Dems need to reframe this as "Health Insurance Reform" not "Health Care Reform." The latter is scary to people because most people like their doctor and actual health care delivery system, but everybody hates the way the current health insurance system works. If Dems made it clear they were reforming the way health care is paid for, not how it is delivered, I think the GOP scare tactics would fall flat.

We need people on TV to focus on calling Republicans idiot liars and stick with that as a message, exclusive of anything else.

If a Republican said the sky is blue you'd have to go out and look.

That's what you have to talk about, only that.

I'm starting to think the mistake may have in coming with a comprehensive bill.

It might have been more politically viable to come with a series of proposals over the course of his term to build up to a systemic reform. Step-by-step reform would quiet down a lot of the fear-mongering and isolate some of the opposition.

Insurance industry is going to support the administration of personal and employer mandates; Employers are going to support anything that drives down insurance costs. Right now, they're united in opposition to the whole bill.

Why not divide and conquer?

It's hard to win a fight with one hand tied behind your back. Since a single-payer system is off the table, Democrats have to convince the American public that the way to fix the Rube Goldberg-esque hodgepodge of private insurance, not-for-profit insurance, managed care, care networks, catastrophic insurance, Medicare and Medicaid is to add a couple more layers of complexity to the system.

Good luck with that.

I totally agree. I've been fruitlessly sending emails to the White House about health care for months. I've wondered if they really didn't care what passed--just so they could say they did something. Obama has not said very clearly what he wants. The 8 points they just put out should have been there months ago. Jon Stewart has been selling health care better than Obama has. Why can't the White House say stuff like Jon does? Obama could say: Older people and vets have the best health care in the U.S. They have government-run healthcare--Medicare and the VA. Why can't all Americans have a public option that makes your insurance company work for your allegiance?

His recent town hall illustrated how confused Americans are. So many people keep irrationally saying, I don't want government-run healthcare, leave my Medicare alone. Obama needs to start at the beginning with pointing out how good our government can do things. Of course, this would threaten his "facilitator" image (which I'm frankly sick of). My main misgiving about Obama during the election campaign was that his health care plan was the worst of the Democratic candidates. I wasn't sure he was really committed to changing things. I still think he would never have tried to address this if first Edwards and then Clinton hadn't come forth with plans. I'm still uneasy about his Rahm and Summers pals. I think that the poor sales job on health care is probably due to a lack of belief in it on his part and those that surround him. Ironically for them, their failure on this issue will cost them big time. And progressives--who they (and other Dems) have always taken for granted--are not going to be okay with half a loaf and "well, we tried." Speaking as an active Democrat for over 30 years, this is it. I'm ready to quit over this.

I think Doug-E-Fresh nailed it. Mention health *care* and it conjures up images of doctors and nurses working hard to make people feel better.

Mention health *insurance*, on the other hand, and you get pictures of evil-minded pimps in suits who get their rocks off raking in piles of cash while the public is left rotting in the streets to die.

From a pure marketing perspective, I know which way I'd jump if I wanted to get the mostly clueless and image driven American people on board to change the current system.

Good one, Doug-E.

Good comments. But I really don't think it is about sales -- the Senators don't give a shit about the people's wishes. The Dems just want to take every excuse possible to bend over for the Repubs.

In my opinion, it is too late. The Democrats have negotiated everything of substance away to the Republicans.

Congress doesn't give a rat's ass what the public wants, only what their benefactors want. The Democrats conned us into giving them a majority on the basis that they're better than the Republicans only to turn around and allow the Republicans to dictate policy.

Great.

I'm done. The Democrats can go to hell as far as I'm concerned.

Congress responds to the public -- Kevin Drum

Only up to a point. Representatives respond a bit more readily, because they're up for reelection every 2 yrs; Senators, given their longer terms, have a better hope that, in time the public will have forgotten their votes (*if* the public is even aware in the first place). And, worse comes to worst and the public is maddened to the point where they *do* give you a bum rush at th poll box? It's better to retire with a couple of mil from the industry you have so faithfully represented, than with just a plain Social Security check.

