The Keith Olbermann show on Friday spotlighted the Americans for Prosperity memo that coaches AFP adherents in tactics for disrupting town halls. Guest host Richard Wolffe offered friendly advice to Democratic Congressmen planning to offer town halls during the August recess:
Those angry protestors who will disrupt your attempts to talk with your voters, and trust me, they will, are being coordinated and coached by industry funded rightwing operatives. … And there’s a good chance they don’t even live in your district. One conservative front group is now busing people from all over the country to protest against Democratic members, a strategy endorsed by Republican Congressman Pete Sessions of Texas, who told Politico.com that the days of civil town halls are now over.
After covering the memo, Wolffe interviewed senior Obama aide David Axelrod and asked him a question I want answered: “Have you lost control of the framing of this debate?”
Axelrod’s answer dismayed me. He said they had not–and proceeded not to talk about framing at all.
I’ll tell you why I don’t think we’ve lost control of the debate. Because I think every month people are still paying their health care premiums, and they know that they’ve been going up ten percent a year. Every day, people are dealing with these growing out of pocket costs for their health care. Every day, small businesses are dropping people, large businesses are cutting back what they’re willing to cover for their employees. This is a problem that people live with every single day, and as a result, they want us to do something about it.
Excuse me, Mr. Axelrod. Although high health insurance premiums have certainly made health insurance reform necessary–and changing “health care reform” to “health insurance reform” is effective framing–that regrettable fact does not speak to Woolf’s question about framing. Y’all are doing a slipshod job in that department. Using the phrase health “insurance” reform is not, by itself, going to reverse the sagging poll numbers on the health care issue.
In part, the change is a hard sell because, despite the need for it, too many people–those on Medicare–already got theirs and thus fear change. Balloon Juice cites a study that says:
By a margin of three to one, 36% to 12%, adults 65 and older are more likely to believe healthcare reform will reduce rather than expand their access to healthcare.
John Cole’s comment on those stats is:
I read somewhere that the fact that our seniors are all covered by medicare really makes health care reform difficult. When the most reliable voting bloc already has their coverage paid for by the state, all the Republicans have to do is peel off a few other haves and convince the old folks that Obama wants to euthanize them.
I don’t know what the framing ought to be: “Medicare for those that want it,” maybe? I do know that the issue is crazy complex, and it’s not being sold convincingly–which is exponentially harder when the MSM doesn’t do its job: when it ignores what Americans for Prosperity is up to at town halls and when it fails to call Republicans out on their blatant euthanasia lies.
It will take considerably more than reframing to get this baby back in the cradle.
Of course Axelrod is famous for talking fast while saying nothing. But Balloon Juice is right in saying that older adults might be inclined to believe reform will reduce their services and they are likely correct in thinking so. The current budget calls for cuts of 600 billion from “Medicare and Medicaid”. How much from each program is uncertain at this time. No doubt, and hopefully, the Advantage plans will be curtailed. But also on the block is payment to providers including Home Health which is being cut as we speak. (I don’t understand how they utilize the Medicare cuts since Medicare A is funded by fiduciary money in the form of a withholding and Medicare B is funded by premiums from enrollees. But that is another discussion.)
Insofar as John Cole (and I don’t know who he is), is concerned, he needs to get his facts straight before he speaks. Older adults are covered by Medicare, but Medicare is not a state program.
Many activists that I know still don’t know the difference b/t Medicare and Medicaid. If they don’t know that then they can’t understand how the system works. It is no wonder that
the insurance industry can pull the wool over American eyes so easily. Especially a public that has been trained to accept everything at face value.
One last comment. Ten Single Payer activists met with Michelle Sherrod and had a teleconference w. Claire’s DC staff on Thursday last week and we were undisturbed. Even stood on the corner w. balloons and had the Channel Four press. I guess we are really unimportant.
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any real irons in the fire except for retaining the status quo. They can afford to stand back and employ dishonest frames. Until we have some mechanism to make the right-wing accountable for their lies, the fight will be unfair.
