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The Selling of Health Care

A president ignores the cardinal rule of marketing

Vol. 5, Issue No. 16 | August 18, 2009 By Denny Hatch
18
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IN THE NEWS

Headlines: Late July-Early August 2009

“Rep. Kratovil hung in effigy by health care protester” —Glenn Thrush, Politico.com, July 28, 2009

“Fire marshal ordered closing of unruly health care meeting” —William March, Tampa Tribune, Aug. 7, 2009

“Six people, including P-D reporter arrested at Carnahan meeting” —Leah Thorsen, St. Louis Post-Dipatch, Aug. 6, 2009

“Citing safety concerns, U. City cancels McCalkills event” —Jake Wagman, St. Louis Post-Dispatch, Aug. 7, 2009

“Obama-Allied Unions Threatened With Gun Violence For Town Hall Participation” —Sam Stein, Huffington Post, Aug. 7, 2009

“North Carolina Lawmaker Gets Death Threat Over Health Reform” —Dina Cappiello, (AP), FoxNews.com, Aug. 8, 2009


The most popular president in modern history that served at least one full term was Dwight D. Eisenhower.

Why? When he came to office, Ike had nothing to prove. He'd already successfully commanded the greatest invading army in history. His accomplishments: ending the Korean War; creating the Interstate Highway System; lighting a firecracker under civil rights when his Supreme Court passed Brown v. Board of Education (1954) and he signed the Civil Rights Act (1957); spending a lot of time working to lower his golf handicap.

With Eisenhower in charge, a high comfort level existed in the country. The president and Congress quietly and competently took care the people’s business so we could do our jobs, feed our families and raise our kids.

Ike’s approval rating never fell below 50 percent. In the end, he handed a peaceful and prosperous country to his successor. Based on presidential approval ratings, it's clear we don't like activist presidents. We're comfortable with chief executives who do what's necessary and no more. With the exception of Gerald Ford, an unelected caretaker CEO, all presidents since Eisenhower have been activists. And a number of activist presidencies imploded—Vietnam, Watergate, Iran Hostage Crisis, Iran-Contra, Lewinsky, subprime catastrophe and bank bailout.

A half century later, our activist president is trying to sell health care reform to the electorate and is suddenly up to his ears in alligators.

The situation might have been avoided if just one of his advisers had a background in marketing.

Backgrounder
On Nov. 7, 20007, at Google headquarters in Mountain View, Calif., candidate Barack Obama made a speech that included a reference to Bill and Hillary Clinton’s failed 1994 health care reform initiative. He said:

They made one really big mistake. They took all their people and all their experts into a room and then they closed the door and they tried to design the plan in isolation from the American people. I would do it entirely differently. We are going to have a big table, and everybody's going to be invited. It will be on C-SPAN. It will be streaming over the net.

Breaking the BIG Rule
On Aug. 13, Daniel Henninger wrote in The Wall Street Journal:

... health care arrived in late May as a trillion-pound federal elephant in an Obama house that was looking like a Noah's ark of every known species of federal spending: the $800 billion public-works stimulus, the deficit-busting $3.5 trillion budget (and now Treasury's Tim Geithner wants Congress to lift the debt limit above $12.1 trillion), the grandiose cap-and-trade bill that foundered when Democratic coal states rebelled, the U.S. engulfment of the auto industry, the tax time bombs.

Takeaways to Consider

  • Based on presidential approval ratings, it's clear we don't like activist presidents. We're comfortable with chief executives that do what's absolutely necessary and no more.
  • Never roll out a national campaign without first testing it down to the gnat's eyebrow.
  • "The consumer isn’t a moron; she is your wife. You insult her intelligence if you assume that a mere slogan and a few vapid adjectives will persuade her to buy anything. She wants all the information we can give her."
    —David Ogilvy
  • Needed: professional marketers and PR practitioners.

