Why Obama Is Screwing the Pooch On the Health Care Pitch

The national health care system is a myriad of give-and-takes and unintended consequences, and since I am not quite knowledgeable enough about it to comment on specific policy proposals, I figured I’m better off addressing why the Obama Administration seems to be failing in an area where they previously had experienced such success: sales. Despite the fervor and interest surrounding the issue, Obama has not convinced the American people that whatever phone-book thick proposal is being put through Congress is going to be a major step-forward. Polling magician Nate Silver takes on the sales pitch problem by grading the administration on a 5-point promotional plan put forth by Democratic pollsters/consultants James Carville and Stan Greenberg. Here are the points with my thoughts:

1. Voters need to hear clearly what changes health care reform will bring.

The public explanation has been seriously  lacking in details. How many people who hear the President explain the health care program can answer 1) How will this improve my care? or 2) If this won’t necessarily improve my care, how will it contribute to the nation’s fiscal health and/or significantly improve the care of a majority of the nation’s individuals? Instead, they just hear about how the plan will raise the deficit.

2. Build a narrative around taking power away from the insurance companies and giving it to people.

Say what you want about a populist narrative, but it’s got traction right now. His opponents mis-fire when instead of proposing better reforms, they rant about how the system shouldn’t be screwed with and any attempt to do so will take us on a straight path to Stalinist Russia. Well the American public certainly doesn’t think the current health care system is the bees’ knees and their grievances are for the most part aimed at insurance companies. And deservedly so. You don’t have to turn into Huey Long, nor stretch the truth. Simply highlight the fact that reform will break the strangehold of the insurance companies. Not too hard.

3. The president and reform advocates have to explain concretely the changes that will mean lower costs.

Here’s where they are really blowing it. Marginal cost is not the same as total cost. Of course the total costs of providing the nation with healthcare will rise if you start covering 50 million new people. But the goal is to reduce the marginal cost, meaning the cost of the next single person getting health coverage. The idea being that while total costs will rise in the short term (due to a wider coverage base), the marginal costs will decrease (as a result of efficiencies, competition, taking on the insurers, etc.), and will eventually lead to a reduction in total costs. Not to toot my own horn, but I think I just explained this fairly clearly. I don’t see why the President cannot.

Numbers 4) and 5) are pretty self-evident: 4) Show all voters that there are benefits for them, including prescription drugs, and 5) All of these points should be made with the dominant framework that continuing the status quo is unacceptable and unsustainable. As Silver points out, #5 (in addition to being scarily true) is probably the only one the Democrats are doing effectively. However, it just might not be enough.