On the other hand, those who are truly wrestling with the complex issues involved in reform, have, at least on some level, to be up-front about how they propose to deliver good care to more people while dealing with an inefficient, private, legacy system that is very deeply embedded and fighting for its life. They have to presuppose a good faith effort to understand that complexity and some tolerance for change and compromise. Unfortunately, many of our citizens prefer slogans to real solutions and the general tolerance for complexity seems to be nil.
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this post at FDL that seems to address much the same issue in a very cogent way.
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Even if Mr Cole is referencing “state” as state in general, (although I have my doubts here) he is still basically incorrect w. respect to the fact that Medicare is funded by fiduciary tax withholdings and premium dollars. He has then confused an already confused issue by referencing “in general”.
The plan has been to restrict Medicare payments to providers based on utilization and outcomes. This was the method used by Managed Care in the 90’s as they undertook to squeeze every excess dollar out of the private system. Currently home health providers are experiencing squeezes and cutbacks. One of the advantages of Medicare that providers cite is that you know exactly how much you will receive for a service and you know that you will receive it promptly. If utilization and outcome measures are instituted, Medicare enrollees may find it much more difficult to find a provider. People may not be aware of precisely this, but there are enough rumblings that they are justifiably anxious.
I don’t consider Single Payer a “dead letter”. It is unfortunate that Mr O. did not allow it on the table as an option in spite of the all the trumpeting that all options were on the table. (I wonder whatever happened to democratic pretense)
Claire’s staff listened respectfully, gave us a full hour of their time, took copious notes and invited us back to other events. That is more than we can say for Carnahan who won’t even give staff time to meet w. us. Incidentally I did attend the Carnahan town hall meet and saw (heard) a few of the naysayers. For single payer advocates, they are not much more distressing than public option proponents who are fond of “inviting” SP people to sit down and shut up.
I am not too clear on your second post. When you say “those in opposition” I am a little vague on who you mean by “those”. I would agree that public option reformists have been reticent about just what sort of parameters they are envisioning for the public option. Initially proposed was a program of 100 million plus that has now degenerated into a program of about ten million means tested, and good, better, and best plans based on ability to pay. Rather than being publicly funded it will be individually subsidized based on the means testing while still costing 100 billion per year. This sort of a program is not a solution and b/c of the constantly changing attributes has become part of the problem. Also problematic is the propensity of PO advocates to refer to their PO as a Single Payer system, which is misleading thereby adding to the general confusion.
I have already used up too much space and will reserve the right to argue again another day. Thanks for your interest in health care reform WillyK
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the reason Single Payer is considered politically unfeasible is that too many politicians on both sides of the aisle are afraid to vote against big insurance and Pharma. They have all taken barrels of this corporate money and now must maintain the status quo. This is the same thing that will sink or at least pare PO down to almost nothing. Max Baucus has said over and over, “we don’t have the votes”. But some version of PO will likely be allowed if it contains a mandate. Insurance is drooling over all the new potential enrollees. They are more than willing to give a little to get a lot.
LBJ faced the same opposition with Medicare, the AMA and monied special interests down his throat. People were afraid that we were going communist and all the same horror stories we are hearing now. But LBJ was determined to do the right thing so he twisted congressional arms and stomped on congressional toes and he saw it passed. Interestingly, he also saw to it that 45 million older adults were enrolled in the time span of 11 months. And he got that accomplished way back in the day when there were no computers. My goodness and our administration and congress aren’t going to be able to get this one implemented until 2013, after the next presidential election. Speaks volumes.
Regarding the utilization and outcome reforms for Medicare and my reference to the managed care usage of these tools in the 90’s, it was nothing much more than a denial of care mechanism, and it has continued to be used successfully and in some cases illegally by insurance ever since.
The thing I have the hardest time understanding is why O says that we need a PO to keep insurance companies honest. Why would we not just want to completely get rid of dishonest traders in health care access. I know, to do so would not be politically feasible.
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