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Sell Me!
Barack Obama says he's frustrated that it's so hard to get across his healthcare reform message. Ezra Klein doesn't think selling it is the problem:
The lived experience of most Americans is that health care is too expensive, but not so bad. Similarly, it's that Europe might do a bit better than us on some things and quite a bit worse on others, but they're not very far ahead on anything. And the Veteran's Administration is terrible — didn't you hear about Walter Reed (which most people don't realize is an army, not VA, hospital)?
I don't think the problem for health-care reform is how it's being sold. The problem is the congressional process, and maybe the fact that it's hard to say what this bill gives the median American because it's trying so hard to leave the median American alone.
As near as I can tell I'm practically alone on this, but I think this is absolutely wrong. It's not that congressional process isn't important. Of course it is. This is congressional legislation, after all.
But underneath that, it's all about how it's sold. Everything has to have a constituency if it's going to get passed. For ag subsidies it's farmers. For lax financial regulation, it's banks. For tax cuts it's rich people.
For healthcare it's.....I dunno. Who? But that's the point. Everyone has been so hung up on congressional process that they seem to have forgotten that Congress responds to the public. If constituents are mad as hell that their healthcare isn't as good as France's, they'll flood congressional offices with phone calls. But if they think America has the best healthcare in the world, while the rest of the world is a socialist dystopia of ramshackle hospitals, yearlong waits for hip replacements, and harried doctors who can't see you for months and treat you like a postal customer when you finally get in — well, who's going to get pissed off about the occasional scuffle with their insurance company? And if the public isn't worked up, then Congress won't get worked up either.
This has always been about public opinion. Everything is about public opinion. It's about public opinion being strong enough to overcome the resistance of whatever corporate interests are on the other side. For some reason, though, liberals don't seem to get that anymore, and because of that 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.
You don't have to lie to accomplish this. But you do have to sell, the same way any salesman anywhere sells stuff. That means understanding your audience, figuring out what they're afraid of, promising them something that will make them better off, overcoming their objections, and then convincing them that they have to call now to take advantage of this one-time offer! Every pitchman on late night TV understands this. Why don't we?
I think you're right and the
I think you're right and the problem is that Obama has not articulated a "vision" of what health care will mean for the average American. He needs to give a "shining clinic on the hill" speech -- create an idea of what a better way for health care delivery might look like.
The key isn't to rally
The key isn't to rally public opinion in support of health care reform. The key is to rally public opinion against Congress, and the broken congressional process. It's hard to sell a reform plan, but virtually everyone already believes that the government is broken. You can really get people fired up over this. Republicans and Democrats alike, even! You can make a completely non-partisan case against something like the filibuster, draw on recent examples of abuse by both parties, point to its role in institutionalizing racism, and blame it for Washington never doing anything. And every bit of reform you make to the legislative process, small or large, is going to pay dividends in progressive legislation as the country shifts to the left.
I don't understand why this hasn't been a larger priority for American liberals. Obama's campaign wasn't popular because he promised climate change legislation or health care reform (so did everyone else), it was popular because it really did look like it might change the way business was done in DC. During the campaign, that idea of change manifested itself as large-scale organizing, a less bitterly combative tone, and an eye on long-term strategy over day-to-day scrapping; now that he's president, what could it possibly mean besides legislative reform?
Not Alone. I'm With You
Kevin, I think you are absolutely right. The efforts by Congress have been abysmal, and Obama's technocrat approach is NOT winning any converts.
I'm skeptical how much impact even a groundswell of public support would have in the face of corporate money, but they're not even trying.
More
The problem is twofold: first, most people don't understand that the debate is about two different things -- health care and health insurance. Second, is that most people really don't care about health insurance per se -- they care about what gets paid for and what choices they have. This is about health care delivery, really.
On the question of health care delivery, it's like everything else -- some people will give up choice for cost; some people will pay more for choice. Some people want NEVER to see a bill (I'm one of those -- I hate bills); some people hate the idea of HMOs and copays. Some people want a quick walk-in clinic where they can get throat cultures and antibiotics for their kids on the same day and they don't care what it looks like; some people want opulent waiting rooms and avoidance of sickly looking smelly poor people with hacking coughs. But politicians are acting like we all want the same thing -- we don't.