Web Sites Related to Today's Edition

"Rep. Kratovil hung in effigy by health care protester"
http://tinyurl.com/ks6d6c

"Fire marshal ordered closing of unruly health care meeting"
http://tinyurl.com/kjd2wd

"Six people, including P-D reporter, arrested at Carnahan meeting"
http://tinyurl.com/mk6o5x

"Citing safety concerns, U. City cancels McKaskills Event"
http://tinyurl.com/ln22d6

"Obama-Allied Unions Threatened With Gun Violence For Town Hall Participation"
http://tinyurl.com/mjelgy

"North Carolina Lawmaker Gets Death Threat Over Health Reform"
http://tinyurl.com/knrhzk

"Obama: Clinton Health Plan Doomed by Secrecy"
http://tinyurl.com/mhto25

"Will They Still Love Him Tomorrow?" by Daniel Henninger
http://tinyurl.com/mwch79

"Obama statements on single-payer have changed a bit"
http://tinyurl.com/naxcck

Doctors fear socialized medicine
http://tinyurl.com/mpks68

"Heath Care's Big Money Wasters"
http://tinyurl.com/m8z6fo

"Fox's Beck: 'Obama is a racist'"
http://tinyurl.com/kntx76

“Limbaugh: 'Adolf Hitler, Like Barack Obama, Ruled by Dictate”
http://www.youtube.com/watch?v=ey9UX7HUkn0

“Obama Wants to Kill Your Grandma” and five myths about health care reform
http://tinyurl.com/npt5gb

"Palin: Obama's 'death panel' would decide Trig's care"
http://tinyurl.com/mtc5ts

"End-of-Life Provision Loses Favor"
http://tinyurl.com/om64hq

"White House Open to Health Care Reform Without Government Plan"
http://tinyurl.com/o4bps7

"The Swiss Menace" by Paul Krugman
http://tinyurl.com/ouh3af

"Obama Campaign Ad Firms Signed on to Push Health-Care Overhaul"
http://tinyurl.com/ndsfxk


 
18

COMMENTS

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Comment *
Most Recent Comments:
Russ - Posted on August 19, 2009
So let me get this straight... what Obama needs is more focus groups, a better pitch, and maybe a new logo? What planet are you on?

His plan exacerbates health care problems rather than fix them. Socialized medicine (aka: Medicare, etc) is the problem! More of it will not deliver different results.

Obama got caught trying to pull one over on the American public. No amount of PR will change that. It's very simple, his "solutions" are wrong.
Thomas Bodenberg - Posted on August 19, 2009
Denny:

Eisenhower's strength was that he did NOT rely on marketing techniques (though BBDO did his first TV commercials, which I believe were the first ones ever done for a presidential candidacy).

I also must disagree with you regarding the methods used to obtain a proper customer/voter gauge: due to the complexity of the audiences, a focus group would be the LAST thing I would resort to- it would be as if you mailed a test package to ten people, two responded, so you immediately would go for a national rollout as your response rate would be 20%. I would rely on more quantitative techniques (tradeoff analysis) due to the complexity and value of the many interest groups and stakeholders. (That is, what would one be wiiling to give up to attain a desired outcome)

Besides, one vital part of leadership is the ability and courage to ride out the storms and howls of protests from groups which one will inevitably offend during their tenure.

I give Obama great marks for tackling this Herculean task. Bush and Rove lacked the maturity and courage to do so (instead, they would put up a "Mission Accomplished" banner as a distractionary measure- and imagine if the draft was re-instituted for this entire Afghan-Iraqi affair - the burden is on the politically helpless National Guard) -and I'm a registered Republican, was a marketing/customer insights director in the direct response industry (does a little company SW of Media ring a bell?), and have been and currently work in the healthcare industry as a hospital administrator, looking at outcomes and proposing improvements in care.