You know what would have made this way less of a problem? An appointment of Howard Dean as HHS Secretary or Health Care Reform Czar. Going on TV and making a compelling case is a strength of his. He also is an innovative strategic thinker who would have had a plan beyond telling Congress, "Y'all come up with something, 'kay?"

How bad do you want it?
How bad do you need it?
Are you eatin’ sleepin’ dreamin’ with that one thing on your mind?

How bad do you want it?
How bad do you need it?
‘Cause if you want it all you gotta lay it all out on the line.

How about Obama and helpers saying ~ "We already have a government program, Medicare, which covers many people and does well. Just imagine a similar program applied to everyone."

Buying into "nudge" theory and incrementalism is the big mistake.

Fear and loathing...

Let's be blatantly honest:
You've got to scare the fuck out of people.
That's what the puggers do so well...

You want to know why Cheney wanted to use the troops in Buffalo?
He wanted to scare the shit out of people.
Planes and troops and armored humvees going past Delaware Park? Holy shit!
Fear makes people easier to control and quicker to say yes.

You want to win the health care debate?

Then run ads showing people losing their homes. Run ads showing people who think they are covered but aren't. Run ads showing people who get requests denied...

You want progress? Forget education for now.
You have got scare the shit out of Harry and Louise. Make them tremble...

The failure to advance meaningful health care reform can be summed up in a couple of pithy aphorisms: Fear trumps hope. Money talks. There's a commie under your bed.

It doesn't matter how folksy or slick or focus-grouped Obama's message is. The insurance companies and the right wing fear factory have a built in advantage, given our current system of campaign finance and a press that is accountable first and foremost to corporations, not people. (And, let's face it, an electorate that is both uninformed and gullible.)

Doug-E-Fresh is completely correct. I wonder sometimes if there are enough marketing savvy folks in Obama's team.

Also our media, who should pick up the ball and present the case, instead waste our time with the "fair and balance" routine. But then it all goes to the ownership factor and again to the 1% wealthiest "Americans".

I think Obama was clear when he said that health reform "won't add to the deficit-and I mean it."

Just a little while ago, I heard Rick Sanchez say to Sherrod Brown, "the President says this won't add to the deficit, but ...I don't believe that."

That's our liberal media for you.

Completely agree on the lack of a comprehensive and effective sales strategy. Should we collaborate on and submit PowerPoint slides?

A good salesperson believes in the cause, utterly and without reservation. In that energetic and committed spirit, they define the problem to which the "product" is the solution. Show the added value. Present the benefits. Sales turn on a clear and vivid demonstration of how much the buyer will gain. This is not rocket science!

It would help if the President didn't come out telling us how reform would save money, followed by the CBO telling us that his claims are a crock.

"You want progress? Forget education for now.
You have got scare the shit out of Harry and Louise. Make them tremble..." -koreyel

Look at all the billions Bush was able to shake out of Congress by shaking the fear of 911 at them every day. Look at the votes on those war supplementals, they gave up the Treasury with nary a whimper.

Amen, Doug-E-Fresh. Hope the White House is still reading this blog....

Obama is kidding himself. The problem has nothing to do with his sales pitch.

The political pragmatism that served to propel him to the presidency should have been shit-canned once the election was over. When dealing with the rule-or-ruin mutts of the republican party (much less their blue dog allies), reasonable compromise is impossible. Unfortunately, he believes his own rhetoric, i.e., that a middle ground can always hashed out. It cannot, leastwise with today's GOP. The man needs to cultivate a mean streak if he expects to accomplish anything substantive in the next four years.

Why are they bothering with the repubs, the republicans did not vote for Social Security or Medicare either.

Could the delay until after the August recess actually be a blessing in disguise for the White House?

More chance to "sell" health insurance reform better and more aggressively. I know it gives the scum time to sharpen their focus as well, but at this point, taking on spears and javelins with a sharper pocket knife is better than with a dull twig.

It's partly the sales pitch and partly the stupidity of the nervous nelly conservadems in Congress.

The criticism of the plan are getting traction for two reasons:

1) They play to preexisting prejudices and fears of the American people -- and the counterarguments are complex and/or speculative.