I agree with this basically,
I agree with this basically, but from the practical standpoint it seems like the selling has to be done in advance. It takes time to convince the public to get behind something, and more time on top of that to have that support express itself in poll numbers and public pressure on Congress. The time for selling to the public was months ago; it's time to sell it to Congress.
Additionally, the Democrats need to finally, finally, finally learn their lesson from the 2004 election. I will call this the "Kerry Doctrine:" fight back! At least half the problem of selling anything is the distortions, misinterpretations, and outright lies (plus a healthy dose of galling stupidity) spread by a certain party I won't name here. As has been pointed out so often here and elsewhere, it's easy to get people to respond to a vague question ("Do you think healthcare should be improved?") with tepid support, but the support disappears after one attack ad. Obama makes fine speeches, but it's not enough. There's a good reason the advertising industry doesn't rely on speeches.
But it makes you wonder...
Why that is necessary. The evidence of the craptacular nature of health care is all around us. I guess it's a case of the "the devil you know" for some folks, so maybe the job really is to know that Canada and Western Europe are not the corpse-strewn hell dimensions they appear to believe they are, but then that's undercut by the fact that we're trying something a bit different from what they have.
Follow the money
With regard to "selling", the problem is that the insurance corporations and their allies, the handful of giant corporations that own virtually all of the mass media in America, are aggressively LYING to the American people without conscience and with impunity.
With regard to the Congressional process, the problem is that most of the legislators "negotiating" the legislation are bought-and-paid-for tools who have been bribed by the insurance corporations to put their profits ahead of the well-being of the America people.
When it comes to delivering high-quality, affordable, effective health care to human beings, the USA has the worst system in the developed world.
However, the USA has the most profitable system in the developed world, and the insurance corporations and pharmaceutical corporations and other "health care" profiteers, and their bought-and-paid-for Congressional allies are determined to keep it that way -- at the expense of, and to the detriment of, the American people.
What SA said. The first rule
What SA said. The first rule of any investigation: follow the money.
Yes, public opinion can be important, and it should be sold better. But in order for public opinion to override bribery to it has to be screaming from the rooftops, pitchforks and torches type public opinion. And so long as most people have some not-completely-intolerable-at-the-healthy-moment insurance, you aren't going to get to pitchforks and torches.
That's why publicly financed campaigns, strict lobbying and revolving door policies, etc. are a more important long-term issue than UHC, banks, what have you. But I've been screaming this for so many years that I'm hoarse over it.
Ditto
SA nailed it.
Kevin is absolutely right on
Kevin is absolutely right on this (and I made this point also in a comment yesterday).
The Democrats are doing a lousy job selling the health care plan, as well as other liberal plans.
By contrast, the Republicans have a very effective communications machine which works at many levels: Catchy statements by Republican senators and congressmen, Fox, O'Reilly, Limbaugh, Palin, talk radio ...
The Republican message criticizing Democratic initiatives is scaremongering, but it's crisp and easily understandable. By contrast, the Democrats have complicated positions that are poorly articulated for dissemination to the wide public.
It's a disaster, and it will doom the Obama presidency if someone doesn't realize it and act on it quickly. It should start with Obama himself, but he seems to have lost his magic communication skills recently.
Canada
Canada, Canada, Canada. It's all about Canada and its health care. Blame Canada, if you will.
That's the first and last thing you'll hear from conservative Americans who Do. Not. Want. Canadian. Healthcare. They're heard (false) horror stories for years about Canada and its interminable waits, its horrific care. They do NOT want that here.
I don't know how many times I've heard this line from family, friends, just about anyone whenever the topic comes up.
Convince them this isn't a plan like Canada's. It's too late to tell them the truth about Canada's system; they won't believe you.
