Saturday, August 22, 2009

"Obama's healthcare messages are backfiring, strategists say/The president's range of abstract arguments for reform are leaving people confused"


















That's the headline atop Pete Nicholas' analysis piece in the LA Times this morning. The piece is worth delving into, because it indicates so much about how the whole debate over health care, on both sides, has gone so wrong.

Let's start by taking a look at that LAT headline again:

"Obama's healthcare messages are backfiring, strategists say/The president's range of abstract arguments for reform are leaving people confused, some Democrats contend."

Note the phrase highlighted above, range of abstract arguments. No kidding! This point became blindingly obvious on August 8, when the Washington Post's Michael D. Shear noted that President Obama had shifted his rhetorical focus from "health-insurance reform," rather than "health-care reform." In other words, Obama went from an abstraction, "health-care reform," to an even greater abstraction, "health-insurance reform."

Which is not to say that health-insurance reform" is not a legitimate issue. But it's just not that engaging to people. When most people thinking about "health," we think, first, of life and death. We think of health and disease, and what's bothering us, and what afflicts our loved ones and friends. And then we might take time to worry about the course of, say, swine flu, or some other epidemic--from HIV to Alzheimer's to obesity--that might threaten large numbers of people. Those are the sorts of health issues that affect us where we live.

The LAT story notes the multiple explanations that Obama has put forward:

For example, Obama has argued that a new healthcare system is necessary to spur an economic recovery. He also has offered up healthcare as an antidote to rising deficits. Earlier this week in a conference call with religious leaders, Obama laid out a "moral" imperative for revamping the nation's healthcare system.

At other points, Obama has portrayed "meddling" insurers as a reason for scrapping the existing system.

"One of the difficulties has been that the explanation has changed," said Howard Paster, a legislative liaison in the Clinton administration. "Originally it was keyed very much to the economy. More recently, emphasis has been placed on issues of fairness and equity. We need to have a consistent set of reasons for doing this."


Note what's missing from this litany: Any sense that the purpose of medicine is cures. The mechanisms of health care delivery are of interest to some, but the question of health cure delivery is of interest to everyone.

The LAT observes that the Republicans, in the opposition, have it easier:

Conservative opponents of the overhaul increasingly use a simple, understandable message: Government-forced cost reductions will restrict treatments, imperiling the ill and elderly.

Note that the conservatives/Republicans aren't really talking talking about cures, either. Or course, at this white-hot political moment, the right might think that it is sufficient, and necessary, to simply beat back Obamacare. And so only down the road somewhere will we find out if the Republicans are really interested in cures, aka Serious Medicine, or if they are simply interested in blocking Obama. If the Republicans make that mistake--if they simply mirror the lefty-nerdy abstractions of the Democrats with righty-nerdy abstractions of their own--they will pay a huge political price, too. So the GOP doesn't have to worry about any of that for now, because Republicans are not in power.

But in the meantime, Obama, who does have power, seems determined to push his own bloodless version of "reform." On Friday, the White House issued a statement, following a meeting with Tom Daschle, affirming the President's determination to press ahead with "health insurance reform." The entire statement appears below:

The President invited Senator Daschle to the White House for a quick check-in on the health insurance reform process and to exchange views on the process moving forward. Senator Daschle is one of the foremost experts on health care and on the legislative process, and has been a friend and sounding-board for the President for several years. The two agreed that substantive reform that lowers costs, reforms the insurance industry, and expands coverage is too important to wait another year or another administration, and they agreed to stay in touch over the coming weeks and months as this critical effort moves forward.

Note the words that are used: "health insurance reform process," "legislative process," etc. So while it might seem obvious that Obama needs to do something different, it looks like he came away from his session with Daschle with a renewed determination to do... more of the same. What's that cliched definition of insanity--doing the same thing, over and over again, despite failure that should be obvious?

And we might further note the words not used: "medicine," "research," "cures." Aren't those the kind of words that move the needle of ordinary Americans?

As Lloyd Green observed here at SMS, the American people are coming to think that what the Democrats have in mind is not so much a health program, as it is an income transfer program. The American people want the expansion of health, not the redistribution of health.

To borrow a phrase from Bill Clinton's 1992 presidential campaign, "It's the health, stupid!"