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How To Fight Heathcare Fearmongers and Demagogues
My friend, Keith, from New Orleans, just emailed to say he attended a local "town meeting" on health care and tried to get a word in favor but was almost hounded out of the room.
Why are these meetings brimming with so much anger? Because Republican Astroturfers have joined the same old right-wing broadcast demagogues that have been spewing hate and fear for years, to create a tempest.
But why are they getting away with it? Why aren't progressives -- indeed, why aren't ordinary citizens -- taking the meetings back?
Mainly because there's still no healthcare plan. All we have are some initial markups from several congressional committees, which differ from one another in significant ways. The White House is waiting to see what emerges from the House and Senate before insisting on what it wants, maybe in conference committee.
But that's the problem: It's always easier to stir up fear and anger against something that's amorphous than to stir up enthusiasm for it.
The White House has just announced a web page designed to rebut some of the insane charges that the right is instigating. That won't be enough. The President has to be more specific about what he's for and what he's against. Without these specifics, the right can conjure up every demon in its arsenal while the middle and left can only shrug their shoulders.
The President needs to be very specific about two things in particular: (1) Who will pay? and (2) Why the public option is so important -- and why it's not a Trojan Horse to a government takeover.
(1) Admit that taxes will have to be raised and that cost-savings won't be sufficient to achieve nearly universal care. But be absolutely clear that taxes will be raised only on the very top. The President needs to decide whether he favors a surcharge on the top 2 percent, or a cap on tax-free employee benefits (which would affect only the very top), or some combination, and then announce which he prefers and why.
(2) Say unequivocally that the public option is essential for controlling costs and getting private insurers to offer people better deals, not at all a step toward a government takeover of health care.
-- Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies and other providers. (Here, he must clear up any confusion about any deal made with Big Pharma.) But this won't lead to a government takeover of health care. The whole point of cost containment is to provide the public with health care on more favorable terms. If the public plan negotiates better terms -- thereby demonstrating that drug companies and other providers can meet them -- private plans can seek similar deals.
-- It will have low administrative costs -- Medicare's administrative costs per enrollee are a small fraction of typical private insurance costs -- but that's no problem, it's a strength. One goal of health-care reform is to lower administrative costs. Competition with a public option is the only way to push private plans to trim their bureaucracies and become more efficient.
-- While it's true that the public won't have to show profits, plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality health care more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, a plus.
-- The public plan won't be subsidized by government. Subsidies go to families who need them in order to afford health care. They're free to choose the public plan, but that's only one option. They could take their subsidy and buy a private plan just as easily. The public plan may not dip into general revenues to cover its costs. It must pay for itself. And any government entity that oversees the health-insurance pool or acts as referee in setting ground rules for all plans will not favor the public plan.
Now's the time for specifics. It's impossible to fight fearmongering lies about specifics with nothing but positive principles.
Mainly because there's still no healthcare plan. All we have are some initial markups from several congressional committees, which differ from one another in significant ways. The White House's is waiting to see what emerges from the House and Senate before insisting on what it wants, maybe in conference committee.
But that's the problem: It's always easier to stir up fear and anger against something that's amorphous than to stir up enthusiasm for it.
The White House has just announced a web page designed to rebut some of the insane charges that the right is instigating. That won't be enough. The President has to be more specific about what he's for and what he's against. Without these specifics, the right can conjure up every demon in its arsenal while the middle and left can only shrug their shoulders.
The President needs to be very specific about two things in particular: (1) Who will pay? and (2) Why the public option is so important -- and why it's not a Trojan Horse to a government takeover.
(1) Admit that taxes will have to be raised and that cost-savings won't be sufficient to achieve nearly universal care. But be absolutely clear that taxes will be raised only be raised on the very top. He needs to decide whether he favors a surcharge on the top 2 percent, or a cap on tax-free employee benefits (which would affect only the very top), or some combination, and then announce which he prefers and why.
(2) Say unequivocally that the public option is essential for controlling costs and getting private insurers to offer people better deals, not at all a step toward a government takeover of health care.
-- Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies and other providers. (Here, he must clear up any confusion about any deal made with Big Pharma.) But this won't lead to a government takeover of health care. The whole point of cost containment is to provide the public with health care on more favorable terms. If the public plan negotiates better terms -- thereby demonstrating that drug companies and other providers can meet them -- private plans can seek similar deals.
-- It will have low administrative costs -- Medicare's administrative costs per enrollee are a small fraction of typical private insurance costs -- but that's no problem, it's a strength. One goal of health-care reform is to lower administrative costs. Competition with a public option is the only way to push private plans to trim their bureaucracies and become more efficient.
-- While it's true that the public won't have to show profits, plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality health care more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, a plus.
-- The public plan won't be subsidized by government. Subsidies go to families who need them in order to afford health care. They're free to choose the public plan, but that's only one option. They could take their subsidy and buy a private plan just as easily. The public plan may not dip into general revenues to cover its costs. It must pay for itself. And any government entity that oversees the health-insurance pool or acts as referee in setting ground rules for all plans will not favor the public plan.
Now's the time for specifics. It's impossible to fight fearmongering lies with nothing but positive principles.
Why are these meetings brimming with so much anger? Because Republican Astroturfers have joined the same old right-wing broadcast demagogues that have been spewing hate and fear for years, to create a tempest.
But why are they getting away with it? Why aren't progressives -- indeed, why aren't ordinary citizens -- taking the meetings back?
Mainly because there's still no healthcare plan. All we have are some initial markups from several congressional committees, which differ from one another in significant ways. The White House is waiting to see what emerges from the House and Senate before insisting on what it wants, maybe in conference committee.
But that's the problem: It's always easier to stir up fear and anger against something that's amorphous than to stir up enthusiasm for it.
The White House has just announced a web page designed to rebut some of the insane charges that the right is instigating. That won't be enough. The President has to be more specific about what he's for and what he's against. Without these specifics, the right can conjure up every demon in its arsenal while the middle and left can only shrug their shoulders.
The President needs to be very specific about two things in particular: (1) Who will pay? and (2) Why the public option is so important -- and why it's not a Trojan Horse to a government takeover.
(1) Admit that taxes will have to be raised and that cost-savings won't be sufficient to achieve nearly universal care. But be absolutely clear that taxes will be raised only on the very top. The President needs to decide whether he favors a surcharge on the top 2 percent, or a cap on tax-free employee benefits (which would affect only the very top), or some combination, and then announce which he prefers and why.
(2) Say unequivocally that the public option is essential for controlling costs and getting private insurers to offer people better deals, not at all a step toward a government takeover of health care.
-- Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies and other providers. (Here, he must clear up any confusion about any deal made with Big Pharma.) But this won't lead to a government takeover of health care. The whole point of cost containment is to provide the public with health care on more favorable terms. If the public plan negotiates better terms -- thereby demonstrating that drug companies and other providers can meet them -- private plans can seek similar deals.
-- It will have low administrative costs -- Medicare's administrative costs per enrollee are a small fraction of typical private insurance costs -- but that's no problem, it's a strength. One goal of health-care reform is to lower administrative costs. Competition with a public option is the only way to push private plans to trim their bureaucracies and become more efficient.
-- While it's true that the public won't have to show profits, plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality health care more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, a plus.
-- The public plan won't be subsidized by government. Subsidies go to families who need them in order to afford health care. They're free to choose the public plan, but that's only one option. They could take their subsidy and buy a private plan just as easily. The public plan may not dip into general revenues to cover its costs. It must pay for itself. And any government entity that oversees the health-insurance pool or acts as referee in setting ground rules for all plans will not favor the public plan.
Now's the time for specifics. It's impossible to fight fearmongering lies about specifics with nothing but positive principles.
But that's the problem: It's always easier to stir up fear and anger against something that's amorphous than to stir up enthusiasm for it.
The White House has just announced a web page designed to rebut some of the insane charges that the right is instigating. That won't be enough. The President has to be more specific about what he's for and what he's against. Without these specifics, the right can conjure up every demon in its arsenal while the middle and left can only shrug their shoulders.