In my part of the country,
In my part of the country, the most effective anti-reform ads - by far - are the attacks on the Canadian system. How can Canada screw up healthcare so badly? A country with enormous resources, small population, no defense obligations - why can't they get it right?
Sell Me!
The GOPhers get it, and are selling lies to the public, like the threat of euthenasia.
Obama is not "feared" as David Brooks wrote recently, so guys like Max Baucus, essentially owned by the insurance industry, thumb their nose at Harry Reid with impunity.
Obama needs to sell, but also knock some heads. Rahm Immanuel is supposed to be a tough guy, the karl Rove of this administratiion, and Biden should have some clout in the Senate.
Until they 'splain how it is to these rogue Dems the little people will again be beat up by the big guys with lots of money to throw around.
Part of the problem is that
Part of the problem is that there are people talking about things like Medicare Advantage but in the current media environment they simply can't achieve the kind of saturation coverage that the anti-reform talking points get.
Here are private insurers that are still getting a 12% premium over the average costs of traditional medicare, despite initial claims that Medicare Advantage would lead to long term cost savings, despite claims that the higher payments were only needed to cover the start-up costs of the pilot program and despite the insurers skimming off only the healthiest retirees. Now, recent investigations by state insurance commissions are showing that some of these insurers are rejecting up to 1/3 of all claims, leading to hugely increased costs to the seniors that were conned into sign up for these boondoggles.
If you watch Rachel Maddow or Keith Olberman, listen to Air America radio or read Krugman then you will hear about this. You will also hear about an insurer classifying an allergic reaction to a legally prescribed drug as "susbstance abuse" and refusing to cover tests or treatments related to the incident, about the 2700 people from 16 states that drove and camped out for days to get free health care at an event in Virginia and about some of the stories that drove people to go to those lengths to get treatment.
But the other side has all of Fox News, the Wall Street Journal, Clear Channel, several syndicated columnists and at least one host of each of the other cable networks who can all be counted on to repeat the same talking points as often as needed to make them sink in. When Democrats attempt to achieve this level of saturation, they are dismissed as shrill or alarmist. The 1 or 2 liberal democrats that are invited on the weekend talk shows will be outnumbered by the Blue Dogs and Republicans will outnumber liberal and Blue Dog Democrats combined.
Here's what I don't get. Why
Here's what I don't get. Why doesn't the average American get that they might need something other than employer-provided health insurance? Or rather, why doesn't the above average white professional get this? Sure, you've got it now, but unlike the way things once worked in the past, you're not going to have it when you retire at 57. I'm on my husband's health insurance, which is great right now. But unless he wants to work until I'm 65 (he's older than me) and I can go on Medicare, what will we do? I have a chronic condition, depression, one that insurers don't like to cover; it may not be possible for me to get individual health insurance at any price. With the number of pre-existing conditions insurers don't want to cover, I can't think my situation is that unique.
the president wants to avoid paying any opportunity costs
The president's problem is he wants poor people to have health care, the middle classes to continue having employer based health care, the upper classes to continue having superior health care and the medical industry to continue earning record profits. The president wants every constituency to avoid paying opportunity costs while changing health care to improve delivery and lower costs. Of course, the constituencies most able to absorb the opportunity costs absolutely refuse to bear them, and use their capital to persuade other constituencies changing how health care is delivered and paid for will harm them. The president's bind is of his own making because he refuses to hold the profit makers accountable for not only withholding health care from those unable to provide the greatest profits, but for co-opting legislators through graft.
Obama is either a weak leader or a closet Blue Dog.
I have to agree with Leanderthal. There is no leadership from the White House. Obama has ceded control of his entire agenda to the Blue Dogs and the Republicans. There is no benefit to supporting Obama and no consequence to opposing him.
Mitch Guthman
So this is why we elected
So this is why we elected govenors and not senators.
Which health care plan?
Good post.
Kevin seems to realize that we do, actually, live in a democracy. If a substantial majority of the people want it, it will pass. Witness the "Do Not Call List" legislation, that went through Congress like a hot bullet through butter, with both parties trying to take credit. If they want it, it will happen.
