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"The American Plan"
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.
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
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 isThe American Planitfits 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 choosethe American Plana different one. Itis fair in that itallows 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 noHMObureaucracy 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 backthe primary care doctors, payingthem what they are worth, and lettingthem 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.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).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.
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
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I'm hoping my link to it in my post below yours will replay. The folks at HealthcareNOW! assured me it would play over and over again. The thing to warn you about, though, is it doesn't start right away -- there's a lot of talking and stuff going on for a good half hour before the actual meeting starts. Feel free to try to move up 41 minutes into it, if you can. Otherwise, you look at nothing but plastic butts that LeftyLoosey and others decided look like cajones. ;)
Your wording here is very effective. Us liberals have to remember to keep it all "very patriotic, American, America, blah blah". When we go too left they label us as Socialists. When we go patriotic, like they do, well...they can't argue with that.
Good point, good blog. Rec'd.
July 25, 2009 5:37 PM | Reply | Permalink
Thanks, Lis, for the heads up about the 41 minutes!
July 25, 2009 6:30 PM | Reply | Permalink
I love it, Steele and other Republicans argue against gov't intervention in our private lives (healthcare reform), using Terri Schiavo, a case where they argued for gov't intervention in peoples private lives.
July 25, 2009 6:01 PM | Reply | Permalink
They're on really dangerous ground if any of our spokespeople are awake and articulate enough to point that out. I might suffer through the Sunday A.M. talking heads to see if it comes up.
July 25, 2009 6:34 PM | Reply | Permalink
Here's a link to what Rahm said;
http://thinkprogress.org/2009/07/24/rahm-emanuel-inhofe/
July 25, 2009 6:05 PM | Reply | Permalink
Inhofe, and that guy that Obama already criticized, are proving aloud what all of us already knew. They just want to be the naysayers and obstructionists for political gain a few years down the line. No matter Rahm loves their honesty.
Will the citizens?
Time will tell.
July 25, 2009 6:31 PM | Reply | Permalink
Oy....I meant no wonder, not no matter.
Oh well.
July 25, 2009 6:36 PM | Reply | Permalink
what ever
July 25, 2009 6:50 PM | Reply | Permalink
July 25, 2009 6:49 PM | Reply | Permalink
Thanks for the link, jonnie. This is what stood out:
They're hanging many of their own out to dry. Rahm's genius in the way he handled this made me giddy. Complimenting them for their honesty in screwing the American people. I love it.
July 25, 2009 6:42 PM | Reply | Permalink
My right-leaning Independent sister has a big problem with congress critters who basically are in it to obstruct and damn the other side of the aisle.
Seems to me, what with moves like Al Franken just made within his first month (weeks?) of office, turning to a Republican to help draft a bill that will help veterans, and then looking at people like Inhofe, well.....seems to me, more Republicans are obstructionists than not.
July 25, 2009 6:55 PM | Reply | Permalink
They're obstructionists concerning anything that has to do with social programs that take care of people. Looking out for others is not one of their values. Looking out for their own self-interest is.
July 25, 2009 7:09 PM | Reply | Permalink
I think it's an very interesting angle, how to package policy ideas and frame political situations to one's own advantage.
I also agree that Rahm has tried to reframe the argument by taking the words of the republicans and using them to cast doubt on their motives.
The only couple of issues I have with Lakoff's theory is that to openly follow it leads one to moral relativism.
The theory implies that you can sell anything, as long as you choose the right words. It also implies that people are incredibly stupid and given the right fodder will follow you like cattle.
I think the American people have been exposed to political verbiage and slogans for such a long time, they can only be taken for a right so far.
The reason healthcare is tanking is not because republicans are doing such a great job discrediting it. It's because it's an unproven experiment, with an ever-changing definition and astronomical price tag, against the backdrop of Democratic in-fighting, which in turn is the child of the 50-state strategy.
It also assumes that the vast majority of people are in crisis over their health care, which is clearly not the case.
July 25, 2009 10:40 PM | Reply | Permalink
Lalo, thanks for the phrase, moral relativism. It seems your explanation quite aptly sums up the conservative message strategy as well as those who buy it.
I don't think progressives have to take it to the extent conservatives have. After all, progressive want to help people, conservatives have been making the case not to. It seems the latter would be a much tougher sell.
My main point is the administration and Democrats in Congress as well as anyone speaking for progressive health care reform have to start using the same language consistently when addressing the public, or anyone, until the job is done. It doesn't seem they have agreed on anything yet, though Rahm is off to a stellar start. They had better get busy.
The reason health care reform is apparently being met with skepticism, even among Democrats (media notwithstanding), could be that there is no existing frame with which to interpret this new concept.