Marilyn - Posted on August 18, 2009
Excellent commentary on the health care situation. I do hope something can be done to remedy these mistakes. Our system is obviously broken.
Wash Phillips - Posted on August 18, 2009
Lot of slogans in your respondents, Denny. And some familiar (hateful) notions spread by internet alarmists (the kind of p/r nobody—including Dick Armey--admits to knowing). Shills aside, many who attended town halls, saying “Don’t touch our Medicare” were inflamed by pervasive internet pass-arounds and a lot of “gut thinking”(which is not really thinking at all).

Citing Canada and the UK is sooooo passe. A PBS special last year featured 7 working health care systems—all better than our own (if you happen to take Glenn Beck at his revised word that our health care ain't so good after all). Four I recall: France, Taiwan, Switzerland and Germany. Several were single-pay, others not. Criteria were cost, choice, access excellence—the usual.

The CLU responding today must be from a state we should all move to, if we care for health care. An insuranceista, he points to pooling of high-risk drivers so all can have auto insurance as a model. In my state, auto insurance is mandatory, so the pool is ALL drivers, a scheme insuring carriers will not just cherry-pick and walk away. That’s one good reason the whole nation must be in the health pool, one way or another—if we really want to control costs. There are no “pre-existing conditions” for drivers, just higher rates SIMILAR to rising rates on aging persons.

After all, the point of the effort is to make things better, no? It may take tort reform AND medical reform, etc. to meet that goal. The notion that candidates win by making large promises, then are faced (by hook or conviction) to try and achieve them, is apt., and thorny.
bill - Posted on August 18, 2009
But the test market HAS been run, repeatedly, and is still going on in countries all over the world.
Socialized medicine doesn't work.
In Canada the wait for a new personal physician is 6 years. Years.
In the interim you get the clinic's "never the same Dr twice" routine. (The detail in that story is truly sad.)
Auth is wrong about"closet" socialists. Check the credentials(Congress doesn't) of the 32+ Czars we now pay for. Some are far left of Socialist, and that's being kind. There is apparently no felt need for closets for socialists any more.

Bart Foreman - Posted on August 18, 2009
Outstanding analysis of the health care situation. I believe that Obama blew it because he used the same tactic as Hillary did. Rather than a massive program, do it in little pieces and as you noted, test test test and get a PR and marketing person that knows marketing is all about influencing the next sale. Glad you are keeping the math question below simple.
Harvey - Posted on August 18, 2009
As a Vietnam Veteran I can tell you a lot about socialized medicine just speaking about the VA Hospital program. Don't get sick.
Al Stanton - Posted on August 18, 2009
I will address my most basic concern on the Health Care topic. While there are issues within the present bills (both House and Senate) that do raise RED Flags for many citizens, the most disconcerting issue is that President Obama and Congress as a whole have failed to listen to the American people. That's where the present outrage comes from. Our "leaders" are intent on developing their own plan -- their constituents be damned!

We have seen, too many times in the past, where a President and Congress (in particular) have taken a good concept and bastardized it to the point where no one can recogize the original.

Social Security (voluntary at the beginning, with payments to be tax free) has had "feature creep" and extended "inclusions" (who have made no contributions to the plan) to the point it can no longer support itself without higher caps and higher payment percentages for both the individual and the employer. (And, we are all taxed TWICE on our "contribtions.")

Congress WILL pass a Health Care bill that may be "watered down" in order to get the necessary votes publicly on board, with the intent of modifying it at a future date to what the liberal proponents originally wanted -- then taxing everyone, rich, poor and middle class alike.

Think about FICA taxes, coming out of everyone's pay check (while being taxed for those dollars first) -- and companies are expected to provide other "retirement benefits". and the same time."

My concern is that the exact same process that happened with Social Security will occur with Health Care -- and we will all be insidiously taxed -- contrary to what we are being told now that the "rich" will be taxed to pay for this.

