HealthCare Reform: How Democrats and the Mainstream Media Can Make It Happen

Improve the messaging.

Why is quality healthcare for all Americans so hard to achieve? Greed, ignorance, and bad messaging. It’s big business, their leaders and their impact on politics that demonstrate the worst aspects of greed. It’s too many Americans who are woefully ignorant of how to reason with facts. And it’s Democrats and the mainstream media who are doing the terrible job of messaging.

The greed of corporations and too many individuals is beyond dispute. Trying to simply legislate greed out of existence is foolish. We can pass some legislation to temper greed but I recommend changing the incentives for greed [read Freakonomics, Levitt & Dubner], more on this later.

After greed, it’s ignorance that is holding healthcare reform back. Too many reports and interviews rely on numbers and impersonal logic. ‘Ten million without healthcare,’ doesn’t compute to the working class as well as ‘Your son can’t get treatment for a life threatening illness,’ does. [Go back and review your Marshall McLuhan.] Here’s what I mean:


I’m going to use a few socio economic and political labels in this essay so it’s important to label myself first. I grew up working-class on the Southside of Chicago. I’m the only one in my family who has graduated from college (University of Illinois). I have taught the disadvantaged and at risk here in Los Angeles, California (LAUSD) for over 25 years. I’ve traveled the world and hung in the hood. I consider myself liberal in my views.

Stop calling Obama “Black” and Don’t call the ACA “Obamacare”

The media loves to talk about racism but when it’s time to talk about policies, it’s as if you’ve all forgotten that racism exists. It is that very racism  that causes people who would be badly hurt by the repeal of the ACA to vote for politicians who want to repeal Obamacare.

I’ve listened to people back in the old neighborhood and other working class and even middle and upper income people talking and those who are racists all seem to hate Obama on principle – because he’s Black. Black people rejoicing over ‘their Black President’ hurt him. They hurt him by excluding him from the mainstream when calling him “Black”. He’s African-American! Emphasis on AMERICAN. Just like JFK was Irish-American and Antonin Scalia was Italian-American. Emphasis on AMERICAN.

During his presidency I heard a Fox news report that said Obama hates White people. Those of us who voted for Obama know that is rubbish. But where was the mainstream media pointing out that Obama’s mother is white? Nobody put forth the following question, “You mean he hates his own mother?” I realize you can’t respond to every bit of drivel that comes from the right wing but distinctions like Africa-American rather than Black would make a difference. American is inclusive. Black is exclusive.

That is a big reason why it is so damaging to call the Affordable Care Act Obamacare.

The name Obamacare came about from its opponents as a term of derision, and was later adopted as a sort of pride thing by the media and the Obama White House. Sort of a, “Oh yeah look what we did!” And Republicans have been trying to overturn Obamacare since it was passed.

What if Mitt Romney had won the presidency back in 2008 and then instituted healthcare reform based on his Massachusetts healthcare reform act? I bet Republicans would have embraced it and called it Romneycare with pride.

But don’t ask what a conservative, pro-life Christian thinks of a basically conservative healthcare plan that saves lives and is called Obamacare. They hate it on principle not realizing their illogic. Think of it this way. Every time you say Obamacare to someone who hates Obama (and that includes a lot of politicians on the right), you might as well be saying (and I know how terrible this sounds) ‘That Uppity Negro’s Big Government Giveaway to the Stupid and Lazy.’

I assure you, that is how many people think, not realizing the illogic of their position, their racism, and what the alternatives are. Next time you go to say Obamacare think that you might be actually saying, ‘That Uppity Negro’s Big Government Giveaway to the Stupid and Lazy,’ and you’ll begin to understand the need to change the messaging. Remember… Affordable Care – good!  Obamacare – bad!

What to do

When Trump wails against “the disaster that is Obamacare” I don’t hear any opposing arguments that are meaningful to me (as someone who’d rather have a single payer plan) or those who want to repeal and replace. I just hear, “It’s not a disaster,” or “X million people now have insurance with Obamacare and x million people would lose it with the Republicans.” Take it from a teacher, this doesn’t put forth any kind of policy direction that is personal enough to be meaningful nor does it serve to educate our populace. There is a more effective way to bring both sides closer. In short you need to compare, answer, and give examples.