You said:
Good points. Who, but the most intrepid supporters would be comfortable with that?
The type of health care under discussion is a foreign notion. At this point there should be official messengers everywhere framing this issue. It doesn't need specifics -- just the big idea. According to Lakoff:
I appreciate your comments. They make me think. Thanks, Lalo.
July 25, 2009 11:38 PM | Reply | Permalink
A very astute observation. . .
From you, ohnocindymaxparsingthru...
I couldn't agree more.
The right has the whole legislative branch on the same page. But the left has no such plan.
In addition, it does become quite an uphill battle when some, even within the community here at the Cafe come up with such gems as the following:
Take this individual's statement that the health reform is some wild ass scheme to...
Or take this other individual's totally unfounded and unsupported out-of-left-field off-the-wall remark about me being paid for pushing an agenda of my...
And in conclusion, the following is from my TPM Cafe post on May 6, 2009:
As you are already aware, but I post this for others who may not have seen it, this is how the Republicans have framed this issue:
With the Republicans -- it's as easy as herding sheep.
With Democrats -- it's more like herding cats.
~OGD~
July 26, 2009 3:12 PM | Reply | Permalink
Oh and here . . .
This is the May 6, 2009 Cafe blog post...
The "Party of No..." Frames Their Attack on the Health Reform Effort
And gee willikers ... I may be accused next of doing the work for Frank Luntz ... (rolling eyes)
~OGD~
July 26, 2009 3:19 PM | Reply | Permalink
So true, OGD.
I'm glad someone else agrees that it's important for the administration to speak in one voice with respect to The American (Health?) Plan. Not to belabor the issue, but it needs a name other than "ObamaCare" or the Obama Health Plan.
Giving it a name would increase its credibility with the public -- make it a household word or phrase. Being associated with Obama can be perceived as a negative by some. It needs to be inclusive. The American Plan evokes patriotism and pride, and has an enduring feel to it. It would be very hard to be openly against it. How to go about getting it adopted? Or if someone has a better idea, any other name adopted?
I saw David Axelrod and Rep. Jim Cooper (D) TN on Face the Nation this morning. Guess who was more persuasive and reassuring that the legislation would be completed and passed by the end of the year? Jim Cooper. Axelrod just spouted facts and figures. Cooper was engaged in the discussion and therefore more convincing.
The lack of a message strategy on insurance reform may be a symptom of the administration addressing too many gargantuan issues at once.
Why not we do it for them? Drafts can be posted as a blog and subjected to review by TPM readers. During the review process, readers would gain exposure to the message and buzz words for use in communications with others. (I'm not worried that there are many different, passionate views on the subject around here. It's a discussion forum, after all.)
Granted, there has to be a quick turnaround. It would be a major feat if the TPM people who are going to Washington could each take with them a message strategy to hand to their lawmakers (read: staffers).
First, the talking points and buzz words have to be identified. Second, rebuttals to Luntz's message strategy have to be crafted. It could be distilled down to two pages.
OGD, you were ahead of everyone on this. What are your thoughts?
Any other takers?
CM
July 26, 2009 4:24 PM | Reply | Permalink
Nicely Nicely done. http://www.straightdope.com/columns/read/260/whats-a-petard-as-in-hoist-by-his-own
July 26, 2009 10:16 PM | Reply | Permalink
Very good Lalo, your presentation is of thoughts and opinions not assertions without fact. Because of this, I can agree these ARE problems facing any legislative effort on this issue.
WELL DONE!
July 26, 2009 8:48 AM | Reply | Permalink
Lalo made an important point above. Many Americans are dissatisfied with their health insurance, or lack of it, but an even greater number are reasonably satisifed, and worried that any change will make things worse for them.
It is factually accurate that failure to reform the system will sooner or later harm almost everyone, as costs escalate to consume more and more of the money employers have available for their employees. Warning those who are currently content about future dangers is a hard sell, however, particularly for individuals. Obama, therefore, is currently focused on conveying that message to the small business community, which is likely to take a more future-oriented view than individuals, particularly since so many small businesses are already feeling the squeeze.
July 26, 2009 12:27 AM | Reply | Permalink
Taken together, all the more need for a unified message. Knowing what the obstacles are, or at least the most glaring ones, should make arriving at that message easier.