What most people are hearing now is, "We're going to reform health care". When people ask, "How? With what?", they're told:"We don't know yet, but trust us, it'll be better!". The fundamental problem here is that people still don't trust the government all that much. For most people, their interaction with the US Government is the DMV, licensing boards, school boards, military bureaucracy and the IRS. No matter how bad insurance companies are, it's easy to sway people by simply arguing that the gov't will be worse. People will believe this. Hey, they'll say, at least I can sue an insurance company. Ronald Reagan's old saying still holds true: "The nine scariest words in the English language are, 'I'm from the government, and I'm here to help.'"
Kevin is merely pointing out that Congress will respond to public pressure. If the public doesn't want health care reform, it won't pass. That means the government is functioning the way it's supposed to. If you want it to pass, first settle on a plan - this hasn't happened yet. Then figure out what you need to do to get people on board, and do it. If you can't, it's not the fault of the Evil Republicans or the Wicked Insurance Companies for making arguments that you can't counter. People don't trust them, either.
If a substantial majority of
If a substantial majority of the people want it, it will pass.
Incorrect. At the beginning of this latest round of health care reform debate, a substantial majority of people wanted single-payer health care.
A more correct revision would be, if the vast majority of the people want it, and a powerful, monied lobby does not oppose it, it might happen.
Not quite...
Reply to dob,
Actually, the polls showed that people would like health care to be reformed so that everybody has decent health coverage. Well, sure. Everybody wants that. But at what cost?
Once they think about it, it gets a bit stickier. Sam Nunn (God, I miss him) used to tell the story of going to his constituents and saying, "We're going to get rid of our nuclear arsenal", and everybody loved this idea. Hey, what's not to love?
But they would come back a day or two later and ask, What about the Soviets? What about China? What about small countries with nukes? Gee, this isn't so simple as we thought....
The same thing happens with health care. People want a better system, but most are wary of government solutions. I would bet my house that if you took a direct poll asking people if we should adopt a single-payer health care plan for everybody, just like Canada's, you wouldn't get a majority saying,"Yes".
And, yes, there are powerful people trying to maintain the status quo. It has ever been thus. Try reforming inner-city schools sometime.
Single payer polling
Single payer polling results
I will take that bet. I grant you, none of these polls are exactly as you describe, but on a fairly worded poll asking about single-payer v.s. the status quo? Yeah, you'll be apartment-hunting in no time.
re-regulated media ownership
GE purchased RCA to prevents the public from forming opinions on issues with reliable data. The public is repeatedly broadcast lies, and until the public stops relying upon corporate owned mass media for information they will be unable to convince corrupt legislators to turn good policy into law. Perhaps Obama should have first re-regulated media ownership prior to tackling health care reform.
John Stossel is about to un-sell Canadian health care
Tomorrow (Friday) where on 20/20 he'll be scaring people with stories about waiting times. Aieee! No mention, of course, that overall health is as good, or better, for much less cost, or that people in need get treated (some promptly, others with some delay).
show them why they should be outraged
The crappiness of the American healthcare system can be illustrated pretty simply. When it comes to infant mortality rates, we rank 45th. ("We're number 45!" How's that sound in a stadium chant?) We lag behind not only England, Canada, France, Italy (and virtually every other country in the EU), but also those economic powerhouses of Greece, Slovenia, Malta, Macau, & Bermuda. Once more, for emphasis -- Bermuda. And we beat out Serbia, Belarus, & Lithuania by only the barest of margins.
We fare slightly worse in terms of life expectancy -- 50th -- where, in addition to the countries who trumped us on infant mortality, we're the bested by the likes of Cyprus, Puerto Rico, the Virgin Islands, & the Cayman Islands. (No more jokes about Caribbean medical schools, folks.)
The most infuriating part of all of this, of course, is that we spend way more, per capita, than any of those other countries do on health care. We have the most powerful military & biggest economy that the planet has ever seen, but a newborn in Cuba stands a better chance of surviving than it does here. That's pathetic.
