As a physician, I am daily on the frontline of the battle over health care reform. Patients regularly ask me my feelings about reform, about Obama's plan, and about a single-payor national health insurance program. Colleagues regularly ask me how to respond to patients and peers armed with GOP soundbites in opposition to overhauling our current health care system. And total strangers call or email me about health care reform after reading something I've written for one newspaper or another.
So I decided the time had come to sit down and write out key words and phrases that I've found most useful when talking about the need for reform. No, they've not been poll-tested, nor have they gone through a think-tank review. But they're ones I've had the most success with over time.
I hope that there are a few readers out there who might find my thoughts and my experience useful as they talk to others about reform, or write their letters to the editor and letters to their elected representatives. I also hope to learn from others here at DK what phrases and words they've found most effective - please offer your thoughts in the comments!
First, let's start off with the expected GOP strategies, in part gleaned from conversations with Fox-indoctrinated patients, and in part gleaned thanks to Frank Luntz's recent presentation to GOP officials:
* Do not directly oppose President Obama. He is exceedingly popular, and the GOP is exceedingly unpopular. Make it a battle of the GOP versus Obama, and Obama will win. Besides, the public WANTS health care reform. Instead, aim to both scare and sweet talk the public into rejecting all meaningful change.
* Acknowledge DEEP CONCERN about the current health CRISIS. To do otherwise would only prove the GOP has a tin ear. Instead, ask the public whether, in this time of great uncertainty, they want to trade one crisis for potentially others. Say: "If some FEDERAL BUREAUCRAT puts himself between you and your doctor, denying YOU exactly the care YOU need, that’s a crisis", or "If you have to WAIT weeks for tests and MONTHS for treatment, that’s a crisis."
* Talk about PEOPLE and their NEEDS (yes, the GOP will need to take some intensive night classes), rather than the health care system, tax incentives, competition, the free market, and yada yada yada – all the usual GOP catchphrases.
* Talk incessantly about REFORM, but really mean reform of whatever dangerous, expensive, cockamamie plan Obama introduces. Say, "We stand for the RIGHT kind of REFORM, reform that PROTECTS the QUALITY of health care for all Americans, and PROTECTS their freedom of CHOICE."
* Dress up the current ugly pig of a current health care system, put lipstick on it, and try to convince the American public that this truly sickening swine is actually a prized porcine heirloom that must be preserved.
* Scare people. You know, FEAR, that old familiar GOP tactic of using frightful fiction to throw doubt into the public mind and so deflect the dictates of common sense. Fear is always the first weapon of those with the most to gain by maintaining the status quo. And the status quo means continued huge profits for private insurance corporations and their shareholders. You’d better bet that the GOP will work day and night to stoke fears that "change" will lead to something far worse than what we have now (even though it’s hard to imagine what would be worse than what we have now).
* Talk about BIG BAD GUBMIT. Say, "changing the current system could lead to government setting standards of care, instead of doctors who really know what’s best"; or, "...could lead to government RATIONING CARE, and making people stand in line and DELAYING their treatment"; or, "...could put WASHINGTON BUREAUCRATS, LOBBYISTS, and POLITICIANS IN CHARGE of health care, making your health care decisions, rather than medical professionals."
* Ask whether the public "really wants a GOVERNMENT TAKEOVER of health care. After all, government is all about WASTE, FRAUD, and ABUSE. And, after all, the GOP should know, having run government for the past eight years.
* Say the words WAIT, DELAY, RATION, and DENY. Say them over and over. Say it more often even than the name Ronald Reagan. Employ hyperbole freely, using phrases such as "WAIT AN ETERNITY" and "DENY LIFE-SAVING TREATMENT".
* Talk about the SACRED doctor-patient relationship, about keeping health care PATIENT-CENTERED rather than government-centered, and about PROTECTING the PERSONALIZED DOCTOR-PATIENT RELATIONSHIP. You know, the old GOP motto: God, self, and security first.