July 26, 2009 6:38 AM | Reply | Permalink
Lalo illuminates powerful impediments to U.S.health care reform. Other impediments include the propaganda-meisters who will do anything, say anything, and buy off anybody and everybody in Congress to prevent reform; those who's health is generally good and haven't experienced the failures of the market based/profit driven mess that we now have (it works for me, why take a chance on change); those who are clueless about health care systems costing significantly less and working well in the rest of the industrialized world (view Frontlines's PBS review of five countries who have various forms of successful universal health care programs whose populations say they wouldn't have it any other way, and in particular the way we do it in the U.S.; and most certainly those whose standard of living has yet to be diminished or have not been led to bankruptcy by the escalating cost of their health care . Add these to Lalo's specifics, and meaningful, constructive reform becomes even more difficult. While given these obstacles to reform, we also have the united Republican Party of "no" marching in opposition lockstep like jack-booted Nazis while the fractious, quarrelsome Democrats eat each other for lunch. This blog outlines a clear path to HC Reform, but maybe another reform needs to take place fast in the Democratic Party.
July 26, 2009 1:16 AM | Reply | Permalink
Any response must be concise and specific and include a compelling factor in support of reform, one that's targeted for incessant replay. Of course all this requires thinking and considerable political will. Do Democrats have what it takes to do this?
Thanks, sigma, for the Frontline reference. Watching that gave me a much broader understanding of the issue. I wonder if the framers of our health care reform legislation have looked at systems in other countries to see what worked like Taiwan did. Here's the link again if anyone missed it:
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
July 26, 2009 7:05 AM | Reply | Permalink
I need to retract my earlier thought about reforming the Democratic party. I should have said reform Congress. I read a Washington Post article carried in our local newspaper this morning about the health care industry's payoffs to congressmen having great influence over health care reform. I apologize for crudeness, but the first word that came to mind in reading this was "whores." In 2007 and 2008, $170 million was given to federal lawmakers by the health care industry, including Max Baucus, maybe especially Max Baucus, chairman of the Senate Finance Committee. The article is titled "Cash flows to senator at center of debate."
One of those donors was Blue Cross/Blue Shield. That reminded me that BC/BS has a Medicare Advantage plan that is subsidized by the federal government to the tune of a 20% bonus for every Medicare insured they suck into their own private plan for seniors. This Medicare eviscerating program was the brain-child of the Bush Administration and its Republican controlled Congress. Oops! Whores again come to mind. (I know, I need to wash out my political mind with a strong dose of soap.) BC/BS is also working the other side of the street. Medicare has outsourced its own government plan claims processing to a private sector company owned by Blue Cross/ Blue Shield. So if we are not careful, we'll get change disguised as reform. We do have protection though. I would opine that we have a statesman as president who will and does put the public interest before special interest. And I believe he will veto any scam cooked up to look like reform but isn't. And I hope I'm right about that.
Cindy Max, as for your advocating "The American Plan", that label has persuasive advantages. For those who are Republican nationalists, how can they argue against it? Wouldn't that make them "un-American?" That's great positioning strategy by the way. And I would guess that for those who aren't nationalists but who are proud Americans, most of us, that label makes a strong promise of good things to come. I cast a vote for "The American Plan."
July 26, 2009 10:45 AM | Reply | Permalink
Since "progressives" do not agree on anything and since Democrats count numerous actual Republicans under the guise of "Blue Dogs" or DLC supporters, or "centrists" it is impossible to do effective messaging on our side. It will remain so as long as the Democratic Party continues to accept these assholes.
July 26, 2009 2:11 PM | Reply | Permalink
oleeb, I cannot disagree more.
Progressives share the same core values including an appreciation for community. Their priorities, however, often differ.
Progressives, being the well-informed people they are (sometimes intimidatingly so!) may sometimes assume the mantle of "being correct." That said, I'm certain they know there can be many "correct" solutions to a problem. The challenge is to codify all those "correct" solutions into one powerful message. Yes. It can be done.
July 26, 2009 4:44 PM | Reply | Permalink
A manned space flight to Mars "can be done" also, but that doesn't make it something we're going to see anytime soon. Getting the intellectual lefties who are the progressives to agree on anything and to head off in the same direction is like herding cats. Sure it can be done, but it is rarely done because of the nature of who the progressives are and what prima donnas so many of them/us are. Everything is always splintered in any progressive initiative because of this including and perhaps mostly message. It is only when in opposition to some heinous act of the Republicans that Progressives manage to agree long enough to coordinate their message. If you don't think this is right, take a look at the past 30 years and think again. Nothing has changed.
July 27, 2009 2:54 AM | Reply | Permalink
Cindy Max,
Count me in on the buzz words, talking points, and rebuttals.
July 26, 2009 5:08 PM | Reply | Permalink
Thank you to everyone who commented on this blog. Messaging is important, especially now. Words really do mean a lot.
Hopefully I can post a draft strategy within the next day or two. Better yet, maybe some of you will beat me to it!
July 26, 2009 5:15 PM | Reply | Permalink