When a Health Care Bill passes, Congress will continue to "tinker&
Jim H - Posted on August 18, 2009
Quote: "Based on presidential approval ratings, it's clear we don't like activist presidents. We're comfortable with chief executives that do what's absolutely necessary and no more."

Denny, this is based on an observation of one instance. The statistics may be against you on this one.

My late father - a staunch dyed -in-the-wool Democrat - would say in his Greenpoint accent, "Eisenhower - da woist do-nuthin' President we ever had."

Patty Coldwater - Posted on August 18, 2009
Denny,

I'm surprised that you're making the same mistake the administration is making. You just can't believe that the objections raised at town hall meetings and tea parties are genuine, individual, thoughtful concerns about our cherished American freedoms.

I'm speaking from personal experience. My husband and I have attended several meetings -- no one recruited us or incited us, or (unlike the administration supporters) paid us to show up and express our outrage.

Among the folks we've met are many who voted Democrat, who've never participated in public protests (that's us) before, but are just tired of being talked down to on OUR dime. We're the small business owners, direct mailers, mechanics, plumbers, doctors, elderly, Christians, sportsmen, children with aging parents, parents of young adults, grandparents, etc. who see our way of life, our children’s futures, and our financial resources being co-opted by a bunch of folks WE elected to represent US.

We're expected to go to town meetings and be good, and ask questions, and listen. On the contrary, we see the purpose of the town meetings as an opportunity for our representatives to listen to the folks who put them in office (instead of remaining isolated within the Beltway and guessing what we think or deciding they know better than we do how to "take care" of us). Wouldn't it be refreshing if they asked us some questions? These ARE focus groups.

Most of us have read part, some of us all, of House Bill 3200. What's most shocking and a grand negation of "transparency" is that the legislation is so vague that if passed, the government bureaucracy can "fill in the blanks" with almost anything. Read it. Almost every page gives powers to a variety of appointed panels to supply the details of how this system will operate.

Carol Worthington-Levy - Posted on August 18, 2009
I agree, there is some substantial marketing to be done by the Democrats. The dichotomy in attitude and action between the republicans and the democrats is astonishing! Democrats have good ideas but the forum is so open that the party comes across as disorganized - too many different ideas are thrown at the American people. And the public is not stupid, but they do become confused.

Rule #1 in DM - do not confuse the customer or they will turn you off.

The republicans are frighteningly good at organizing sound bites of monumental and even outrageously twisted proportions and selling them to the public through an organized barrage of consistent messaging. They even contradict themselves and get away with it - Palin passed legislation in Alaska for a day to work on your health including writing an advance directive - and two weeks ago she called such directives a death squad or some other nonsense.

DM Rule #2 - Believe passionately in what you are selling, then organize the "sell" and state what you want them to do, and why, clearly and consistently. Being coy and offering too many choices does not work.

The Democrats and Obama need to hunker down and 'do the Republican thing' - organize and sell their message with conviction! otherwise the nation will continue to flounder in indecision about essential issues.
Brent D. Gardner, CLU, ChFC - Posted on August 18, 2009
1. In my state, there are 929 Medical Doctors that are in general practice / family physicians, according to the state medical board. According to Medicare.gov, only 90 of them accept Medicare reimbursement.

2. The 47 million uninsured is a myth. Out of that figure, there are ONLY 2 million who want/need health insurance and cannot buy it at standard rates due to pre-existing conditions. The rest are eligible for some free or subsidized (read: affordable) coverage and are either too lazy, too stupid, or just refuse to pay even one red cent for coverage.

3. In my state, small group coverage is guaranteed issue (2 to 49 employees). The maximum a company can rate up the group is 166%, which is a steal if you're sick when you compare the premiums to the cost of care.

