These last months have been hard. There's nothing more demoralizing than watching the congressional sausage making process - seeing good ideas whittled down to nothing.
About a month ago, it occurred to me that, on the issue of Medicare for All, we only did half the work required of us.
I won't ever call it "single payer", nor ever use the term "public option" again, and the reasons why are what this diary is about.
I've read at least three diaries lately describing strategies to move HCR forward:
Half The Job
Spearheaded by nyceve, slinkerwink and others, the lefty blogosphere did a wonderful job of describing the abuses of Wall Street owned health insurance companies. We've all heard the horror stories. They are compelling enough (for me, anyways) that when Obama tried to suggest that the employees of these firms are "our neighbors" too, I flatly rejected that sentiment. At once. Were I to hear that one of my neighbors chalked up a fat bonus for finding or creating ways in which an insurer could deny someone needed medical treatment, I'd go up one side of that person and down the other. My "neighbor" would have no doubt that I believed he or she was the scum of the earth who belonged behind bars.
Good words for us.
All of which describes the need, not the solution, a mandatory, nationalized system of health insurance paid for by a tax. Sounds awful when I put it this way, but the closer you examine it, the better it looks. The trick is to skip the first part and go directly to the second - what nationalized healthcare looks like in practice and results.
Know Thy Enemy
I know that some around here know the name Frank Luntz already. For those of you who don't, you should. He was vital in killing the national health insurance initiative, which candidate Obama campaigned on. The president called it, "the public option." That he got all of us to call it that as well was nothing short of a political disaster.
He wasn't making a serious proposal then, though this wasn't immediately apparent. If he was serious, he'd have been advised from the get go to change the name.
Frank Luntz is a master marketer. With the tools of marketing and advertising, he helps the GOP frame issues - focus groups, dial groups, polling - he is paid to find the most effective language, the exact words, used to express right wing talking points, and his THE LANGUAGE OF HEALTHCARE 2009 (.pdf - h/t to thinkprogress.org) contains talking points that will seem depressingly familiar to everyone.
I've maintained all along that the left owns the human face of healthcare reform, and it was used very effectively during the national debate. What we failed to do was "sell" the solution, whether it was the efficient, cheap, abundant, humane AmericaPlan insurance alternative (otherwise known as the PO). We failed to demonstrate it's benefits, and that's the other half of what was required.
I've already asserted in comments that a Medicare for America (single payer) plan is feasible by 2020, if a well-funded, well-organized effort is made to sell it - to illustrate its benefits. We already know the need. Deduct 12% of my wages for an efficient national health insurance plan, and I'll gladly pay for your well being, you pay for mine. No more medical bankruptcies. No more worry over the financial burden of saving the life and health of a loved one. Just go and get well again, with the hopes and best wishes of all of America, who have invested in your well being.
Should the democrats become as sophisticated as the republicans in their use of language and issue marketing, the question arises, is this honest debate? My answer is, yes and no. Have the republicans a point, when they say that another entitlement program poses some danger to the economic well being of America? Yes, but only if we overreach and only if there is some way to control costs in the long run. The fact of the matter is, the republicans aren't making that point at all. They are, deliberately, going for the emotional argument:
- “If some bureaucrat puts himself between you and your doctor, denying you exactly what you need, that’s a crisis.”
- “If you have to wait weeks for tests and months for treatment, that’s a healthcare crisis.”
- “Waiting to buy a car or even a house won’t kill you. But waiting for the healthcare you need – could. Delayed care is denied care.”
- “In countries with government run healthcare, politicians make YOUR healthcare decisions. THEY decide if you’ll get the procedure you need, or if you are disqualified because the treatment is too expensive or because you are too old. We can’t have that in America.”
- protect "the personalized doctor-patient relationship.”
- and what we essentially get out of this congress: “more access to more treatments and more doctors…with less interference from insurance companies and Washington politicians and special interests.”
Not everyone who takes such talking points at face value is a teabagger. For those working two or three jobs these days, those putting in the crushing hours trying to make their startup go, those distracted with worry over paying their bills or having a family member overseas at war, this is perhaps about all the debate they can handle. And yes, I believe we should provide an answering argument on the same level. Not just about the evils of murder-by-spreadsheet insurance companies, but not about a proposed solution. Is it honest? If done honestly, yes.
Even playing on an uneven field, almost two-thirds of Americans think that having the choice of a low-cost, efficient, government run health insurance plan is a worthwhile initiative. People aren't all dumb. Many realize that it would have a rocky start and would need adjustment as it went along. I believe most people would be fine with that. We're so close now. The Senate bill and the house bill, even with the emasculated PO contained within, are indeed remarkable legislative achievements. What they are not are remarkable achievements of health care reform, and therin lies the difference.
The Way Forward
We, on the left, need to do our homework. We need to lay the groundwork for the next round. And the round after that. And the next one. We need to do the whole job.
I'm convinced that the one who first creates the public campaign describing their particular solution will win the fight for health care reform.