2) Conservative Democrats in Cingress lend these criticism credibility by validating them and fighting the President's reform plan.

If you had the first without the latter, I think the attacks on the plan would be far less effective. The latter gives the media an excuse to have story after story about how the Democrats are divided on health care, and that conseravtives are opposing it because it's "too expensive," or "bureacratic," or "raises taxes too much," etc.

The GOP has become virtually irrelevent in this whole debate (except for Max Baucus's rather stupid idea to negotiate with them in his committee).

The media is also institutionaly biased agianst massive health care reform. So they gleefully report on the :democrats divided" stories. It also hgurts Obama's poll numbers because it makes him look weak, ineffective, and "like he's trying to jam a huge new liberal social program down everyone's throat."

The solution is to pass a GOOD health care bill. Not a watered down one that only breeds more internal Dem strife and opposition. The Blue Dogs are idiots. Their reason for opposing the reform as it was first crafted was purely cynical. It was not an ideological opposition. Nor was it principled. Hell, even GOP opposition is ore principled because at least they have a legitimate political interest in seeing Obama fail. What is the motivation for a conservative dem in a marginal district to cause his President and party's poll numbers to go down the tubes for next year's middterm elections? They are really dumb, dumb, dumb.

People without health coverage probably can't afford to go to Washington for a mass rally.

But they probably can afford to send a letter to their Republican congressman.

Dear Sir,

Enclosed please find a sample of my spit.

Please have it tested and send me a note as to whether I have liver disease.

Thanks,

Your pal,

me

I disagree in part because it is more who holds the microphone to create such confusion.
It's really hard to find news coverage of sensible HC reform forums...but those that are disrupted by tea baggers or wingers are all over the media.

Few elderly people buy into the "deather" bit but Mathews puts it on his show and all the other media then covers Mathews and suddenly we are led to believe that "many" elderly are now thinking this. They aren't.

Selling requires a market and unless you've lost your HC ins lately or were one of the millions screwed by ins companies, then you are getting your info from the MSM...and what are they running...conservative talking points...and full course Obama attacks and distractions.

Then we get the conservadems trying to find any means possible to keep the profiteers in the game.

Everything...let me be clear...everything about real HC ins. reform including coverage and costs is quite simple. Battling an army of lobbyists and the senators they control is the only hard part to enacting real reform. We are heading to not for profit single payer HC ins eventually out of necessity.

Selling requires contact which is being blocked by media exposure. Spending $1.4 mil/day to obstruct (in every way possible) HC reform will only pay dividends if reform fails or is so weakened as to not be reform at all. So far, Obama is the only one getting media attention on the positives for HC ins reform. Yet everyday we hear from the detractors of reform or have to deal with the latest from congressional obstructionst like Baucus and Conrad or the so called Blue dogs of hypocrisy.

The initial polls of 72% of Americans wanting reform were right and since then it's just been a full court press to make us believe "that 'can't' be right".

After all...it was the American people who "sold" the idea to congress. Obama just got in front of the parade. If Obama needs to sell it to anybody...he needs to sell it to congress.

Not a one of his detractors voted for him...nor do they really care about the issue of Hc reform as anything but a way of changing the political landscape. Obama or not...HC ins reform must happen out of necessity.

Other places, people pointed out that Obama and WH staff could be using Howard Dean as salesperson and Bill Clinton to negotiate with Blue Dogs. Excellent ideas. I've wondered why Dean has been so absent. Finally saw him on Charlie Rose with Frist and he was GREAT. He gets it and he's honest and doesn't kowtow to sacred cows in public. He didn't let Frist get away with much (although he didn't challenge the defunct Repub talkingpoints much, like the "market will fix it", just pushed his own, which was a shame). Get Dean out there more.

There is indeed a great deal of health insurance reform in the proposed legislation, but that's only part of it. Other parts are made to address "bending the cost curve". I think Drum is right that a series of digestible bullet/talking points - sound bites explaining how the various parts of the currently broken system will be fixed - is necessary. Too many people still believe that an un/poorly regulated free market is the safest, best and therefore *only way of delivering good health care.

