Think it Through

After two weeks in New York City as a health care consumer (spine surgery) – rather than an observer of public opinion on health care – I have returned home to Washington, D.C. thinking of Casey Stengel when he managed the interesting New York Mets in 1962. On a particularly exasperating day, Stengel slid his baseball cap back, scratched his head and bellowed: “Doesn’t anybody here know how to play this game?”

If Casey was a political consultant in Washington today, he might look at what is going on regarding health care and ask four questions:

Casey’s question #1. Doesn’t anybody, except the right wing, know how to use the power of television?

Liberals are panicked that the far right has scared the Congress into abandoning meaningful health care change. Why? Because a relatively small number of probable non-voters at recent televised town hall meetings played to the cameras and frightened the daylights out of the usually coddled Senators?

Did it not occur to any of the Senators or their professional media advisors that this was an opportunity to educate the wider television audience and look like a leader?

Why not answer the screamers to make a point, such as:

“Before you accuse anyone in government of taking away your country, let me remind you that over the last 40 years, the federal government has cut your federal taxes in half. Yet, you still seem angry. Maybe it is not the government you should be mad at. If you think you are getting the shaft, then give a little more thought as to where the shaft is coming from. Then, do one more thing: Think about where you would be without Social Security and Medicare – two government programs. You would not only be angry, you might be poor and sick. So I don’t know how you could say the problem in your life is too much government.”

These televised town halls were a teachable moment for the nation, but the politicians were not up for it.

Casey’s question #2. Doesn’t the President know the difference between fielding and hitting?

Fielding is when you play defense. In order to score you need to hit, and if you do not score you cannot win.

The President has spent the last few weeks roaming center field, catching just about everything the other side hit. He seems to like it out there, and has spent so much time on defense; this is all that has dominated the news coverage. The President is on every news channel pleading against “misinformation.”

Obama cannot win if he never takes a bat in his hand.

He must end the discussion on the process of health care reform and start talking only about the payoffs – how each of us will benefit from what he proposes. If someone on his communications team tells him the devil is in the details, immediately send that person to the devil.

Casey’s question #3. Since you already know which is your best pitch to hit, why not just go ahead and hit it out of the park?

Reform is not a friendly concept. Mention “reform” efforts and people get a headache. When we introduce any “reform” issue in a focus group of voters, you can see people immediately pulling away from the table. Their body language says: “What are you going to take away from me?” And as George Carlin admonished, “When I hear the words ‘bipartisan’ and ‘reform,’ it makes me think an unusually large deception is about to take place.”

The public wants protection from insurance company abuses, guaranteed health care coverage, and reduced premiums. But Health Care Reform could just as easily say to some people that they will have to pay higher premiums or be unable to see the doctor they want.

What should be the message to define the change in health care as highly valuable to every person, not scary, workable, and really without much risk at all?

Many Democrats in and out of Congress sum up the message mystery in one word – Medicare.

If President Obama tells the nation he intends to expand a proven program that has helped improve the lives of millions of Americans, he will have hit a grand slam and leave his opponents speechless.

Call it MEDICARE PLUS, ALL AMERICAN MEDICARE, or whatever. If your proposal is to expand Medicare to cover everyone, either all at once or incrementally over years, you will never need to defend why you are proposing reform.

You will only need to ask those who oppose you one question: Tell me why you do not believe all Americans should not have access to the same level of health care we offer people over age 65? Why are you discriminating against young people and middle aged people?

You immediately gain the message high ground on values – fairness, personal security, and caring for your family. If you are 55, is your quality of life less important than your neighbor who is 75? Tell me why a 40 year old mom does not deserve the same opportunity for good health care as a 65 year old grandmother?

Your opponents will be left asking process questions, such as:

Won’t expanding Medicare be too expensive? Answer: Year after year Medicare has delivered health care at a lower cost than private insurers. It has no middleman, no insurance executives. Medicare will lower our costs in the long run. But that is not the only reason to pass Medicare Plus. We cannot in good conscience continue to offer one quality of health care to people over 65 and a lesser quality to nearly everyone else.

Aren’t you calling for a socialist government takeover of health care? Answer: No. It is not a government takeover of medicine; it is just Medicare, a program that has worked for decades. There will be no government doctors and no government hospitals. Medicare gives you the choice to go to whatever doctor you want and whatever hospital you want. You just do not need to deal with the insurance agent.