4. In my state, if you're declined by two companies for pre-existing conditions, you can go into "the pool" which is guaranteed issue major medical. Round figures, the premiums are about 50% higher, but here's the juice on that: The ONLY people who get stuck with this are the ones that WILLINGLY MADE THE CHOICE to go without insurance. Individuals are NOT singled out to receive rate increases because of their individual claims. If you get a DUI, your auto insurance will be higher. If you smoke, your life insurance will be higher. If you're sick, you're health insurance will be higher, UNLESS you bought it WHEN YOU DID NOT NEED IT.

That's how insurance works: Buy it when you don't need it, because when you need it, you can't get it, or it's way too expensive.


Chet.Dalzell - Posted on August 18, 2009
Thank you Denny for informing this debate about the debate. You really nailed down the vested interests here (in the status quo) and fears about the yet-to-come -- and why we need a better way, both in the total package and the selling of it. I don't think marketing/PR can fix it alone -- but taking 1,000 pages and making it simple to understand (based on truths about the plan) has been severely lacking and that's what marketing/PR can do. Meanwhile, the horse trading goes on... At least there's an effort going on to finance the proposal -- unlike the prescription drug bill two/three years ago.
Dave - Posted on August 18, 2009
So let me get this straight: You're problem isn't the government's scheme to take over healthcare, destroy the insurance industry and intrude deeper into our private lives... it's just that they're "SELLING" it wrong?

My friend... Obama doesn't need a better PR firm, he simply needs a conscience.

Stop reading Paul Krugman and come to America, Denny.
Chris - Posted on August 18, 2009
I wish it were all so easy as a great PR effort (focus groups, terminology refinement and all). From 2004 to 2007, there was a quiet gathering from all major health care stakeholders through Search for Common Ground, a DC-based conflict mediation organization.
http://www.sfcg.org/programmes/us/us_health.html
But the fact is, there is no way to continue the current system without a lot of gored oxes, so in the end, everyone unwilling to give up a LOT is teaming with everyone who never gave this administration a chance in the first place. It's a perfect storm, with or without the perfect marketing antidote. Nevertheless i agree, a more realistic big table approach balanced with a firm PR effort would communicate more confidence in the underlying values and the plan itself, certainly helping to sell it. But it would never go anywhere without a fight from those who have something to lose.. or to gain.
Trish - Posted on August 18, 2009
Denny: Here's one other suggestion I would make: Sell it in manageable bites. Rather than so many different messages (and a 1000 pages of legislation) just tackle one issue at a time so the public can understand. Start with "Getting Insurance for the UnInsured" and once that's passed, move to "Lowering Overall Healthcare Costs". There can be a master plan of where the overall healthcare reform should go, but "Explain it with a crayon."
Jude Dettmann - Posted on August 18, 2009
I hope the President reads this...
Dave Culbertson - Posted on August 18, 2009
Another spot-on analysis, Denny. From my perspective, Eisenhower's ability to be a non-activist president sprung from the fact that he had a long track record of successful leadership before he ever ran. Since then most presidential candidates have lacked a similar track meaning they have to campaign on big ideas / big changes. So, once they get into office they have to start forward with change or they'll be branded as failures. Political ideology probably plays a role also.
Click here to view archived comments...
Archived Comments:
Russ - Posted on August 19, 2009
So let me get this straight... what Obama needs is more focus groups, a better pitch, and maybe a new logo? What planet are you on?

His plan exacerbates health care problems rather than fix them. Socialized medicine (aka: Medicare, etc) is the problem! More of it will not deliver different results.

Obama got caught trying to pull one over on the American public. No amount of PR will change that. It's very simple, his "solutions" are wrong.
Thomas Bodenberg - Posted on August 19, 2009
Denny:

Eisenhower's strength was that he did NOT rely on marketing techniques (though BBDO did his first TV commercials, which I believe were the first ones ever done for a presidential candidacy).