Kevin Drum is basically right. Despite vast archives of documents describing the problems, there is no constituency for any particular reform. It's being forced now because Obama and Rahm saw the opportunity.

That was the same problem that doomed Pres. Bush's proposed "reform" of Social Security. There was no large constituency demanding change, and no majority supporting any proposed change; and there were plenty of warnings that the change might not be good, warnings that were confirmed by the subsequent declines in the financial markets.

And despite the Republican "lies", there are pie-in-the-sky promises in the Democratic health-care reform plans, and plenty of facts about them that cause most people to recoil from support. Even the supporters can not agree what the most important features of the new plans are.

As to "separating fact from fiction", what we have are dueling warnings and projections. Nobody really knows what the first-year through third-year costs to America's small businesses (and their millions of employees) really will be, but there are severe warnings from opponents and "rosey scenarios" from proponents, along with a casual "The government could hardly make things worse, could it?"

The truth has no Fox News.

lack of credibility,

Neither Democrats nor Republicans have a lot of credibility right now. Obama lost some of his when he confessed that he did not know what was in the bill that he was supporting. Lack of credibility is not a problem for bill opponents: all they have to do is read aloud the sections of the bills that are contradictory.

Obama's recurring aw-shucks naivety is getting a little tiring. I'm sure a true believer will be along any moment to label me a troll and explain to me how this is all part of some master plan.

I really feel like the the reason the polls are shaky on this is that there are a lot of lies and misinformation out there. Two big ones:

1. Seniors will be put to death by the government.
2. The House bill will make it illegal for you to buy private insurance if you don't have it already.

Obama needs to say something like this:

"If you hear a rumor about health care reform, and it sounds horrible and outrageous, ask your self this question: Gosh, is there any chance that this is actually a health insurance industry lie? The answer is almost always going to be yes."

The Democrats would have had no problem "selling" the American people on a universal, nonprofit, single-payer medical insurance system under open, accountable, efficient public administration -- e.g. "Medicare For All" -- since that's what the overwhelming majority of the American people want.

The problem the Democrats have now is that they put the system that the majority of Americans want "off the table" and now we have so-called "conservative" corporatist Democrats and far-right corporatist Republicans "negotiating" a system that will protect the huge profits of the insurance corporations, at the expense of and to the detriment of the American people.

And the system has to be made complex and inexplicable, in order to hide the fact that it really does nothing to "reform" health care or health insurance, but is just a cover for channeling more and more of the American people's wealth into the hands of giant corporations.

Instead of an efficient, nonprofit single-payer system, the Democrats and Republicans together are creating a system that will require, by law, that every single American buys expensive insurance from bloated, inefficient, obscenely profit-seeking insurance corporations, so their fat-cat executives can rake in millions of dollars a year and fly around the country in corporate jets eating gourmet feasts from gold-plated china, while their companies deny sick and dying people the coverage that their premiums have paid for.

Yeah, that's a hard sell.

This turning into a truly royal clusterfuck. Well, the Dumbocrats will get the punishment they deserve in 2010 and 2012. Too bad the country will be punished right along with them.

MatthewRMarler wrote: "Despite vast archives of documents describing the problems, there is no constituency for any particular reform."

Of course there is. Polls have repeatedly shown that the overwhelming majority of the American people, as well as the majority of doctors, want a universal, nonprofit, single-payer medical insurance system under open, accountable, efficient public administration -- e.g. "Medicare For All".

But that is "off the table" -- because it is viciously opposed by the only "constituencies" that matter, namely the for-profit insurance corporations who enrich themselves by denying sick and dying people the health care that their premiums have paid for, the giant pharmaceutical corporations who grotesquely overcharge Americans for their products because they can get away with it, and the other "health care" profiteers who are able to "make their voices heard" in Congress by virtue of millions of dollars in bribes (a.k.a. "campaign contributions").

The USA has the most profitable health care system in the world, and the bought-and-paid-for corporate shills in Congress are determined to keep it that way.

