While supporters of the health-care bill focus on politics, opponents focus on policy. President Obama made an unfortunate stumble in his August 11 town hall meeting on health care reform. "FedEx and UPS are doing just fine," he said, attempting to allay fears that a public option would drive private insurers out of the market. "It's the Post Office that's always having problems."
That's precisely what Americans fear, though--that any government-run program would simply eat up tax dollars while they stood in long lines for service. Inadvertently, the president captured Americans' views about health care reform.
Polls suggest that people are reasonably content with their health care coverage now--even with all its imperfections. They might want to see costs lowered or access increased, but they're deeply skeptical of a Post Office approach to those problems.
This is what supporters of health care reform don't seem to get--that Americans are concerned about the policy itself. Supporters of reform seem more concerned about the politics, casting aspersions on town hall participants, saying they're "Astroturf" and not grassroots, or "un-American" for speaking out loudly.
This focus on politics over policy continues in the video ads aired on television and the web. These ads offer an illustration of what opponents are concerned about and how feckless supporters are by focusing on politics over policy. Here's a quick round-up of some ads pro and con:
Pro-Obamacare: A religious progressives' advertisement features clergy and other ordinary church-goers (identified as such in the subtitles) telling us, one after the other, how "special interest groups are spending millions" to block reform and how these churchgoers pray we get reform. If this ad is targeting like-minded citizens of faith, it's subtly insulting. It presumes that all you need do is dangle a clerical collar in front of religious people and they'll follow you anywhere. The overall message, however, is that special interests are torpedoing reform.
Anti-Obamacare: In an ad run by the Family Research Council, a man anguishes over a rejection letter, saying to his wife, "They won't pay for my surgery." He goes on: "To think that Planned Parenthood is included" in the health plan, along with "spending tax dollars for abortions." The voiceover at the end sums it up: "Our greatest generation denied care, our future generation denied life." While the denied surgery isn't named, many viewers have probably been in that man's shoes, getting a similar rejection from an insurance company. Viewers know that government plans are unlikely to be any better and might even be worse (as the president acknowledged). The ad focuses on specific policy concerns--denial of care and tax-funded abortion.
Pro-Obamacare: Moveon.org has a few ads out--their main thrust being special interests and Republicans are blocking reform. One shows people in waiting rooms morphing into piles of cash while a voiceover tells us that insurance companies see money when they look at patients, and this is why the insurance companies are blocking reform. Insurance companies are heartless? Who knew? This is unlikely to persuade the skeptics or those on the fence.
You can always count on Moveon.org's tin ear when it comes to paid messages, though, as evidenced by another of their ads showing a football tossed around while a voiceover reads quotes that appear on the screen from various conservative politicians and pundits showing how conservatives want to score a political point by squashing reform. As if the visual isn't clear enough, the voiceover explains that Republicans have turned health reform into a "political football." Like the ad mentioned above, the focus is politics, not policy.
Anti-Obamacare: Senior citizens are the target of a well-done ad by the 60-plus association featuring historical photo stills of the "greatest generation," all with the message that "seniors have sacrificed" for this country, but "now in their most vulnerable period," Congress wants to pay for health care reform by cutting 500 billion from Medicare. As the voiceover tells us what that will mean (fewer doctors and important procedures) dated citations from USA Today, the New York Times, the Associated Press, and Washington Post appear on the screen. The closing lines tell us that "many of our politicians are designing a plan that they won't use themselves." A lot of information is crammed in this ad about policy--its cost, its impact on seniors, and a possible double standard of those who are designing the policy.
Pro-Obamacare: An AARP ad, on the other hand, features a visual of a screaming ambulance, cut off in the road by two cars obviously representing the special interest groups blocking reform, the message the voiceover reinforces. The voiceover also assures viewers this reform won't ration care. This last bit is a nod to policy concerns, but it's so brief and lacking in depth that it might as well have been left out--it lacks specificity. The bulk of the ad merely repeats the "special interests blocking reform" message. Politics, not policy.
Anti-Obamacare: Conservatives for Patients Rights has a number of ads that include some hard-hitting specifics, or case histories, including one that shows patients being "squeezed" off the screen by various subtitles declaring that reform raises taxes by 600 billion, adds a trillion to the federal deficit, new rules that could hike health insurance premiums, and people still might end up on the government-run health plan. The visuals are boring, but the message is simple and focuses on policy--its cost and coverage implications.
Another earlier CPR ad featured real "victims" of nationalized health care systems in Canada. A similar ad focused on stories in Britain. The message: "Before Congress rushes to overhaul health care, listen to those who have government run health care." Policy concerns about rationed care are the focus of both ads.
As this round-up illustrates, opponents of health care reform are using a lot of specifics--case histories, examples of what rationing could look like, citations to news articles, stubborn facts about the spending involved. These ads give voice to the skepticism of many Americans.
In the face of such skepticism, generalities don't work. For example, it's not enough to go before crowds saying you're not going to "pull the plug on grandma." Even people who haven't read the health care bills know that end-of-life counseling is in them, and that reformers have talked about containing costs by cutting out so-called unnecessary drugs and procedures. Americans fear where that kind of talk could lead--if not exactly to death panels, to some process where strangers, paid or reimbursed by the government, may cut off care in some way.
Until supporters of reform start addressing those concerns with real references to the bills involved and adequate explanations rebutting critics' claims, they'll continue to struggle. But that might be the core of supporters' problem--they won't be able to rebut critics' claims if the claims are true. It's far easier in that case to focus on politics, not policy, as most of the ads supporting the Democratic legislation do.
Libby Sternberg is a novelist, the author of four young adult mysteries (the first of which was an Edgar finalist) and two humorous women's fiction novels. Her latest novel Fire Me (written as Libby Malin), was released in May.