Friday, August 21, 2009

Health Care on Life Support

As progressives have watched in horror and disbelief—can it be possible that the same right-wing fools who gave us Bush/Cheney, the war in Iraq, and its related bag of lies, fraud, raiding of the public treasury and outright criminality, have regained the initiative?—the alleged movement for health care reform has been chopped to pieces and is now threatening to collapse altogether into some fraud tailored to the specifications of big Pharma and big Healthcare. Sarah Palin has accused the new Democratic proposals of providing “death panels” to threaten the life of her Down’s syndrome child (has there ever been so shameless a public figure, willing to use her handicapped child to score political points?), while health care companies like United Health have urged their employees to mob the Democrats’ vaunted town hall meetings and shout them down with their slogans. To top it off, several of these yahoos have shown up at town meetings packing guns—one yo-yo at a recent Obama event with an assault rifle slung over his shoulder was featured in every newscast.

The coup de grace came this week, with both Obama himself and Health and Human Services Secretary Kathleen Sebelius saying that the “public option” wasn’t really essential to health care reform, and that co-ops could be a way to go. This was mightily pleasing to both Republicans and that “key” senator from the crucial state of North Dakota, Kent Conrad, who characterized co-ops as a workable compromise that could pass the Senate.

In the midst of the sinking feeling that whatever does emerge as health care reform will be so gutted as to be meaningless (or worse: it turns out that Obama has already made a deal with big Pharma that his health care plan won’t, repeat WILL NOT use the government’s bargaining power to get lower prices for drugs!), two recent proposals seem worth considering. One was posted by Thom Hartmann on Common Dreams August 17. In the form of a letter, it suggested to the president that a simple solution would be: let all who choose to buy into Medicare. No new program to invent. No nonsense about forcing people into something they don’t like. Simply amend Medicare so that

“any American citizen can buy into the Medicare program at a rate to be set by the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS), which reflects the actual cost for us to buy into it….To make it available to people of low income, raise the rates slightly for all currently non-eligible people under 65, to cover the cost of below-200%-of-poverty people. Revenue neutral.”

Seems like a plan to me. Nearly everyone who has Medicare seems to be quite satisfied with it (even the morons who have been ranting at town-hall meetings that they’re dead set against government-controlled health care, most of whom actually have Medicare!). Hartmann’s point is, why limit it to just people over 65? Let everyone buy in, pay for their own coverage until they reach 65, and thus cover everyone who’s dissatisfied with the Health-Care pirates.

The other is a brilliant piece by renowned linguist and activist George Lakoff, who analyzed what’s wrong with the Obama approach so far. In a piece titled “The PolicySpeak Disaster for Health Care,” (, 8/20/09), Lakoff points out what he’s been trying to drum into Democrats for years, the importance of “framing.” The Republicans, by imitating marketing techniques, have long since mastered this stuff. The Democrats seem to think it’s manipulating the public and try, instead, to employ Policy Speak to appeal to the public’s reason. According to Lakoff, this is based in 17th century views that “if you just tell people the policy facts, they will reason to the right conclusion and support the policy.” In other words, rational discussion and logic will persuade people of the rightness of liberal democratic principles. WRONG. As Lakoff points out, even though 80% of the public wants a public plan, calling it the “public option” is a disaster. As cognitive neuroscientists have discovered—and marketers and Republicans, unlike Democrats, have taken into account—you have to appeal to people as they really think, in a way that resonates with them, and inspires them to act. Emotions are a big part of this, and emotions as well as the moral sense must be appealed to (Republicans appeal to emotions in the most calculating, irrational, and truly nefarious ways: “death tax,” “death panels,” “socialized medicine,” even Obama with a Hitler mustache—at the same time he’s accused of being a Commie).

Accordingly, Lakoff suggests a simple narrative, using a simple patriotic title: The American Plan. It would tell the truth, but tell it simply, without fear of appealing to morality:

“Insurance company plans have failed to care for our people. They profit from denying care. Americans care about one another. An American plan is both the moral and practical alternative to provide care for our people.
“The insurance companies are doing their worst, spreading lies in an attempt to maintain their profits and keep Americans from getting the care they so desperately need. You, our citizens, must be the heroes. Stand up, and speak up, for an American plan.”

Lakoff also recommends using other simple, but emotional/moral language and slogans instead of boring “policy speak”: Doctor-patient care; Coverage is not Care; Insurance Company profit-based plans ration care; Doctors care, insurance companies don’t; and so on.

Lakoff also punctures the simple-minded Democrat attempt to avoid the dreaded accusation, “culture wars.” As he notes, the culture war is already on and can’t be ignored. Call the villains and liars out, in public. The president has the biggest bully pulpit in the land. He has to start using it, instead of continuing to make a vain attempt to achieve some longed-for spirit of bipartisanship. He needs to demonstrate some passion, if for no other reason than to counter the evil passions being stirred up by his opponents, and that includes so-called moderates like Senator Chuck Grassley. Grassley displayed no reluctance at all to suggest, on the Newshour recently, that Obama’s plan was a government takeover of all health care and equivalent to socialism. There’s no way to make nice or use logic with such people. Use the power of the presidency, and the power of the Democratic majority, letting the Republicans know that if they wish to come along, fine, but if not, they will be accused of placing their corporate constituents ahead of the majority’s welfare.

I would also add that it’s time the administration started to play hardball with the so-called Blue Dog Democrats. Why should these refugees from conservative districts, along with a few white-bread legislators from small-population states like Montana and North Dakota shape and control the most important legislation of our time? Every Democrat should know that a “public option” (finding another name for it) is critical, that it must be included in any bill that the president will sign, and that failure to support it will be dealt with by means of all the patronage tactics available to the party’s leadership.

Short of these course corrections—and it’s not too late, though the fight now, if Obama has the political and moral courage to engage it, will be long and dirty—the signature initiative of the Obama presidency will go down in flames. With it will go the hopes that the United States might be saved from the military/corporate/privatizing corruption that has engulfed it these last thirty years.

Lawrence DiStasi

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