have the "necessities" of life.

I would agree that a "good" person is concerned for the lives of those around him. I don't agree that this there is a fundamental right to be cared for, especially as a function of government.

[BruceHNV]

"...you have a basic right not to be killed by your government or by other citizens."

You have mis-defined the right to life. Were that the case, we would not have to render medical aid to prisoners - even death row inmates - a duty which the Supreme Court has held arises in the constitutional right to life.

If a dying man appears in an emergency room and has no money, he must be treated. It's the law. Why? Not because the law dictates socialized medicine, but because to have to capacity to save a life and to refuse to do so violates the right to life. It is tantamount to murder. It is merely a matter of degree.

[BruceHNV]

Recently, commenting on the furor at the town halls., Rep. Clyburn of SC stated, "This is all about activity trying to deny the establishment of a civil right. And I do believe that health care for all is -- a civil right...and I think that is why you see this kind of activity. This is an attempt on the part of some to deny the establishment of a civil right."

He is correct.

When John Dingell of MI remarked that the last time he saw such venom, it was during the days of "Ku Klux Klan folks and white supremacists and folks in white sheets," Pat Toomey of PA defended the mobs, accusing Dingell of "wildly insulting ordinary, honest, decent, hard-working American people."

It is incumbent upon us to remember that those who doggedly, sometimes violently and criminally, resisted racial equality in the 50’s and 60’s were “ordinary, honest, decent, hard-working American people." They were elected officials, law enforcement officers, soldiers, small business owners, housewives, common laborers. The assumed decency of the malcontents imputes no credibility to their hysteria. Their “everyman” message that universal access to care deprives them of “their rights” and “their country” must NOT carry the day.

There is a RIGHT to health. Access to health care is a human RIGHT

[PWM]

I agree. Healthcare is a right in any civilized nation in the world today. Americans should be ashamed putting off something that even Communist Cuba provides its citizens.

[hoosier96]

Entitlements and benefits are not rights when they can only be given to one person by taking from another by way of taxation.

[BruceHNV]

In the US, sixty people a day, every day, die for lack of healthcare. We have, essentially, the rest of the month of August to drive home the urgency of caring for our fellow man THIS time, THIS year, in THIS session of Congress. This demands a stark, simple, clear and unambiguous message. Despite the complexity of the issue and its logistics, the message has to come down to a single phrase, preferably a single WORD, and be repeated over, and over, and over - at every venue, in every context, by every speaker, and via every medium.

Proper messaging builds support.

The talking points of the Rabid Right, though false, are stark and too simple. Hence, they are sticking and gaining ground. We need something equally simple.

This is the message:

There is a RIGHT to health. Access to health care is a human RIGHT.

President Obama has adopted similar language, "moral imperative" in recent days.

[Chironomid]

A key point in this article "reform that doesn't infuriate insurance exec's isn't worthwhile" or some such.

As long as big insurance trade groups are on board, I'm going to be smelling a rat. Those people don't give a d*mn about our welfare. Right now, they're playing both sides of the fence, supporting the concept and running vague support ads, but drumming up irrational fear about the public option.

Reform without a strong public option is a sellout.

[nancytheragingliberal]

"Now, with much of America's economic and health future riding on this bill, let's see if Democrats can rise to the challenge and be effective champions for truth and common sense." Somehow, when I think of the Dems, I can't seem to come up with your words, "challenge", "effective champions" and "common sense", in the same sentence. I'm wishing, hoping, thinking, praying, watching and waiting, but when you have the healthcare complex funneling $1,500,000.00 per day to ax care for Americans, then the chance for change is slim. Too bad and BC BS is robbing me blind.