Today, Michael Steele resurrected Terri Schiavo to kill health care reform. It's an emotional appeal that cannot be countered effectively with factual data. This is a classic example of insidious, but effective, conservative message strategy.

As I've mentioned in comments here and there, I'm reading George Lakoff's Don't Think Like an Elephant. He wrote it in 1994. While reading it today, I remembered he and some colleagues had a post concerning health care reform on The Huffington Post a while back. I skipped over it then, but after getting into his book, I wanted to see how he would frame the health care issue now.

With respect to framing, it seems progressives are all over the lot. There must be a unified message. In their post, George Lakoff, Glenn W. Smith, and Eric Haas, provide an excellent template.

The thing that jumped right out in their post was the label The American Plan. To me, it's sheer genius from a framing perspective. It invokes patriotism which encompasses everyone's version of American values no matter how diverse. Even in it's developmental stages, it seems the health care reform plan, outlined by President Obama and underway in Congress, would be much more widely accepted if it were consistently referred to as The American Plan.

Here are some excerpts from Lakoff et al. I left out the first three points. Then I took the liberty of honing the remaining messages with strikeouts and made suggested revisions in italics. For making the case for health care reform, the revisions would perhaps appeal to an even broader audience (except perhaps insurance and pharmaceutical execs, right wing ideologues, and some Florida surgeons). I know the revisions almost seem laughable, but if you understand the mentality of those we're up against, perhaps you'll understand why I made them.

Principle 4. The President's plan is The American Plan it fits our principles and serves our people. It represents patriotism at its finest.

The American Plan allows you the freedom to keep your current health plan or choose the American Plan a different one. It is fair in that it allows everyone to afford excellent care. And it allows us to demonstrate in the most visceral way that Americans care about and for their fellow citizens. The last sentence would appeal to progressives and liberals, but likely not people who look only to their own self-interest. They also don't place much stock in fairness.

Principle 5. The American Plan is a doctor-patient plan. You and your doctor determine your treatment. There is no HMO bureaucracy standing between you and the care you get.

Principle 6. The American Plan relieves oppressive HMO government. Right now HMO's govern your life. Unaccountable HMO bureaucrats decide what treatments you can be "authorized" for and they function to say No to care whenever they can justify it. They make you wait too long, and limit your choice of doctors, clinics, and hospitals. HMO's are oppressive forms of government. The American Plan diminishes bureaucrats' control over your life. Your American government could act only as a bursar, paying your bills and making sure there is no fraud. Your treatment is up to you and your doctor.

Principle 7. The American Plan provides care instead of denying it.  Why do HMO's have a high administrative cost - 15 to 20 percent or more? They spend money to justify denying you the care you need and all too often delaying care so much that you are harmed by the delay. The American Plan is there to provide you care, not deny or delay it. Its administrative costs would be low, about 3 percent. It would save money.

Principle 8. The American Plan costs less and does more. HMO's are big spenders, not on your health, but on administrative costs, commercials to tout their plans, and profits to investors. As much as 20 to 30% of what you pay does not go to your care. In The American Plan, 97% of what you pay goes for your care. It's a better deal for you and for our country. There's good information in the strike-out passage, but the danger is too much information can bounce off.

Principle 9. The American Plan helps primary care doctors. HMO's put the squeeze on primary care doctors and have created assembly line medicine. HMO's require doctors to take too many patients per hour, more than they can effectively treat. And they pay doctors as little as possible per patient, so that the HMO's make greater profits, while your doctor loses out -- and you may lose your doctor. As a result, Many thousands of primary care doctors have left their profession. The American Plan will bring them back the primary care doctors, paying them what they are worth, and letting them practice medicine rather than deal with mountains of paperwork.instead working on an assembly line.

Principle 10. The American Plan will make prescription drugs cheaper. Why? Because they can be purchased in greater volume and at a discount. No longer will Americans have to go to Canada to buy their meds, or order them from other countries. No longer will the cost of medicine threaten to bankrupt older Americans on a fixed income.

This is just a start. I don't have cable so don't hear the talking heads. It seems, though, from watching Lehrer and Moyers that there isn't yet a unified, consistent message in support of health care reform. It would behoove us to come up with one -- now. I think Rahm was on to something powerful yesterday (I can't find it now), in the way of a larger theme, when he talked about appreciating the Republicans' honesty for not wanting health care reform of any kind (I'm paraphrasing--badly).

Hopefully, someone with the right influence will broadcast a concise set of buzz words and talking points about health care reform soon that will become mantra. Learning occurs through repetition. Meanwhile, we're getting clobbered with the specter of Terri Schiavo -- again.

Note: I went to the HealthCare Now teach-in today, but couldn't get in. Maybe they presented something persuasive on this very subject.

CM

Thank you to everyone who offered suggestions as to what to include in my letter to the St. Petersburg Times rebutting Rep. Adam Putnam's July 20 opinion piece. What made it really easy in the end was Obama's interview with Jim Lehrer last night. I made notes and matched Obama's talking points with Putnam's assertions and pointed out some omissions as well.