* And, finally, scream about CANADA whenever possible. Create fictions of Canadian old folks withering away, their health needs neglected; of Canadian children not getting life-saving treatment in time; and of Canadians applying en masse for asylum in the U.S. in order to escape their country’s brutal health care system. Show commercials of ninety-seven year-old Canadian grandmas denied quadruple-bypass surgery, of eighty year-old Canadian grandpas denied their Viagra prescriptions, and of aging fifty-something Canadian women denied their face lift and botox injections.
Sniff. Excuse me, while I go get some tissues.
Now for the words and phrases I've found useful in countering someone who voices their opposition to reform of the current system:
• Reforming the health care system is for the BENEFIT OF THE AMERICAN PEOPLE, NOT PRIVATE FOR-PROFIT COMPANIES
• Our health care system is so DYSFUNCTIONAL AND UNJUST that we SPEND MORE AND GET LESS than most other countries.
• Our health care system is NOT MEETING OUR NATION’S NEEDS. Neither our families nor our firms can prosper under the current system.
• Americans and American business DESERVES AND WANTS a better system
• Americans need a BETTER health care system, one that is FAIR, JUST, and EQUITABLE
• Americans need a health care system that is INNOVATIVE, HIGH QUALITY, and is truly FOR ALL
• ENOUGH of large, impersonal, FOR-PROFIT corporations and their shareholders MAKING MONEY BY DENYING CARE
• ENOUGH of the corporate for-profit insurance industry REJECTING SOMEONE BASED UPON THEIR PRIOR HEALTH STATUS OR ABILITY TO PAY
• ENOUGH of ONE IN SIX AMERICANS HAVING NO HEALTH CARE COVERAGE
• ENOUGH of PUTTING OFF CARE, or skipping it altogether, because CARE IS UNAFFORDABLE
• ENOUGH of half of all Americans NOT HAVING THE FULL COVERAGE THEY NEED WHEN THEY ARE SICK OR INJURED
• ENOUGH of families holding garage sales and bake sales and putting out collection jars to pay for medical expenses while big insurance corporations continue to make big profit off denying care.
• A PUBLIC NOT-FOR-PROFIT PLAN will GUARANTEE IMPROVED ACCESS to health care FOR ALL.
• A PUBLIC NOT-FOR-PROFIT plan will REDUCE COSTS. We already know after more than forty years that the cost of health care per patient is less expensive with public, not-for-profit plans than with private, for-profit insurers.
• A large number of Americans already get their health care from a public plan, including Medicare, Medicaid, the Department of Veterans Affairs, and the Children’s Insurance Plan. A public national health insurance program is just an EXPANSION of the ideas we already know that WORK, that offer a GREATER CHOICE of doctors than do most private plans.
• A public plan will be PORTABLE. No longer will workers need to worry that changing jobs will mean leaving their entire family without health care for some period of time.
• A public plan will EMPHASIZE WELLNESS AND PREVENTION. More and more private, for-profit insurance plans will not cover regular check-ups and preventative care.
• Under the Obama plan, Americans will STILL HAVE CHOICE, STILL HAVE OPTIONS. They will get to CHOOSE between a public, not-for-profit health insurance option similar to Medicare, or a private, for-profit insurance plan.
• WE HAVE HARSH RATIONING NOW. Nearly FIFTY MILLION AMERICANS have NO HEALTH CARE COVERAGE for all or part of the year. Millions more go without needed care because of cost.
• Today, good insurance is astronomically expensive to purchase. Most private insurances have high and growing higher deductibles and co-pays. And, more and more, private insurance companies are refusing to cover someone with prior health problems. All this in the name of PROFIT.
• Our current system is not only UNFAIR, it’s INEFFICIENT. One of every three dollars spent on health care today is wasted on bureaucratic inefficiencies, or is made as profit.
• One’s income and wealth should not determine the amount and quality of care one receives.
• And, finally, the words of the great Reverend Dr. Martin Luther King, Jr.: "There is no greater injustice than inequality in health care".