Maybe something this big needs to be treated like a political (or even military?) campaign, the goal of which is legislation? Break the project down into manageable tasks, assign them to good people, orchestrate it all through a campaign manager. You take control of media coverage by framing the debate. That's really what we're talking about here - creating a compelling narrative and sticking to it.

Messers Drum and Benen are spot on, and as much as I agree in spirit with SecularAnimist @ 5:25, this thing has to sell. Moreover, the better a sales job the White House does (because, let's face it, nobody else is gonna do it), the better chance of getting tight regulation and an decent public option. Interesting that Obama appears to've been a victim of the classic liberal trap of assuming that the facts will speak for themselves - what one might call a "functional fallacy." Hopefully there's some serious retooling going on within the White House message machine.

MattMarler is way wrong. There is a huge number of people that want change. Hell a good number of voters voted for Obama because of health care.

H.R. 676, the single-payer bill submitted by John Conyers runs just 32 pages compared to over 1,000 for the various reform bills being considered now. This is partly because, since the bill is not going anywhere, there has been little input from other congressmen to clutter it up with individual priorities. However, it is largely because single-payer is much simpler than trying to merge existing health insurance providers with more effective regulation, a public option, employer mandates, individual mandates, subsidies, etc.

... we don't spend enough time on either side of the basic vox populi equation: (a) hammering home why individuals, personally, should be unhappy with the status quo, and (b) promising them, personally, lots of cool new stuff if they buy into change.

the problem is that people already know about (a) quite well, thanks, but Obama & co. are not actually offering (b). "support our plan because your legs have been crushed and under our new plan we'll send you a get-well ecard" is not a riveting sales pitch.

SecularAnimist: "Medicare For All".

If that's what a majority of Americans want, then that's what Obama should write out and submit to Congress. If that's what a majority of Americans want, they'll re-elect the Senators and Representatives who vote for it.

If that is what a majority of Americans want, they are being awfully quiet about it. They need to get out wherever there are tea parties and outnumber the tea partiers.

"This shouldn't be such a hard case to make, because the American consumer is really not getting a good deal."

It is truly amazing that Obama and the D's can't take a good idea and make it happen, while Bush repeatedly had really bad ideas (like the Iraq war) and had little trouble getting them passed.

That's our "great communicator" prez. Who has never struck me as being that.

It is very easy to describe, in clear, simple terms, how important this is.

Every time a treatment (by extension, a test; by extension, a diagnosis) is postponed for at least three months, someone at an insurance company gets a bigger bonus.

I'm going to repeat that sentence, because it was a little on the long side.

Every time a treatment or a test is postponed for at least three months, someone at an insurance company gets a bigger bonus.

Now think about how medicine works. Now think about outcomes.

Now draw your conclusion.

And yet, it's proving to be a very hard case to make, with more and more Americans buying into conservative critiques, even the ones that don't make sense.

Is this true? I've been interpreting weaker poll numbers on health care as catching both hardcore conservatives who hate the whole idea (FREEDOM! or something) _and_ people who want a better plan, or who are upset about how long it's dragging on without getting done. What's the source for "more and more Americans buying into conservative critiques"?

Someone needs to point out to the President that he's also disapproved of by the liberals and progressives who are PISSED that he's not going to deliver single payer.

Or as FlipYrWhig said.

And yet, it's proving to be a very hard case to make, with more and more Americans buying into conservative critiques, even the ones that don't make sense.

And how do you supposed they're being exposed to nonsensical conservative crituques repeated uncritically and with no regard to the facts? I hope this whole sorry episode drives a stake through the heart of the "liberal media" myth once and for all.

Come to that, the myth of the "liberal media" didn't spring up overnight. It was the products of decades of Republicans repeating the lie, to the point where even the media believed it. Yet the so-called "liberal media" never denied a megaphone to the very people who were castigating them as biased shills. Why aren't Democrats working the refs, pointing out that the media is anything but liberal? No, Howard Kurtz will never accept the idea, but his successors might have the scales drop from their eyes.

Irony alert: MatthewRMarler comments on credibility.

Nice to see you've dropped your pretense as an honest commentor and returned to your typical bad-faith Republican shilling. There, now, doesn't that feel better?

Shame on you, Marler.

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