As Obama pointed out yesterday, every false or misleading statement has to be refuted. There likely will be many opportunities for TPM readers to write letters of their own to set the record straight in the coming weeks. I offer my letter up for constructive criticism in the hopes it might give other people ideas for writing letters of their own. Exposing the weaknesses of mine, and I'm sure there are many, might help other letter writers do better.

One thing I'm keenly interested in is message strategy. I'm off from work for a few weeks and meet my dad every morning to walk our dogs in the park. He's a retired marketing professor, and before that was an advertising executive and message strategist. He mentioned this morning a strategy memo by Frank Luntz that's been leaked. I can't wait to root through this, but in reading the review at the Wonkroom (some of which I disagree with), it's likely a must read for anyone who might end up debating opponents of progressive health care reform.

I'm reminded of the swordsman Miyamoto Musashi's A Book of Five Rings the Classic Guide to Strategy. In it he says, 

Knowing the times means, if your ability is high, seeing right into things. If you are thoroughly conversant with strategy, you will recognise the enemy's intentions and thus have many opportunities to win. You must sufficiently study this.

I can think of no better place to start than Luntz's memo.

Here is my letter, such as it is. Whether it gets published or not remains to be seen -- it's long. Nonetheless, it was a good exercise.

Rep. Adam Putnam stated in his opinion piece on July 20 that decisions about one's choice of physician and the kind of care and treatment one receives would be influenced by a "new bureaucracy" under the proposed health care reform legislation.

President Obama has clearly stated, and said so again Monday, that people would not have to give up health plans or doctors they already have if they want to keep them.

Mr. Putnam did not mention that people with insurance, particularly those with individual policies (as opposed to large group policies), contend with a bean counter bureaucracy rationing their health care right now. When claims, procedures, or treatments are denied, that's rationing. By denying claims or canceling policies using "gotcha" techniques which often involve fine print or confusing questionnaires, insurers save money and increase their bottom line. This makes shareholders happy. Meanwhile, the people denied benefits often get sicker without treatment or go deep in debt to get the treatment they need. Bankruptcies caused by illness have reached unprecedented levels.

Mr. Putnam dismisses people between the ages of 18 and 24 who do not have health insurance "because they tend to be healthy." However, when they do get sick or have an accident, they often end up in the emergency room for treatment. The costs for that treatment, and treatment for other uninsured patients who pass through that emergency room, are passed on to people who do have insurance in the form of higher premiums. According to a study commissioned by Families USA, approximately $1,000 of the annual premium for a family of four goes toward paying for the uninsured.

Mr. Putnam says to "hold on to your wallet." The new health care system would "require wholesale tax increases to fund it." President Obama on Monday said that rather than raising taxes on the highest income earners, he would prefer to see a cap on deductions instead. Small businesses would not see an increase in their taxes to pay for health care.

Mr. Putnam does not mention that employers are increasingly hard-pressed to maintain the levels of coverage to which their employees are accustomed. Because of skyrocketing health care costs, many employers periodically weigh the costs of plans offered by different companies. Employers can and do change insureres to save money and their employees can do nothing about it. They are stuck with whatever the new company offers.

The proposals under discussion in Congress will allow people to keep the same plan, doctor, and hospital, if they choose to, even when they change or lose their jobs. If they want to make a change, however, they are free to do that, and they won't be denied access to coverage if they have a pre-existing condition.

As President Obama said Monday, the American Medical Association, the nation's nurses, hospitals, AARP, and even WalMart are now supporting health care reform legislation underway in Congress. Health insurers, understandably, are still balking. Changing how they do business and reigning in excesses will affect their bottom line. But isn't making health care a right, not a privilege worth it?

Well, there it is. If you see fit, pick away!

My morning paper, The St. Petersburg Times, had an opinion piece concerning health care reform by U.S. Rep. Adam Putnam (R), Washington office #202-225-1252.

Here is an excerpt:

Your choice of physicians and the kind of care and treatment you receive are some of the most personal decisions you can ever make. The prospect of having those decisions influenced by a new bureaucracy that would combine the efficiencies of FEMA with the compassion of the Department of Motor Vehicles ought to alarm every American. (my italics)

First, we need to commit to protecting the physician-patient relationship, and not place the federal bureaucracy between you and your doctor.

I am writing a letter to the editor to correct some of Putnam's misinformation. It has a good chance of running -- many of my letters have been published.

Although I'm working my way through Howard Dean's book, "Prescription for Real Health Care Reform" and doing my best to absorb what appear to be facts on the subject from numerous sources, if anyone has any talking points to add, they would be most welcome. Or, better yet, write your own letter! Most of you are way more pointed than I.

This is going to be a battle to the finish. The GOP, true to form, will spout misinformation to scare the less informed among us into acting against their own interests. Every false or misleading statement must be countered to win this fight. If the public is not armed with facts, this effort will not succeed.