I also must disagree with you regarding the methods used to obtain a proper customer/voter gauge: due to the complexity of the audiences, a focus group would be the LAST thing I would resort to- it would be as if you mailed a test package to ten people, two responded, so you immediately would go for a national rollout as your response rate would be 20%. I would rely on more quantitative techniques (tradeoff analysis) due to the complexity and value of the many interest groups and stakeholders. (That is, what would one be wiiling to give up to attain a desired outcome)

Besides, one vital part of leadership is the ability and courage to ride out the storms and howls of protests from groups which one will inevitably offend during their tenure.

I give Obama great marks for tackling this Herculean task. Bush and Rove lacked the maturity and courage to do so (instead, they would put up a "Mission Accomplished" banner as a distractionary measure- and imagine if the draft was re-instituted for this entire Afghan-Iraqi affair - the burden is on the politically helpless National Guard) -and I'm a registered Republican, was a marketing/customer insights director in the direct response industry (does a little company SW of Media ring a bell?), and have been and currently work in the healthcare industry as a hospital administrator, looking at outcomes and proposing improvements in care.

Marilyn - Posted on August 18, 2009
Excellent commentary on the health care situation. I do hope something can be done to remedy these mistakes. Our system is obviously broken.
Wash Phillips - Posted on August 18, 2009
Lot of slogans in your respondents, Denny. And some familiar (hateful) notions spread by internet alarmists (the kind of p/r nobody—including Dick Armey--admits to knowing). Shills aside, many who attended town halls, saying “Don’t touch our Medicare” were inflamed by pervasive internet pass-arounds and a lot of “gut thinking”(which is not really thinking at all).

Citing Canada and the UK is sooooo passe. A PBS special last year featured 7 working health care systems—all better than our own (if you happen to take Glenn Beck at his revised word that our health care ain't so good after all). Four I recall: France, Taiwan, Switzerland and Germany. Several were single-pay, others not. Criteria were cost, choice, access excellence—the usual.

The CLU responding today must be from a state we should all move to, if we care for health care. An insuranceista, he points to pooling of high-risk drivers so all can have auto insurance as a model. In my state, auto insurance is mandatory, so the pool is ALL drivers, a scheme insuring carriers will not just cherry-pick and walk away. That’s one good reason the whole nation must be in the health pool, one way or another—if we really want to control costs. There are no “pre-existing conditions” for drivers, just higher rates SIMILAR to rising rates on aging persons.

After all, the point of the effort is to make things better, no? It may take tort reform AND medical reform, etc. to meet that goal. The notion that candidates win by making large promises, then are faced (by hook or conviction) to try and achieve them, is apt., and thorny.
bill - Posted on August 18, 2009
But the test market HAS been run, repeatedly, and is still going on in countries all over the world.
Socialized medicine doesn't work.
In Canada the wait for a new personal physician is 6 years. Years.
In the interim you get the clinic's "never the same Dr twice" routine. (The detail in that story is truly sad.)
Auth is wrong about"closet" socialists. Check the credentials(Congress doesn't) of the 32+ Czars we now pay for. Some are far left of Socialist, and that's being kind. There is apparently no felt need for closets for socialists any more.

Bart Foreman - Posted on August 18, 2009
Outstanding analysis of the health care situation. I believe that Obama blew it because he used the same tactic as Hillary did. Rather than a massive program, do it in little pieces and as you noted, test test test and get a PR and marketing person that knows marketing is all about influencing the next sale. Glad you are keeping the math question below simple.
Harvey - Posted on August 18, 2009
As a Vietnam Veteran I can tell you a lot about socialized medicine just speaking about the VA Hospital program. Don't get sick.
Al Stanton - Posted on August 18, 2009
I will address my most basic concern on the Health Care topic. While there are issues within the present bills (both House and Senate) that do raise RED Flags for many citizens, the most disconcerting issue is that President Obama and Congress as a whole have failed to listen to the American people. That's where the present outrage comes from. Our "leaders" are intent on developing their own plan -- their constituents be damned!

We have seen, too many times in the past, where a President and Congress (in particular) have taken a good concept and bastardized it to the point where no one can recogize the original.

