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

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.

Follow Tom Watson on Twitter: www.twitter.com/tomwatson

Comments

[creolechild]

If you are concerned about receiving "real" health care reform in this country, please take the time to watch a video on our current system. The video was created by Oregon physicians who are advocating for the single-payer option. The video is very informative and helped me to gain a better understanding of various aspect of health care, as we know now it.

https://www.madashelldoctorstour.com/Mad_as_Hell_Video.html

These Oregon physicians are in the process of organizing a caravan designed to inform the public about the benefits of the single-payer option. At last count they will be stopping in approximately 23 states, on their way to demonstrate in Washington. They need volunteers and our support. Please spread the word.

[Jezreel]

Wow! I feel like Tom Watson just reached into my mind and heart and pulled out all of the frustrating thoughts and disappointments I personally have had with how the Dems have handled the messaging war on this critical issue.

Thanks Tom for giving expression to what has been in my heart for weeks now.

Nancy Pelosi tried weeks ago to put real faces with real stories in front of the health care debate. But the MSM basically ignored her. It was like it never happened.

Real people with real stories should have been at each Democratic town hall meeting. Instead, we ended up with charts, power points and expert panels that no one listened to.

God bless our President. But we don't need a Professor right now. We need a Chicago-style community organizer who has intimate knowledge of the people he serves. He understands their issues and their pain and frustration. He knows what its like to watch one's mother fight for health insurance while facing death by cancer.

I remember how at the end of the campaign, when Barack returned from Hawaii after his grandmother's death, he broke into tears at a NC rally where he reminisced with passion about the length the campaign and how tough it had been. He spoke with passion about the change that was needed in America.

That's the Barack Obama we need now.

http://www.youtube.com/watch?v=SvF-XdANsNM

[sterlingsilversurfer]

The World Health Organization Ranks the US 24th in life expectancy, behind virtually every European country as well as Canada and Australia (which of course the US doesn't want to be like).
The US ranks #72 in Health Performance behind countries like Cuba #36, Columbia #51, and Mexico #63.
Where the US leads is in total health expenses as a precentage of GNP at #2. In the world only the Marshall Islands are more expensive.
When politicians tell you that the US has the best health care THEY ARE LYING TO YOU.

[TruthJusticeForAll]

They are so weak, they no longer even call it Health Care Reform. They started with an excellent idea. It has de-evolved to the point that if any of the versions now being kicked about are passed, I truly believe the American people will be worse off. People desperately wanted change & hope. The only change we got was another politician who is hoping to get re-elected.

[vanmungo]

Russell Mokhiber of www.singlepayeraction.org gets to the point:

What do:

Rush Limbaugh

Barack Obama

Newt Gingrich

Nancy Pelosi

PhRMA

Families USA

America’s Health Insurance Plans

AARP

Harry Reid

Mitch McConnell

and Fox News

have in common?

They are all freaked out by single payer.

They have all bought the corporate line:

The market has a central place in health insurance.

In contrast, the majority of doctors.

The majority of nurses.

And the majority of the American people favor single payer.

They all agree — the market has no place in health insurance.

Single payer would eliminate the 1,300 private payers (insurance companies).

And replace them with one public single payer.

As Dr. Marcia Angell, former editor of the New England Journal of Medicine puts it:

Single payer is the only option that will control costs and cover everyone.

The right wing is seeking to defeat Obamacare primarily because they irrationally fear creeping socialism.

We seek to defeat Obamacare because it’s a bailout of the insurance and pharmaceutical industries.

And it won’t deliver universal health care to the American people.

Time to scrap Obamacare.

And start from scratch.

[johnsonc20]

I agree. That's why I won't lift a finger to help Obama pass his increasingly dubious plan. If it goes down hard that will illustrate that bipartisanship and playing footsie with the health care industry doesn't work. We need to take the profit out of medical care or the cost and the inequities will eat our nation alive.

[MeinNH]

Hellloooo there is no plan in place, no Obamacare, no Democare, no Repubocare­.....

We need single payer health care for all Americans.­..even the dumb ones.

[joeinvt]

Control was lost the moment Rahm Emanuel and David Axelrod stuck it to Howard Dean and began advising Obama about healthcare on the basis of political calculations (which turned out to be completely of base). People (whether Karl Rove or David Axelrod) who put reelection as the highest priority often give advice, which is wrong as well as amoral.

[jsarets]

They lost control of the narrative because they reverted to the same old public vs. private debate that the bankers know how to win.