It is their fault when their
It is their fault when their arguments are flat out lies that they make up faster than progressives can debunk them and when the press doesn't do its job of pointing out at least the most blatant of the lies and calling them what they are.
P.S. This should have been a reply to rhinoman a couple posts upthread. I don't disagree with the need for Democrats to get more message discipline, but I do think they are at a disadvantage.
Heard this before
Response to tanstaafl:
(I like the handle, btw)
I have been hearing hard core Dems say this since Nixon beat McGovern back in '68. The complaint is always that we're so righteous and accurate and those evil backstabbing jerks won't let the truth come out. I heard this with Carter, Mondale, Dukakis, Gore, Kerry, Hillary's health care plan, etc etc. (BTW, the GOP does this too, and it's just as irritating).
Funny, though, it's hard to find JFK, LBJ or Clinton really complaining like this. (Clinton would gripe, but no more than any other president, they all think the press is out to get them). Look, guys, these are the big leagues. You want to pass a huge change in the way America operates. You're going to have to fight it out in the arena. Politics ain't beanbag, as they say. Whining that the other side is throwing spitballs and it's, like, so unfair! may make you feel better, but it doesn't accomplish anything.
You want to pass health care reform? You had better start thinking in terms of what works and what doesn't. If it helps, I guarantee you that's how Rahm Emanuel thinks.
Yup. The sales point from
Yup.
The sales point from Obama has been: "Nothing will change for you." Or alternatively: "You won't be screwed, promise."
Not exactly a needs based sales approach.
I love how when something fails, like health care in 1994, it is automatically assumed that it's polar opposite is the recipe for success.
The knowledge that ramming a bill through congress doesn't work created the common wisdom that congress had to generate the bill itself. Ugh.
>"The lived experience of
>"The lived experience of most Americans is that... Europe might do a bit better than us on some things and quite a bit worse on others, but they're not very far ahead on anything."
Say what? Most americans have lived in Europe? Wow, you learn something new every day. About sweeping arrogance of some pundits, for example.
Re the Canadian health care system - we throw around scare stories of its failures ourselves. But that's not because it's bad - it's because its failings stand out starkly against the general background of success.
The clearest proof of this is the simplest - any politician, of any party, who threatens universal medicare here would be committing political suicide. This has been proven election after election. To paraphrase, you couldn't pry universal medicare out of our cold dead hands.
">"The lived experience of
">"The lived experience of most Americans is that... Europe might do a bit better than us on some things and quite a bit worse on others, but they're not very far ahead on anything."
Say what? Most americans have lived in Europe? Wow, you learn something new every day. About sweeping arrogance of some pundits, for example."
You're misreading this, I think. If most Americans had lived in Yurp, our rattletrap health care system would have been reformed years ago. And Ezra's not stupid. He knows that most Americans haven't lived anywhere else. What he meant was Americans think those things are true because they learn them from the media.
A complex issue. However,
A complex issue.
However, there is NO myth, legend, or conspiracy theory propagated by the FAR right, believed by the CENTER right, and dismissed by the CENTER left, that isn't basically the result of a deeply held belief or fantasy of the FAR left. An example. "Obama will take your guns away". A lot of people worry about this. The liberal and progressive media says there are too many tin-hat conspiracy believers and it won't happen. But dig a little into the leftist blogosphere and you'll find plenty of "confiscate em all" types.
The same with healthcare. At the bottom is a deep lust for egalitarianism by the left, where there is a gov't run, gov't funded, and gov't regulated health delivery system, with no provision for private patient-doctor interactions. Everyone is covered and everyone is equal. End of discussion. You get what the gov't decides.Period.
But Obama will tell you you get to keep what you have, it isn't going to be gov't run healthcare, but HR3200 is full of stuff that disagrees with this, and the left says it doesn't go far enough. The media just wants controversy.
Any confusion is to be expected.
Good on you rahzayfon
Good on you rahzayfon wherein your post is its own counterexample.
excuse me?
"with no provision for private patient-doctor interactions...You get what the gov't decides.Period."
Uhm, bullpucky. Show me anyone in the "leftist blogosphere" saying this. You pulled this out of you-know-where.
