Retooling Health Care

Congress and President Obama will soon be returning to Washington. The gentle wounded beast called health care reform awaits them. Here's my humble opinion of how it was mismanaged and what they can do to save it.

How Obama Fumbled Health Care Message
By John F. Wasik,
Author of The Audacity of Help: Obama's Economic Plan and the Remaking of America

Foul. Turnover. Two strikes. No matter which overused sports metaphor you use to describe the Obama team's handling of their health care reform agenda, it's clear that the best one to date is "fumble!"

The most audacious health plan in two generations is sputtering thanks to really awful communication planning, a mixed and confusing message and poor defensive strategy.

Since I just finished researching and writing a book on Obama's economic plan (The Audacity of Help), I can tell you he hasn't clearly communicated the dollars and sense argument. Everyone knows that health-care costs are going up and it's not sustainable. But how much will his plan save the family of four, the single mother, the high-income household? Will there be any real savings at all when you figure in the costs of paying for it? That was the first blunder. Americans always vote with their wallets and the Obama crew missed this fact.

I'm sure that Obama's team had an inkling of what they were up against in terms of a massive anti-lobbying campaign. Yet the disinformation blitzkrieg ranging from the loony Sarah Palin to the grannie "death panels" has not been fully dispersed. Not even close.

According to research by Bloomberg News, for every lawmaker in Congress, there are six health-care lobbyists. That's an army of 3,300 arm-twisters, back-biters and potential sources of re-election funds in the faces of our elected officials. There have been so many influence peddlers that an average of three lobbyists per day have been registering in Washington since July 1.

What has Obama's team promised the heavy hitters in this cabal? He's met with doctor, hospital and pharmaceutical groups in the White House. Did he promise to not reap cost savings on a large scale? Did he tamp down plans for a public option? Did he promise to keep the boondoggle that subsidizes drug prices and managed care in Medicare? He has not been forthcoming with those details and that hurts his credibility.

"The whole process is seedy and demonstrates cruel disregard for the millions of Americans who, whether in dire need of medical services or not, voted for 'change we can believe in,'" wrote Ralph Nader in a recent column.

The sinister locomotive of this train wreck is the fee-for-service business model in the system. Few are talking about it and the industry doesn't want to touch it. Hence the vicious counter-attack. If you're a hospital, doctor, clinic or drug company why would you want government messing with this virtually unlimited source of income?

If you're a doctor and own an MRI facility, you tell your patients to get scans because it directly benefits you. If you're a pharmaceutical corporation, you want doctors and hospitals to use the latest -- albeit most expensive -- name-brand drugs. The last thing you want is a single-payer system or an amorphous "public option" plan negotiating huge discounts and doing studies that compare your heavily advertised product with generic equivalents.

If you're an insurer, you loathe the idea of a public plan even more. Not turning away people who are really sick or burdened with "pre-existing conditions" means reduced profits and lower executive bonuses. After all, claims in insurance parlance are "losses." Private insurers are in the business of investing money, not healing people.

Now that the White House seems to be backing off the public option, how will his plan reduce costs while protecting those with chronic conditions and those considered "uninsurable?" Not a week goes by when I don't have a conversation with family or neighbors on how they will afford coverage if they lose a job or get seriously ill. I have the same fears myself.

To best battle the manic propaganda machine, the Obama team can get back into the game but needs to craft its defense and offense around three streamlined concepts:

1. Choice. You keep your doctor, hospital, Medicare and other providers. Maybe rebrand the entire plan as "iChoice." Branding is everything and right now they have a mish-mash that confuses everyone.

2. Affordability. Whether working or not, poor or disabled, you won't go broke paying for coverage -- ever.

3. Universal. Everybody is covered. No questions asked.

To their credit, the White House team has attempted to combat the effluent of the disinformation campaign on their whitehouse.gov blog in a late-to-the-game spinoff www.WhiteHouse.gov/realitycheck.

Yet the Obama team's pushback needs to be ferocious, clear and boiled down. How will the plan impact those with insurance through employers? Will it cost more or less over time? If the public option is dropped, how will those without employer-provided insurance obtain guaranteed, affordable coverage?

Is there any point to reform unless the more than 60 million uninsured and under-insured can be covered and not face bankruptcy? There should be some irrefutable part of the program that will prevent the 20,000 annual deaths of people who avoided life-saving medical care because they just couldn't afford it.

©2009 John F. Wasik, author of The Audacity of Help: Obama's Economic Plan and the Remaking of America