Social Security (voluntary at the beginning, with payments to be tax free) has had "feature creep" and extended "inclusions" (who have made no contributions to the plan) to the point it can no longer support itself without higher caps and higher payment percentages for both the individual and the employer. (And, we are all taxed TWICE on our "contribtions.")

Congress WILL pass a Health Care bill that may be "watered down" in order to get the necessary votes publicly on board, with the intent of modifying it at a future date to what the liberal proponents originally wanted -- then taxing everyone, rich, poor and middle class alike.

Think about FICA taxes, coming out of everyone's pay check (while being taxed for those dollars first) -- and companies are expected to provide other "retirement benefits". and the same time."

My concern is that the exact same process that happened with Social Security will occur with Health Care -- and we will all be insidiously taxed -- contrary to what we are being told now that the "rich" will be taxed to pay for this.

When a Health Care Bill passes, Congress will continue to "tinker&
Jim H - Posted on August 18, 2009
Quote: "Based on presidential approval ratings, it's clear we don't like activist presidents. We're comfortable with chief executives that do what's absolutely necessary and no more."

Denny, this is based on an observation of one instance. The statistics may be against you on this one.

My late father - a staunch dyed -in-the-wool Democrat - would say in his Greenpoint accent, "Eisenhower - da woist do-nuthin' President we ever had."

Patty Coldwater - Posted on August 18, 2009
Denny,

I'm surprised that you're making the same mistake the administration is making. You just can't believe that the objections raised at town hall meetings and tea parties are genuine, individual, thoughtful concerns about our cherished American freedoms.

I'm speaking from personal experience. My husband and I have attended several meetings -- no one recruited us or incited us, or (unlike the administration supporters) paid us to show up and express our outrage.

Among the folks we've met are many who voted Democrat, who've never participated in public protests (that's us) before, but are just tired of being talked down to on OUR dime. We're the small business owners, direct mailers, mechanics, plumbers, doctors, elderly, Christians, sportsmen, children with aging parents, parents of young adults, grandparents, etc. who see our way of life, our children’s futures, and our financial resources being co-opted by a bunch of folks WE elected to represent US.

We're expected to go to town meetings and be good, and ask questions, and listen. On the contrary, we see the purpose of the town meetings as an opportunity for our representatives to listen to the folks who put them in office (instead of remaining isolated within the Beltway and guessing what we think or deciding they know better than we do how to "take care" of us). Wouldn't it be refreshing if they asked us some questions? These ARE focus groups.

Most of us have read part, some of us all, of House Bill 3200. What's most shocking and a grand negation of "transparency" is that the legislation is so vague that if passed, the government bureaucracy can "fill in the blanks" with almost anything. Read it. Almost every page gives powers to a variety of appointed panels to supply the details of how this system will operate.

Carol Worthington-Levy - Posted on August 18, 2009
I agree, there is some substantial marketing to be done by the Democrats. The dichotomy in attitude and action between the republicans and the democrats is astonishing! Democrats have good ideas but the forum is so open that the party comes across as disorganized - too many different ideas are thrown at the American people. And the public is not stupid, but they do become confused.

Rule #1 in DM - do not confuse the customer or they will turn you off.

The republicans are frighteningly good at organizing sound bites of monumental and even outrageously twisted proportions and selling them to the public through an organized barrage of consistent messaging. They even contradict themselves and get away with it - Palin passed legislation in Alaska for a day to work on your health including writing an advance directive - and two weeks ago she called such directives a death squad or some other nonsense.

DM Rule #2 - Believe passionately in what you are selling, then organize the "sell" and state what you want them to do, and why, clearly and consistently. Being coy and offering too many choices does not work.

The Democrats and Obama need to hunker down and 'do the Republican thing' - organize and sell their message with conviction! otherwise the nation will continue to flounder in indecision about essential issues.
Brent D. Gardner, CLU, ChFC - Posted on August 18, 2009
1. In my state, there are 929 Medical Doctors that are in general practice / family physicians, according to the state medical board. According to Medicare.gov, only 90 of them accept Medicare reimbursement.