The President needs to be very specific about two things in particular: (1) Who will pay? and (2) Why the public option is so important -- and why it's not a Trojan Horse to a government takeover.
(1) Admit that taxes will have to be raised and that cost-savings won't be sufficient to achieve nearly universal care. But be absolutely clear that taxes will be raised only be raised on the very top. He needs to decide whether he favors a surcharge on the top 2 percent, or a cap on tax-free employee benefits (which would affect only the very top), or some combination, and then announce which he prefers and why.
(2) Say unequivocally that the public option is essential for controlling costs and getting private insurers to offer people better deals, not at all a step toward a government takeover of health care.
-- Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies and other providers. (Here, he must clear up any confusion about any deal made with Big Pharma.) But this won't lead to a government takeover of health care. The whole point of cost containment is to provide the public with health care on more favorable terms. If the public plan negotiates better terms -- thereby demonstrating that drug companies and other providers can meet them -- private plans can seek similar deals.
-- It will have low administrative costs -- Medicare's administrative costs per enrollee are a small fraction of typical private insurance costs -- but that's no problem, it's a strength. One goal of health-care reform is to lower administrative costs. Competition with a public option is the only way to push private plans to trim their bureaucracies and become more efficient.
-- While it's true that the public won't have to show profits, plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality health care more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, a plus.
-- The public plan won't be subsidized by government. Subsidies go to families who need them in order to afford health care. They're free to choose the public plan, but that's only one option. They could take their subsidy and buy a private plan just as easily. The public plan may not dip into general revenues to cover its costs. It must pay for itself. And any government entity that oversees the health-insurance pool or acts as referee in setting ground rules for all plans will not favor the public plan.
Now's the time for specifics. It's impossible to fight fearmongering lies with nothing but positive principles.
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Post Office analogy: U.S. Postal Service has not driven Fed Ex or UPS out of business but since U.S. Postal Service exist the other two lack monopoly power and can't raise prices too high.
August 12, 2009 3:53 PM | Reply | Permalink
How can you defend a bill that doesn't exist? The unknown is one of the culprits in this mayhem. I blame the blue dogs for delaying the process and then the fear mongers for amplifying the chaos with lies and distortions.
August 12, 2009 3:59 PM | Reply | Permalink
Exactly. I said as much yesterday - http://tpmcafe.talkingpointsmemo.com/talk/blogs/jeffcrook/2009/08/in-favor-of-a-10-flat-tax.php
Corporate money is seeding the protests, but fear of the unknown, combined with deliberate disinformation, is what's feeding them.
August 12, 2009 4:43 PM | Reply | Permalink
Mr. Reich, is there a word for both agreeing and disagreeing with the same thing? If not, there needs to be.
All your criticisms here are dead on, but I suggest that your solution is impractical. The complexity of this issue cannot be overstressed. There is no way to simplify it without first simplifying the policy.
Maintaining the for-profit and/or private health insurance industry alongside a public healthcare provider is the cause of the confusion and complexity. Until we get rid of that, there will always be room to muddy the debate.
The simplest solution, as well as the easiest solution to explain, is Medicare for Everyone. No need to build anything new, just scale up the existing system to cover everyone.
http://tpmcafe.talkingpointsmemo.com/talk/blogs/jeffcrook/2009/08/in-favor-of-a-10-flat-tax.php
August 12, 2009 5:34 PM | Reply | Permalink
Mr. Reich, is there a word for both agreeing and disagreeing with the same thing?
Cognitive disonance? This describes more what sometimes happens after one finds themselves in that predicament.
August 12, 2009 11:36 PM | Reply | Permalink
Ambivalence?
-- ARG
August 13, 2009 12:35 PM | Reply | Permalink
Somewhere it may be good to point out that the rules of the free market do not apply to U.S. healthcare. Where the drastic increases in healthcare expense go to? A new MRI that is interactive and can clear clogged arteries? A new high tech triple medium medical records solution?
The expenses are more akin to selling lifeboats on the Titanic to folks with corporate credit cards. The fearmongers and demagogues act like the rules of supply and demand have a place in that business.
August 12, 2009 5:39 PM | Reply | Permalink
I like that lifeboat/Titanic analogy.