Compare what you have now with what you had before.

The Problem:

I had insurance but lost it. Due to Obamacare.
Insurance companies are leaving my state. Due to Obamacare.
I didn’t have insurance but now I have it. Due to Obamacare.

The Lesson:

Start by comparing states by legislatures and legislations. Which states have Republican legislatures; which have Republican governors; which states didn’t agree to the MedicAid Expansion? Now compare the number of those who got insurance with the number of those who lost insurance state by state. Those are much more relevant statistics and they show which party is watching out for the people. And it’s more personal to the average citizen. Compare those states where the insurance companies are leaving with those where they are staying and ask, “Why?”

Answer questions about what bothers you about the ACA.

The Problem:

Why are insurance companies leaving?
Why can’t my brother get insurance?
Why do I have to pay full price out of pocket for generic medication when I have Medicare and insurance?
I had X healthcare protection before Obamacare, then after Obamacare I lost it. Why?
Why are costs are out of control?

Short Answers:

I don’t know why insurance companies are leaving some states and not others. I guess it has to do with profits. They leave where the profit margin is low and stay where the profit margin is acceptable or good. Come on media – explain this (state by state – company by company) or shame on you. Get them to answer a simple question, “Why did you leave Wisconsin and stay in California (or whatever states you find relevant)? Are you getting out of the health insurance business all together?” Expose the greed and the profit motive insurance companies have to overturn or save the ACA.

My brother is 61 years old. He is too young for Medicare and he can’t get health insurance (even though he was employed and had insurance until he was forced to retire due to health issues). Is it the fault of a flaw in the ACA or is it that his state didn’t accept the MedicAid expansion?

I have Medicare (parts A, B and D), supplemental insurance, and I live in California which did accept the MedicAid expansion. Yet, I had to pay full price for a generic, doctor prescribed, medication for my back pain. It’s non addictive and has no serious side effects. But they will pay for Vicodin! Come on Democrats and mainstream media – explain that one to me. If the ACA is to blame then that should be an area of focus rather than wholesale repeal.

Do a weekly newsletter, show, or article that takes on the question of pervious healthcare that was lost. Again, if the ACA is to blame then that should be an area of focus not wholesale repeal. But explain it to people. Don’t just recite the national statistics. Explain some specifics.

Then ask the legislature to consider, would it be better to require insurance companies by law to remain in states where they were previously doing business? Would it be better to control costs by putting caps on what hospitals, doctors and drug companies could charge? Would a single payer plan be better? (Be sure to define what single payer means – do it regularly.) What are the possible consequences of the Republican ideal of free market insurance?

Give concrete examples of alternatives

A free market approach to healthcare is neither fair or workable. To say otherwise ignores the mathematics of it. When Republicans say that everyone will be covered at lower cost, it’s like saying, “We’re going to make sure everyone can afford a window screen to hold over their heads for protection from the rain.” Lower costs frequently mean lower quality service. Next time you fly coach (lower cost) with your knees up under your chin remember that Ronald Reagan deregulated the airlines to improve service and lower cost. Good old Republican free market competition brought you that competitive seat size.

The Individual Mandate

One complaint I’ve heard repeatedly, is about the individual mandate — the rule that says everybody has to buy/have health insurance. Why have I not heard a single pundit or politician point out that each of the 50 U.S. states and the District of Columbia requires automobile drivers to have insurance coverage for both bodily injury and property damage? The minimum amount of coverage required by law does vary by state but insurance is still required (to drive legally that is). If you can require people to buy automobile insurance why is it such an imposition require people to buy health insurance?

That question may seem obvious to you and this may seem inconsistent with good thinking, but I have been in conversations with people who abuse their bodies, abuse the emergency room costs (or generosity), and then complain about being forced to buy health insurance under Obamacare.

