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Personal stories are a great rhetorical device, especially for the kinds of people that remain skeptical, long after the established facts and statistics are spelled out. Cory Doctorow doesn't necessarily have a compelling story, but because of his prominence in the blogosphere, I thought I'd paste in his bit:
I've lived under the Canadian, US, British and Costa Rican health care systems and of the four, I believe that the Canadian one functions best (I'd rank them Canadian, British, Costa Rican and US). My experience with all four includes routine and urgent care. I've had firsthand experience of pre-and post-natal care in Canada, the US and the UK; I've also seen the Canadian, US and UK palliative care system in action.(more from Boing Boing)
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There's a lot of pages out there about debunking Canadian healthcare myths, and this is another good one. For example, Canadians come to the US for healthcare:
Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care.(more from the Denver Post)
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I recently came on a phrase in an article in the journal "Annals of Internal Medicine" about an axiom of medical economics: a dollar spent on medical care is a dollar of income for someone. I have been reciting this as a mantra ever since. It may be the single most important fact about health care in America that you or I need to know. It means that all of us -- doctors, hospitals, pharmacists, drug companies, nurses, home health agencies, and so many others -- are drinking at the same trough which happens to hold $2.1 trillion, or 16% of our GDP. Every group who feeds at this trough has its lobbyists and has made contributions to Congressional campaigns to try to keep their spot and their share of the grub. Why not? -- it's hog heaven. But reform cannot happen without cutting costs, without turning people away from the trough and having them eat less. If you do that, you have to be prepared for the buzz saw of protest that dissuaded Roosevelt, defeated Truman's plan and scuttled Hillary Clinton's proposal.(via kottke)
Law 13 of the 48 Laws of Power states: When Asking for Help, Appeal to People's Self-Interest, Never to their Mercy or Gratitude. This is why it's important to emphasize how quality-of-care in America has so much room to grow under healthcare reform. Here's a little snippet about quality-of-care in Canada vs. the US:
On most measures of patient-reported physician quality, Canada comes out slightly ahead of the U.S. The Commonwealth Fund report shows somewhat fewer reported physician errors, lab errors, medication errors and duplicate tests north of the border, and Canadians report more satisfaction with their doctors.(Read the rest on factcheck.org)
I've been listening to conservative talk radio and FOX News for months now, cringing as they smear Obama's healthcare plans. Since then, I've been accumulating my ideas on this blog, coming up with various ways that we can win the war of rhetoric. I've now summarized these ideas into a short memo that will help us change the terms of the debate.
Five years ago, I was inspired by George Lakoff's Don't Think of an Elephant, which offers suggestions to progressives on how better to frame political debates. Immediately it is clear that he uses his own advice as he refers to his audience as progressive instead of the smear-word liberal. The book was a cult hit when it came out, but unfortunately the advice was too late for John Kerry's election.
Right now, the conservatives are winning the war of words on healthcare, but we can turn the tide. Here are five message control suggestions for healthcare reformers:
1. When they mention socialist medicine, you mention unregulated, profit-driven, fragmented, capitalist medicine
When the opposition mentions socialist medicine, almost every time it kills the conversation. But it doesn't have to play out that way. Just as socialism evokes Stalin, Mao, and Che, why can't you evoke the robber-barons of the early 20th and late 19th centuries? Just as Americans are suspicious of socialist icons overseas, they're also suspicious of capitalist pigs at home, from Enron-types to Big Oil and Big Pharma.
The opposition is getting away with being the underdog party that will say "No" to socialist medicine. So it's our duty to reveal what they're implicitly for, which is essentially profit-driven, capitalist medicine. Ask the rhetorical question, "Why should providing health insurance be a profit-driven enterprise?" "Would you want to face an insurance company that has all the money and incentives in the world to deny your claims?"
2. Stop using the word public
When the opposition talks about privatized healthcare, they're subtly playing on Americans' fears about privacy invasion. When they talk about public healthcare, they're invoking Americans' fears of public services, like the DMV or welfare. Instead, try to appeal to patriotism using terms like National health insurance.
3. Stop referring to Europe and Canada
70% of Americans do not have passports. So in the average American's mind, the grass isn't greener on the other side, precisely because they've never seen it. The European label was political death for John Kerry in his failed 2004 bid for president. Likewise, Michael Moore didn't endear anybody by showing how Cuba's healthcare is so much better.
If you have to mention a comparative system, maybe mention Australia, a country that the cowboy types of America can identify with. And say something along the lines of this:
Health care doesn't have to be exclusively socialist or "capitalist". The Australian system is a good example. Everyone is provided with free public health care and about 40-50% also have private health insurance. You have the benefit of efficient, effective "capitalist" healthcare, and the safety net of the public system if something like what you described were to happen.(source)
4. Instead of focusing on healthcare reform, start talk about insurance reform
The opposition has been playing on many Americans' fears that Obama is just causing too much change too much fast. The opposition talks about healthcare reform in terms that have nothing to do with Obama's proposal. It's almost a fact in conservative talk that Obama wants to put doctors on government payroll or that Obama wants to run the healthcare industry like he's "running" GM.
Also, the fact is most Americans are happy with their healthcare. That is probably the number one hurdle in changing the hearts and minds of Americans on this issue. It's the Lake Wobegon effect, where the average American believes their healthcare is above-average.
However, by referring to what Obama's reform plan is mostly about—insurance reform—you can localize the scope of the change. I think ordinary people have an intuitive sense that the insurance industry as a whole is corrupt and needs reform.
5. Instead of universal healthcare, talk about comprehensive healthcare
You have to tip-toe around people's fear of health welfare. Expanded coverage is something people agree with publicly, but in private, they would rather save their tax dollars.
By mentioning comprehensive healthcare, you invoke ideas of better health quality for individuals, which is actually very much a part of this. Small business owners, for example, who have been providing limited or no health insurance to their employees, have been clamoring for precisely this kind of reform.
Plus, you also remind people that perhaps their coverage may be limited. How many of you, when choosing your health insurance plan, had to make compromises and trade-offs? With national, comprehensive health insurance you won't have to do that. Rather you get more freedom and choices. What can be more American than that?
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This is an angle that didn't occur to me, but could be really powerful if mentioned on conservative talk shows:
You hear a lot about how small businesses would get crushed by raising taxes on the wealthiest 1%, or how small business will be crushed by excessive regulations, or how small business would be crushed by a carbon tax or cap & trade. But those same people who claim to stand up for small businesses disappear when we're dealing with something that does crush small businesses - the no-win scenario of either letting the employees who feel like your family go without benefits, opting for the "split the baby" solution of getting a high-deductible or high cost-sharing plan that you know will be insufficient, or subjecting to yourself to the slings and arrows of outrageous insurance monopolies, where the only safe prediction is that your costs will go up.(from the NOW! Blog)
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Obama's common sense assessment is spot on:
Premiums have been doubling every nine years, going up three times faster than wages. So the notion that somehow we can just keep on doing what we're doing, and that's okay, that's just not true.(from Washington Post's Most Want Health Reform But Fear Its Side Effects)
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