Casey’s question #4. By now, Casey is a little more hopeful, and he asks: if the cleanup hitter starts hitting, could that be contagious?

Maybe…

While many polls show support for health care reform dropping, changing the way we deliver health care in the U.S. is still a must for Democrats. On just about every poll over the past eight years we have seen a great divide on issue priorities. Democrats across the country consistently place health care reform at the top of their priorities, while Republicans and Independents do not. The non-Democrats tell us in focus groups – what’s the problem, I’ve got good coverage. This is maybe something we should think about for the uninsured, but it is not a priority.

Democrats, on the other hand, become emotional as they tell stories of horrific injustices at the hands of insurance companies. For Democrats and other voters who do not have high incomes but pay a lot of attention to the issues, this is an issue of life and death. This fact should be a warning to those Blue Dogs who represent Democrats and middle to low income people.

For those who want comprehensive changes in health care, Casey Stengel’s original question to the Mets is still valid. After the various teams come back from the beach this September, we will find out if anyone of them knows how to play this game.

from Bjorn J via Creative Commons

These days, the tail that wags the dog in Congress is colored blue.

The so-called Blue Dog Democrats are not a majority of the House of Representatives. They are not even a majority of the Democrats. But they are tugging so hard on the reins of the majority that they are determining the direction of heath care reform.

Think of the 52 Democrats in the House of Representatives who call themselves Blue Dogs as Darwinian creatures of politics – descendants of a pest called the boll weevil that infested Congress in the 1980’s.

Russonello’s political dictionary defines a “Blue Dog” as: “a congressional animal that barks incessantly about saving the taxpayers money while quietly carrying water for policies that increase the federal deficit and the national debt.”

The most important thing to Blue Dogs – about half of them come from Southern states – is presenting themselves to their local news media and their constituents as fiscal conservatives in order to send the message that they are a different kind of Democrat – code for not too liberal.

The Blue Dogs feed on a special brand of “fiscal conservatism,” which claims to spend less of taxpayers’ money but in reality merely shifts what the government’s money is spent on and who pays. Their ancestors, the boll weevils, worked against any spending in the 1980s that was not a weapons system.

They had a large impact on government and our country:

By the end of Ronald Reagan’s second term in office in 1988, spending on domestic needs such as health care; child nutrition; economic programs to help create jobs, build housing and educate our children; medical and scientific research; and everything else except entitlements and defense, dropped from 20.1% to 14.8% of the federal budget. Congress, with the boll weevils leading the way, found the money to increase military spending from $158 billion in 1981 to $291 billion in 1988, and spending on the military rose from 23.3% to 27.3% as a proportion of the federal budget. These fiscal conservatives were responsible for the budget deficit increasing from $79 billion to $155 billion during the Reagan years (1981 to 1988).

Taxes on the wealthiest Americans dropped to their lowest rate in decades (from a top marginal rate of 69.125% to 28%). The interest on the federal debt reached $12.65 billion every month.

Today, the Blue Dogs have health care reform by the neck. They intone ominously about their fears of a high price tag on President Obama’s plan for comprehensive health care. Then they oppose provisions that will save money for health care consumers and for the federal government. Specifically, they oppose a strong public option because it would be too difficult for private insurance companies to compete against – in other words it would provide quality care at less cost. They are also willing to draw a line in the sand to block health care reform if it includes new taxes on businesses or millionaires.

They dubbed President Obama’s stimulus package as “too costly,” but gave President Bush an open check book to wage war in Iraq. Their reasoning seems to be that many of them came from traditionally Republican districts, so they need to act like Republicans.

If the President loses meaningful health care reform because of the Blue Dogs, he has his chief of staff to blame. Many of the current Blue Dogs were recruited by Rahm Emanuel when he served as chairman of the House Democratic Congressional Campaign Committee. He believes they are the key to the Democrats holding the majority in the House because only the pro-insurance company, pro-millionaire type of Democrat can get elected in these districts.

This type of thinking is part of the reason why people tell us in focus groups that it doesn’t matter who wins elections, because “they are all the same in Washington.” Voters legitimately ask: why should we work for the Democrats to win a majority in Congress if they are not willing to make real changes from what the Republicans offered?

Nothing will test this assumption more powerfully than the outcome of health care reform.