August 12, 2009 6:09 PM | Reply | Permalink
LIAR!!!!!
That is the response to anyone trying to make the points you suggest. Those protesters don't care to listen to reason or specifics.
August 12, 2009 7:39 PM | Reply | Permalink
Better, I think, is to say, "That is not true; you have been lied to!"
"You should be angry at the people who lied to you!"
"That is not in the bill; whoever says that is repeating a lie!"
Then counter with some actual facts: "Nearly two-thirds of all bankruptcies are caused by medical bills. And more than three-quarters of those people have private insurance!"
"Most of you in this room are one terrible illness away from serious financial trouble. If you don't think it can happen to you, you're wrong."
"Every 90 seconds, someone in the US files bankruptcy due to an illness. The vast majority of these people already have health insurance."
"Private insurance companies deny coverage to people with pre-existing conditions, and they deny life-saving care to people who have coverage -- their customers."
I think it's best to counter lies with the truth. Even though we don't have a specific bill yet, we can still hammer on the need for reform.
-- ARG
August 13, 2009 12:50 PM | Reply | Permalink
Oh and it appears to me that whenever Obama attempts to explain things, the media falls asleep and calls him wonky, advising him to wrap things up in a sound bite. I guess Obama needs to start pushing his policies in commercials with catchy slogans and jingles. Maybe there could be a commercial featuring hot young nurses with boob jobs giving an old man a sponge bath.
August 12, 2009 7:44 PM | Reply | Permalink
"In the case of health care; look--we have a deeply, deeply flawed system, where you've got insurance companies competing by figuring out better and better ways to kick the sick off the rolls...to deny insurance to people because they have a pre-existing condition. ...Leading people to ask, "What's the point of having insurance if you lose it as soon as you get sick?
"Wasn't that the point of having the insurance?"
"We've got to find a way to limit the growth of costs."
"You've seen the cost of insurance double over the last ten years. You've seen a massive monopolization and consolidation of the insurance industry. This is a market that is unlike other markets, where they're competing by finding better ways to exclude the sick, rather than giving you more for less money."
"...Let's just have something that keeps the insurance companies honest, in a world where there's only one insurance company serving the whole market."
--Austin Goolesby, Member of the President's Council of Economic Advisors; and on the Economic Recovery Board. (comments made on 08-11-2009)
August 12, 2009 11:06 PM | Reply | Permalink
There are three things Obama needs to do:
1) Quit pandering to the conservatives that want to kill reform regardless of the cost for political gain.
2) Quit pandering to the corporations that are willing to let people die in the name of profit(greed).
3) Get a spine!
August 12, 2009 11:43 PM | Reply | Permalink
You mean Obama must lead a effort that reduces rentier income?
Not his job. Not gonna happen.
August 13, 2009 7:40 AM | Reply | Permalink
What Robert Reich could do is not add to the opposing side's arguments with provocative headlines accusing Obama of undermining democracy.
August 13, 2009 8:01 AM | Reply | Permalink
Robert Reich is full of great ideas, but he misses the point. His advice didn't serve the Clinton administration nearly twenty years ago, it will not serve the progressive agenda now. Because Americans don't care about great ideas.
Americans respect strength, not reason. The left will continue lose control of the agenda if it continues to try to reason with an, on average, unreasonable population.
One can make all the reasonable arguments one wants, it is not going to convince the patriotic, emotional center.
At this point this is a war of words, not ideas; argue:
"Health insurance reform will make America healthier.
Health insurance reform will make America stronger.
Health insurance reform will keep America competitive in the world economy for the next 100 years."
"Whether they know it or not, reform's opponents want to make America weak.
Whether they know it or not, reform's opponents want to make Americans sick.
Whether they know it or not, reform's opponents want to to let America fall behind its competitors over the course of this new century."
Obama caught the imagination of America because he made strong, patriotic arguments during the election, and in comparison McCain looked weak and confused. But more and more Obama has presented himself as a wise academic full of good ideas. Like Robert Reich. And this is not what mainstream Americans have ever wanted to see in a President.
August 13, 2009 12:17 PM | Reply | Permalink