This should have been about price controls and standard coverage. There are privately-financed universal healthcare systems in Germany, Japan, and Switzerland, but they all have price controls and standard coverage.

The big savings from single payer isn't because the government is more efficient than private insurance companies, it's because single payer systems have price controls and standard coverage. Without price controls, it doesn't matter if we have a public option.

Democrats represent the portion of the American public that senses that there's something wrong with the whole system but can't put their finger on exactly what the problem is or how to solve it (or at least there's no consensus on causes and resolutions).

Democrats just want the government to do something -- anything -- to paper over what they perceive as blind spots in the corporate world-view. In their view any healthcare reform bill is better than no bill at all. They don't imagine that the government could make the situation any worse by intervening.

PhRMA and the Obama administration don't want the public to get bogged down in the details of their secret agreements banning price controls. They just want us to support their efforts to pass a healthcare reform bill. Of some kind.

[mountainweb]

Democrats lost control when they refused to address what NOW they are admitting were issues with the plan. And of course trying to tell people to shut up did not help or even the cry to shut down radio programs that raised questions. Had they just taking the stance of addressing the issues instead of taking the attitude that if you oppose the program you are stupid, boy did that raise some red flags. He did make the mistake on the front end of giving Congress the task of leading the charge on health care reform, whose approval rating is now heading south of 20%, sort of like riding a dead horse.

[vie2012ne]

When your narrative is based on wildly inflated numbers of uninsured and would resul in much higher costs with no improvements in quality, you deserve to lose control of the debate.

[Yermammy]

Riddle me this. How can you control the narrative when the news is controlled by greedy and bloodthirsty corporations? Barack wimped out in not passing some form of the fairness doctrine so you have racist corporatists blabbing hate and lies over public airwaves. PUBLIC airwaves, mind you. Don't talk to me about narrative until that problem is solved. The Keith and Bill'O debacle is proof positive that big money owns the news.

[NYCPub]

Great article. Kind of makes you wonder where the A-team went, doesn't it? Where did all these smart and motivated people go? Or is it that they're not interested in seeing this through?

[CTtransplant]

Please, please spread the word!!!

People, we can no longer afford to stand by and do nothing! The only way to get solid health care/health insurance reform is to continue to push for it - and not let up! To this end, I have set up a petition to have paid health care removed from our representatives in Congress until such time as they reform health care - to include a strong public option - for 'we the people' who they are supposed to represent.

If you agree with what I am doing - I am going to ask you to do what I have been
asking others to do...sign it, then spread the word to anyone and everyone you know!

I am but one person - and cannot make a difference on my own...but there is
strength in numbers and, if we work together, with assistance and determination, all things are
possible! Please do what you can to help us further the cause of health care with a strong public option! Thank you!

http://www.petitiononline.com/PubOp676/petition.html

[freshnotbitter]

The White House strategy so far may yet prove to have been satisfactory if O steps in and declares that the inability of different bills to coalesce has nudged him to take over the role of mediator.

However, I don't think the present sales pitch from the White House is going to work.

I think much of the problem we reformers face is the fear among elites in Washington - both in government and the media - that the present health care arrangements they have will be disturbed.

The only reform that will work is a two track approach that leaves present arrangements - corporate health care, that is - undisturbed while arguing that a public health plan is as necessary as public education, space program, etc.

Corporations did nothing to advance our space program. Without the totalitarian regime in Russia, would we even have visited the moon? I don't think so. Our nuclear deterrent would be B-52 bombers which the corporations wanted to build en masse.

A strong public health sector will drive medicine forward just as NASA drove the space program. The present corporate health system should remain in existence to assure the Cokie Roberts, the Sam Donaldsons, et al., that their cancers will be treated with utmost priority. At the same time we need to get going on delivering more health care for less dollars which we can do through a public health system but never through corporate insurance.

[rughead23]

Thats a shame, Obama may have lost some of his platform of change for all Americans.

[thefirehorse]

Its time to give the Repubs the same treatment that Dems are receiving. We need, "and I mean all of us who are talking loud and doing nothing", to show up at every Republican town hall meeting and let them know that they are on the wrong side of this debate. We need to bring out our signs and voices. All the media is focusing on is the disruption of the Dems town hall meetings. Its time for us to change their focus.

[Cool-headed]

You are right. One thing is to debate and moan and suggest online, and a very different one is to go somewhere in person. As they say, Dr. Martin Luther King would never have accomplished anything if he and his companions "marched" online rather than in the streets.