It's Not About Selling, It's About Telling
Well, Kevin, it would be a lot easier for liberals to sell health insurance reform if the 4th Estate was doing its job and reporting facts instead of talking points. People are ready to believe whatever gets jammed down their throats enough times, and whoever has the money to make that happen gets to control the narrative. You say everything is about public opinion, but politicians only give lip service to their constituents---they actually listen to the big money that buys their votes. Once upon a time we turned to journalists and reporters to tell us what was really in a piece of legislation and how it would impact us, but those days passed with Mr. Cronkite. Now, instead of them actually strapping on a pair and trying to fill his shoes, we get a lot of crocodile tears from media clowns about how no one now could do what he did, and isn't it a shame there are no more giants in the earth? The fact is that if they only gave us more investigation and truth-telling, and much less opinion-masturbation, people might actually be able to figure out what the hell the proposed bills would do.
And by the way, rahzayfon, I've been a leftist all my life, with a rifle and a couple shotguns in the closet, and I've never known anyone or any blog that ever suggested confiscating all guns. That crap is only served up by the shills for the arms industry.
The problem it's having is Republicans
We need to make Republicans the issue. They're the problem, not the legislation.
Some form of this thing is known to be needed by everyone. The problem it's having is Republicans.
But people on blogs talking about it isn't going to help. Democrats on tv have to talk about Republicans and only Republicans, not get lost in distracting details.
The issue is obstruction.
The problem is NOT
The problem is NOT Republicans (or Blue Dog Democrats). It's the Money Party. We get what they want, sold to us by their networks and their shrills. Ignore party labels, they peel off and are quickly replaced with something newer and shinier.
The Money Party is well represented by the national media and K street lobbyists. We are not.
Healthcare
I am a 56 year old white male. I am self-employed. My healthcare costs me $425/mth that I cannot really afford. My partner was recently laid off. My partner who is 50 years old has a healthcare plan which costs $850/mth (Cobra - before the temporary government subsidy). This is all very discouraging.
Kevin Is Right
This is where liberals went off the rails.
Americans don't want to know the details. We don't ask about our cars, or our sodas, or even very much about the mortgage agreements we sign.
Americans want health care reform. They don't care if it costs a lot- everything costs a lot. They don't care if it means changing their plans- everybody changes their plan anyway when they get a new job.
Liberals somehow convinced themselves that most people didn't want a change, and that they would be immensely concerned about the cost. Then the 'liberal' coverage became an exhaustive trek through what you least want to see- the process of laws being made. Migod, it's like watching Saw while you eat dinner.
What the liberals need most is a party to the left of them. Things are looking better on that front than they have in a century, but we're not there yet.
Congressional/"hey, big
Congressional/"hey, big spender"/lobbyist healthcare reform is like immigration reform or the patriot act. Oxymoronic, Orwellian doublespeak.
My impression is that Obama
My impression is that Obama abhors the idea using his bully pulpit to pressure the Congress. He is from Chicago, you know, the capital city of insider deals.
Why was health care reform
Why was health care reform in its current form a hard sell.
1. The debate got centered around a "public option". Everyone transltates "public" into "government run".
2. You can argue until you are blue in the face that "French health care is like this", "Canadian health care is like that" and spout outcomes, mortality tables, and statistics about number of unnecessary deaths until the cows come home. These do not account for a hill of beans because most people have never lived or toured France or Europe, and those that have had a major illness ( and are still voting ) probably had an OK health care experience. People by now are used to statistics lying. Claims built upon national statistics of infant mortality don't mean anything.
3. But people do have a great volume of experience with "government run". Namely the post office, and the DMV. Get these places to run well, and you can turn the numbers on health care. If they keep running like they currently do --- ( I don't mean the total mail delivery per dollar, or the number of total licenses processed, I mean the lazy workers who don't care a bit about customer service and take their break on the dot at 10 AM even if there are 90 people currently in line. ) --- you may be able to turn the corner on "public" health care. Until then, it isn't about selling anything about health, its about selling government run business.
