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The Looming Health Care Wreck: It's the Narrative, Stupid

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If there's one thing Democrats should have learned from the contentious and unsuccessful attempt to pass public health care reform in the Clinton Administration, it's this: never lose control of the narrative.

Though much attention is paid to how President Clinton brought his own complex bill to Congress in '93-94 -- in contrast to President Obama's decision to let Congress carry the ball this time -- the real story of that disaster was the framing of the issue in public.

Then, Democrats lost control of the gut-level, short-story branding of public health care. Despite endless public hearings, town halls, and polite op-ed discussions, the enemies of progress in this country succeeded in making a simpler, more direct case against health care for more Americans.

And the bad guys won.

So what's new this summer? Well, the top-down strategy of the Clinton years is gone. The Obama Administration has ceded the crafting of reform to Congress, while still making the issue its top domestic priority. Congress has pulled together five or six different plans, while predictably running an overhaul of the nation's expensive and lagging health care system through the leadership destruction juicer known as "bipartisanship." Now, you can argue whether that was the right call. And you can worry about Blue Dog Democrats, the leadership of the Speaker and Majority Leader, moderate Republicans, and the versions of various bills winding their way through committees.

But you can't argue this: once again, Democrats have lost control of the narrative.

As Congress began its recess, town hall meetings are erupting in staged dissent and violence. Democrats who expected polite discussion over the various facets of reform -- cost controls, health care co-ops, prescription plans, and so on -- are being met with sharp elbows, loud bellowing voices, and hateful disinformation. Public health care is being compared to Nazi medicine. The specter of euthanasia is used as a scare tactic to rile up the elderly. Obama is compared to Hitler. Or wears white face as the Joker. Of course, commentators like Steve Perlstein are right:

The recent attacks by Republican leaders and their ideological fellow-travelers on the effort to reform the health-care system have been so misleading, so disingenuous, that they could only spring from a cynical effort to gain partisan political advantage. By poisoning the political well, they've given up any pretense of being the loyal opposition. They've become political terrorists, willing to say or do anything to prevent the country from reaching a consensus on one of its most serious domestic problems.

And so we wring our hands, and decry their low, inherently evil tactics -- expecting somehow that common decency will prevail, and that the general polity will magically rise in disgust against the bullies. And while we're all screaming about Rush Limbaugh and arguing over astroturfing "activists," the forces arrayed against public health care are stealing the narrative, like the sticky-fingered back half of a crack pick-pocket team.

Sure, it's outrageous. And the mainstream media immediately goes into its fair and balanced relativism act, thereby showering the belligerent anti-reform mob with legitimacy. Yeah, Paul Krugman is correct:

Some commentators have tried to play down the mob aspect of these scenes, likening the campaign against health reform to the campaign against Social Security privatization back in 2005. But there's no comparison. I've gone through many news reports from 2005, and while anti-privatization activists were sometimes raucous and rude, I can't find any examples of congressmen shouted down, congressmen hanged in effigy, congressmen surrounded and followed by taunting crowds.

But they don't have to be right. They just have to be loud. And quite frankly, Democrats -- from the president to both delegations in Congress -- have done a lousy job of framing the issue, of making the clear and simple case for why public health care is good for all Americans.

It shouldn't have come to this. Our ducks should have been in line months ago. Simple and straightforward slogans. Effective advertising. Faces of the uninsured, the underinsured, and declining standards of care. Famous spokespeople and surrogates. Millions of boots on the ground. All of it wired for action and success by a killer social media operation. You know, like the campaign. But as Peter Daou pointed out earlier this week, this is far different than an election campaign. Of the reasons Peter cited, one stood out to me:

Inside baseball is less effective when you're on the inside. The media manipulation that helped win the White House, the masterful messaging, the leaks, the back-scratching, the hard-hitting conference calls with strategists and advisers while the candidate stayed above it all, the playing of one outlet and one reporter against the other, the smart turns of phrase, the snarky retorts, the outsider vs. insider kabuki, all these lose a good deal of potency when campaigning gives way to governing. Especially when bankers are running away with taxpayer money, polls are shifting and the public is hurting.

Yeah, exactly. Yet one aspect to this whole looming disaster (and I say anything less than a legitimate public option is a disaster for this Administration and this Congress) really is surprising.

And that's the level of Democratic surprise itself.

Oh, we're so shocked and outraged. But this was easy to see coming. This is the real kitchen sink thrown against Barack Obama. It was inevitable. Indeed, the conservative leadership that follows Limbaugh was transparent in both its strategy and its organizing -- the anti-progress forces said were out to hand the president a landmark defeat. They wanted him to fail. And no they've put thugs on the ground in pursuit of that goal.

This was hardly a sneak attack. And for a political operation that was incredibly savvy, fast-moving and professional during the 2008 campaign to somehow seem flat-footed against the lame-ass birthers, and tea-baggers and Rush fans is dispiriting. As Josh Marshall wondered aloud this week, "where's the other team?"

I could go on about what the Administration has to do to save the day, but I just don't have the energy. It feels to me like the narrative battle's been lost, and it'll be hell to get it back. Besides, you kind of sense the will isn't necessarily there among our leaders -- or the very ground troops that brought Obama to victory -- to fight this one to the finish. So maybe Bob Stein's right to grab a few lines from Yeats to sum up his despair:

Things fall apart; the center cannot
hold

Mere anarchy is loosed upon the world

The best lack all conviction, while the worst

Are full of passionate intensity.