The time has come for universal health care in America.
- Barack Obama, Jan. 25, 2007
Now is the time to finally keep the promise of affordable, accessible health care for every single American.
- Barack Obama, Mile High Stadium, Denver Colorado, August 28, 2008
It's the story of hardworking Americans who are held hostage by health insurance companies that deny them coverage, or drop their coverage, or charge fees that they can't afford for care that they desperately need.
I believe it is wrong. It is bankrupting families and businesses, and that's why we are going to pass health insurance reform in 2009.
- President Obama, Portsmouth, NH, 11 August, 2009
I've listened to the President's townhall and have been reading various commentators over the past few days. In particular, something struck me about the President's choice of language. It suggests a subtle re-shifting of the language.
Obama has, in the course of his campaign to become President and since becoming so as well, gradually shifted his position on healthcare. He has moved from where he wanted to go, to where he realises what's possible. To those who suspect he does not, after all, have the interests of progressives at heart, re-read the words above, to remind you where his heart truly lies.
But Obama is, above all, a canny politican who knows how to get to where he wants to be and is realistic about what can be achieved. His devices are the same as many a politician, but his power of language gives him an extra edge. And it struck me that he is re-framing this debate again in a way that suggests that the package of reforms out there - however imperfect they might be in the eyes of perfectionists - will get passed.
But now that the oppostion has revealed their hand, i.e. destructive, obstructionist, unfounded, he is shifting the frame of the debate. The debate seems to be less about healthcare, but about health insurance reform. Again, re-read the words above from his townhall yesterday. Although he has always talked of lower premiums, abolishing the exclusion of pre-existing conditions, this looks and sounds new. It sounds specific. It sounds reasonable. It sounds understandable.
America might have one of the worst healthcare systems in the developed world in terms of coverage and cost. But no-one disputes the excellence of its doctors and/or techniques. When talking of healthcare reform, it is difficult to imagine the alternative unless bogus, scarey alternatives are conjured up, like long-waiting times, etc.
But by framing the debate as one of health insurance reform, it is smart politics and easy to sell: most citizens have had a problem with the insurance companies, and selling the reform package as one which will help reform health insurance providers is one that will resonate with most people. I expect to hear Obama talk more in the coming weeks and months about health insurance reform.
So when you're locked in heated argument with a sceptic or an outright opponent, heed the message above. Keep talking about health insurance reform, and the message will begin to stick - we're on your side, man, because we don't want the health insurance CEO's making a mint on your dimes. And by reforming the insurance system, we won't touch your care.