Selling reform to the public...
Why should we do it? If it works we all save a LOT of money and you'll get better treatment by your insurance company!
Who's going to pay for it? Some health care insurers and a very few rich people.
Tell me again, what does it do?
It fills the Medicare donut, so you won't lose insurance coverage at any time on your prescription drugs. That will save a lot of retired people a lot of money!
It requires employers with 500 or more employees to insure them or pay a fine. That means a lot more people will get to have cheaper group-rate insurance.
It requires everybody to be insured so fewer people will need expensive ER treatment instead of regular family physician care and it expands Medicaid to assist people to buy their insurance.
It creates an 'exchange' which brings insurance plans together, so you can choose more easily. The competition that creates should lower or restrain costs to everyone.
It creates a 'public option' insurance plan which is NOT run for profit, won't advertise and will be available to anyone who can't get private coverage. It will be run like any other insurance plan with no government direction or government money. It will pay for itself. It also provides competition to the private insurers which ought to "keep them honest".
The reform also requires medical treatment options to be studied, so we can discover what works best. That might help reduce overly expensive or needless treatments to save costs.
For people buying (or with) private insurance it requires insurers to ignore any pre-existing conditions you might have. That prevents them from refusing to insure you and from dumping you because of pre-existing conditions.
It's a good thing!
Paul Krugman of Friday
Paul Krugman of Friday illustrated the American public's ignorance of how the health care system now works:
Yes, Obama needs to address the nation on the subject and spell it out because people don't get it: Medicare is a government program, and what we want is to make all health care work like it. Plain and simple. Then let the conservatives play defense for a change.
health care sales
good post. The stewart clip of Obama's response to some poor elderly lady who had heard the crap about the govt getting ready to send out people to ask how we want to die ---- I know it was probably too stunning, but clear, direct, NO WE ARE NOT NEVER GOING TO DO THAT, followed by attack dogs - Joe Biden, Howard Dean, I don't care, to keep up the message, and to keep it SIMPLE. THIS IS WHAT THE PLAN WILL DO: THIS IS HOW THE R"S are Lying; etc.
Obama creates objections, rather than overcoming them
I agree with the author that most of this has to do with Obama's incredibly poor sales ability. He started off the discussion by stating that he was getting rid of Medicare Advantage. As a disabled person under 65 in a state where Medigap insurers are not required to sell me a Medigap policy, Medicare advantage was the only way I could close some of the bankrupting holes in Medicare. So after Obama threatened my only lifeline, he failed to tell me how he would replace the safeguards he's ditching.
Next, he sets up his payment scheme on doctors, one which is almost EXACTLY like what the HMO's tried to cram down are throats. It incentivises a doctor to test less, even if the tests are necessary, because that will increase the doctor's pay. After discovering through an MRI that my excrutiating stomach pain came from stenosis in my back, Obama's payment scheme gives me chills. Sure I had received previous tests of the area, but this was the first test in a CHANGING situation that showed me what was going on. After essentially saying doing less can lead to higher pay for a doctor, I probably would never have discovered the stenosis that caused the pain.
Then there was the reliance on the "end of life counselors." These are not sweet counselors who give you a choice. Instead, as Obama portrayed them, they're bureaucrats who will tell you when and how you have to die. You see, the sooner you die, the less you will cost.
Probably NONE of the above three things are as ominous as Obama made them sound, but he did NOTHING TO COUNTER THAT APPEARANCE. It was a horrible mistake on Obama's part. He actually created objections to his plan, then did nothing to neutralize them. The trick of sales is overcoming objections, not creating them.
I believe we will get what I have always wanted, universal quality healthcare - maybe not everything we want, but 90% of it. It would probably be usefull at this point to have Kathleen Sebellius do more talking to the press, and for Obama to do less talking. I think America is a little sick of him hogging the spotlight on healthcare and diiplomacy. I'm know I, a left wing liberal, am sick of listening to him and by the end of his term he will probably have hogged the spotlight so much that most of the nation will be sick of listeing to him also.