At the outset I would never post a right-wing article here on this board, but I am making an exception this time. Today in the Post conservative columnist Charles Krauthammer has an article proclaiming that the healthcare plan is dead called Obamacare: The Coming Retreat. I take it apart to express my frustration with how the healthcare debate has turned out beneath the fold.
Krauthammer's main point is:
Hardly. Whatever structural reforms dribble out of Congress before the August recess will likely not survive the year. In the end, Obama will have to settle for something very modest. And indeed it will be health-insurance reform.
To win back the vast constituency that has insurance, is happy with it, and is mightily resisting the fatal lures of Obamacare, the president will in the end simply impose heavy regulations on the insurance companies that will make what you already have secure, portable and imperishable: no policy cancellations, no preexisting condition requirements, perhaps even a cap on out-of-pocket expenses.
Nirvana. But wouldn't this bankrupt the insurance companies? Of course it would. There will be only one way to make this work: Impose an individual mandate. Force the 18 million Americans between 18 and 34 who (often quite rationally) forgo health insurance to buy it. This will create a huge new pool of customers who rarely get sick but will be paying premiums every month. And those premiums will subsidize nirvana health insurance for older folks.
And unfortunately Krauthammer is probably right. Instead of the public option what we will end up with is a MA-style plan that will leave those with the greatest need with what NYCeve calls "junk insurance". "Health insurance reform" isn't what people elected him for but that is what we are going to end up with.
(Also I have to take exception to the statistic that 80% of Americans are happy with their care. They most likely have never had to file claims and deal with denials.)
That is because months of effective conservative ads from groups like Patients United Now (PUN) and Conservatives for Patients Rights (CPR) have succeeded. The GOP has (once again) outsmarted the Democrats at the PR level. To prove my point I cite this New York Times article that shows that polling numbers have steadily turned against Obama and the Democrats.
Although I want to believe that Obama and the Democrats can turn the tide, from what I've seen in the media and in the newspapers, the public seems to have bought into the GOP side of the debate enough to make it difficult for any sort of meaningful reform to pass. I knew that there was going to be a problem when a recent CNN poll showed Obama's plan ahead by only a narrow 51-45% margin. With numbers like those passing anything meaningful becomes difficult, if not outright impossible.
Again the reason that I have been aggressively writing about this issue recently is because, unless Obama and the Democrats take stock of the political realities at hand, they will go on to lose the next policy debate. These situations will happen over and over again. Without further ado I list some of the key points that I would hope that the Democrats and liberal groups would remember for when the next serious policy debate happens.
Here are my thoughts:
- Have a clear goal at the outset.
I blame Obama for this failure. First of all he didn't come out the first day and say in one sentence:
My health plan is going to offer Americans a public option that will guarantee their health security.
He needed to have a clear, crisp goal that everyone could understand. I don't think that he ever made a statement like that.
- Don't delegate it all to Congress.
Some people will disagree with me on this point, but one major problem is that we have several committees fighting over getting a bill through. Each committee head has been implementing his/her vision. Obama should have clearly stated to Congress what he wanted--see point #1---so that they could create a bill that met the goal. He should have said something like this:
Clear Goal: My health plan is going to offer Americans a public option that will guarantee their health security.
The bill will achieve this by:
*Creating a public insurance that will be available to everyone regardless of condition at a small cost
*Make it illegal for insurance companies to retroactively cancel policy
*Allow Americans who are happy with their coverage to keep their insurance
*Allow Medicare and other government programs to negotiate drug prices
Again those four prongs would have been simple and then Congress would have had some guidance. Obama did not do that.
3. Don't let the opposition define your side early on.
I am putting this argument in bold font for one major reason. Disclaimer: I live in the DC area TV market, so maybe I haven't seen what has been on the air in other states. But for months on end the groups that I mentioned above have been airing ads. PUN and CPR aired ads that went unchallenged for months on end. They succeeded in defining the other side as pushing for "rationing", "government-run healthcare", "taking away choice", allowing "the government to come between you and your doctor". Over time, as the polling that I've shown above confirms, the public started to believe that narrative.
The Democrats still have yet to realize it, but ignoring attacks--even ones that most people think are absurd--gives the impression that the lies are the truth. And again, much like Kerry failed to answer the Swift Vets, the right wing's lies about reform became the truth. This is a very important point.
- Which leads to my next point: Have a clear message
The left has not had a clear message. The right has a clear message, which is:
Government-run healthcare will lead to rationing
The government will come between you and your doctor
Socialized medicine will cost too much
There will be a government takeover of healthcare
Bureaucrats will make medical decisions
Government-run healthcare will lead to long waits
They've constantly stuck to those points over and over again. If you were to poll 100 people and ask them what the Obama's plan's positions were I doubt that you could get statements like that. The problem here is that the Obama team has failed to develop a clear message that is brief and to the point, which leads to my next argument.
- Have a message that is brief and to the point.
We live in an era of soundbites. Americans have neither the time nor the desire to research complex policy issues. They don't care about the complexities. They aren't going to go online and research proposals. Time is short and the most that they'll hear about the issue is what they see on that 30 or 60 second commercial or what they see on the local evening news.
To that end the pro-reform messages needed to be simple and brief. They needed to be to the point. But the pro-reform side has not aired ads that are like that. Also missing are ads showing the personal plight. There aren't ads showing families who've suffered:
*bankruptcy because their insurance capped and they couldn't afford the massive bills
*cancellations because their insurance companies retroactively canceled their policies
*families who face rising costs every year
*patients who've had to fight to get their care they need, only to die waiting
*patients who can't get treatments because the insurance companies deem them too "experimental"
*doctors who have to spend hours that they could spend treating patients trying to deal with rude and unhelpful insurance companies.
What makes the PUN ad effective is that they show a woman (even though other reports indicate that she is a flat liar and fell $100K in debt anyway) suffering. She tells her plight. Has our side aired such an ad? No.
In the future our side needs to develop three or four simple points and phrases that will translate into crisp soundbites. They need to be phrases that are simple that will resonate with most Americans.
- Don't let the GOP guests on cable and other news shows talk over the Democrats.
I've seen it again and again. Tonight I was watching CNN and the conservative pundit interrupted and talked over his liberal counterpart over and over again. My main point here is simple: Don't let the Republican pundit talk over the Democrat. Interrupt and return the rudeness because people will think that the Republican is telling the truth if no one responds to the lies.
- Stop trying to be "bipartisan".
The GOP has no incentive to negotiate in good faith. Why didn't the Stimulus bill experience teach that to the Democrats? The GOP will not compromise and they will not do so in good faith. If anything they will do everything possible to make sure that the weakest bill possible--or no bill at all--passes. That's all that they are going to do.
These are the key lessons that the Democrats need to learn. Until the left learns how to develop a strategy, stick to it, use effective marketing, and stay on message, they will lose this and every other future policy debate.
I hate to repeat myself over and over again, but I am just downright disgusted by what I am seeing. I am a Democrat because of issues like healthcare reform. I just don't understand why it is so controversial to have decent healthcare in this country. And I just don't understand why the Democratic Party never learns its lesson in the PR area.