The high cost of disingenuous advertising

One way to lower the costs of insurance and pharmaceuticals (and healthcare in general) would be to curtail or ban advertising of insurance and pharmaceuticals, or at least improve the honesty of the messaging. Auto insurance is different from health insurance in significant ways but let’s use the two for a comparison.

Auto Insurance vs. Health Insurance

An ad I have seen on every news station is the one where a forlorn driver is pictured in front of a great national symbol of freedom. The driver bemoans that they crashed their car and their insurance company won’t replace it at full value. The medium: an emotional movie. The message: obviously they picked the wrong insurance company. Then the announcer comes in and clearly states that if they had a particular type of policy with the advertising insurance company they’d get their whole car back. The medium: lecture. The message: we are the better insurance company.

What gets missed in this messaging is the fact that EVERY auto insurer will sell you coverage for almost every contingency if you are willing to pay more. What would be a more honest ad would be, skip the emotional movie part and say, “For drivers willing to pay more at the start of their policy, our company (like every other company) will replace your car.” I know that seems obvious to those who are smart shoppers but… to the unwary consumer with the original example it isn’t. The medium is the message!

How would this translate to health care? Try this for similar advertising: A forlorn man tells us that he lost his leg due to snakebite (i.e. there is no one to sue).  He tells us that his insurance company would only remove the infected parts and then gave him a sweatshirt with ‘Stumpy’ written on it. Then the announcer comes on and says, “For those with our full limb replacement policy you’d get your whole leg back.” Ridiculous, but necessary to point out, if we are to emphasize to people that decreased costs frequently means decreased service. Remember your airline seat size – oh yeah, that doesn’t directly apply because along with decreased service it isn’t cheaper either!

Though, a dented fender can go unfixed; a broken leg, serious infection or any of a number of maladies must be treated or serious life damaging consequences both personal and social will ensue. In every case, the government or the hospital (and ultimately we taxpayers) will have to absorb the cost of full treatment for those with the lowest cost ‘affordable’ health insurance. This doesn’t get talked about enough. Of course the poor can always do as Scrooge recommended, ‘…die and decrease the surplus population.’ But I think it’s better to have a single payer plan to negotiate and/or regulate costs and insure everyone.

Pharmaceutical Ads and Cost

And then there’s the disingenuous pharmaceutical advertising. How often have you seen the one that shows laughing people living it up, suggesting that clearer skin will bring you love (which it might but…). Then the horrifying list of very dangerous side effect is announced over laughing people enjoying themselves. The medium: a romantic movie. The message: our drug will bring you happiness. What if the announcer said, “Are you willing to risk death to have a 4 in 10 chance of clearer skin after 4 months?”

Effective products don’t need expensive 24/7 advertising. Medical marijuana is a billion dollar industry and is very profitable without advertising. And there is no record of anyone ever dying of marijuana overdose.

Striking a blow for the people

What if NBC or its more liberal wing MSNBC were to announce, “In an effort to demonstrate the importance of lowering healthcare costs we will no longer air any advertising of any kind from drug companies. In an effort to show the connection between the high cost of insurance and insurance advertising we will no longer air health insurance ads or any ads from companies affiliated with health insurers. For example, if FixItAll auto insurance is a part of a corporation which also controls or owns CureItAll health insurance we will no longer accept advertising dollars from either company.”?

Would such an announcement cause a stir? Would the very stations which put on Democratic representatives and rail against corporate greed have the guts to turn down advertising?

Educate don’t obfuscate!

You who would inform us of our options regarding policy need to get down from your ivory towers and out from behind your computer screens and answer the questions and concerns of the average Joes. Instead of simply asking people if they are steadfast in their support of repeal and replace you’ll have to take them on and ask them why? What do they think would be better? Do they realize that lower costs (as they are currently being proposed) probably does mean lower quality service? Give them some of the scenarios outlined above and ask them what they think.

“If you know the enemy and know yourself,
you need not fear a hundred battles.”
Sun Tzu

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