2. The 47 million uninsured is a myth. Out of that figure, there are ONLY 2 million who want/need health insurance and cannot buy it at standard rates due to pre-existing conditions. The rest are eligible for some free or subsidized (read: affordable) coverage and are either too lazy, too stupid, or just refuse to pay even one red cent for coverage.

3. In my state, small group coverage is guaranteed issue (2 to 49 employees). The maximum a company can rate up the group is 166%, which is a steal if you're sick when you compare the premiums to the cost of care.

4. In my state, if you're declined by two companies for pre-existing conditions, you can go into "the pool" which is guaranteed issue major medical. Round figures, the premiums are about 50% higher, but here's the juice on that: The ONLY people who get stuck with this are the ones that WILLINGLY MADE THE CHOICE to go without insurance. Individuals are NOT singled out to receive rate increases because of their individual claims. If you get a DUI, your auto insurance will be higher. If you smoke, your life insurance will be higher. If you're sick, you're health insurance will be higher, UNLESS you bought it WHEN YOU DID NOT NEED IT.

That's how insurance works: Buy it when you don't need it, because when you need it, you can't get it, or it's way too expensive.


Chet.Dalzell - Posted on August 18, 2009
Thank you Denny for informing this debate about the debate. You really nailed down the vested interests here (in the status quo) and fears about the yet-to-come -- and why we need a better way, both in the total package and the selling of it. I don't think marketing/PR can fix it alone -- but taking 1,000 pages and making it simple to understand (based on truths about the plan) has been severely lacking and that's what marketing/PR can do. Meanwhile, the horse trading goes on... At least there's an effort going on to finance the proposal -- unlike the prescription drug bill two/three years ago.
Dave - Posted on August 18, 2009
So let me get this straight: You're problem isn't the government's scheme to take over healthcare, destroy the insurance industry and intrude deeper into our private lives... it's just that they're "SELLING" it wrong?

My friend... Obama doesn't need a better PR firm, he simply needs a conscience.

Stop reading Paul Krugman and come to America, Denny.
Chris - Posted on August 18, 2009
I wish it were all so easy as a great PR effort (focus groups, terminology refinement and all). From 2004 to 2007, there was a quiet gathering from all major health care stakeholders through Search for Common Ground, a DC-based conflict mediation organization.
http://www.sfcg.org/programmes/us/us_health.html
But the fact is, there is no way to continue the current system without a lot of gored oxes, so in the end, everyone unwilling to give up a LOT is teaming with everyone who never gave this administration a chance in the first place. It's a perfect storm, with or without the perfect marketing antidote. Nevertheless i agree, a more realistic big table approach balanced with a firm PR effort would communicate more confidence in the underlying values and the plan itself, certainly helping to sell it. But it would never go anywhere without a fight from those who have something to lose.. or to gain.
Trish - Posted on August 18, 2009
Denny: Here's one other suggestion I would make: Sell it in manageable bites. Rather than so many different messages (and a 1000 pages of legislation) just tackle one issue at a time so the public can understand. Start with "Getting Insurance for the UnInsured" and once that's passed, move to "Lowering Overall Healthcare Costs". There can be a master plan of where the overall healthcare reform should go, but "Explain it with a crayon."
Jude Dettmann - Posted on August 18, 2009
I hope the President reads this...
Dave Culbertson - Posted on August 18, 2009
Another spot-on analysis, Denny. From my perspective, Eisenhower's ability to be a non-activist president sprung from the fact that he had a long track record of successful leadership before he ever ran. Since then most presidential candidates have lacked a similar track meaning they have to campaign on big ideas / big changes. So, once they get into office they have to start forward with change or they'll be branded as failures. Political ideology probably plays a role also.