Peter Baker of the New York Times writes about the Obama administration’s effort to explain the continuing unpopularity of the Affordable Care Act. (Baker points out that just 32 percent supported the Affordable Care Act when it was approved in March 2010, according to a New York Times/CBS News poll; and as of a month ago, 34 percent supported it, virtually unchanged.)
The problem, Team Obama would have us believe, has nothing whatsoever to do with the defects in the law. The blame rests with an insufficiently effective PR effort.
“Unfortunately, we never had a really effective strategy around communicating to the public the benefits and the rationale behind health care reform,” said Ezekiel J. Emanuel, a physician and University of Pennsylvania vice provost who was a top White House adviser involved in developing the program. “We never had a spokesperson, and the public never really understood what we were doing.”
That failure still baffles supporters like Dr. Emanuel, given the significance of health care to Obama’s legacy. Some see it as a result of the president’s own instinctive diffidence or the natural desire to move to the next challenge. Others note the complexity of the act itself, or criticize the president’s advisers for not being more assertive.
But as I showed in this essay in COMMENTARY, the White House was highly aggressive in its public advocacy for reform. In the summer of 2009, for example, it was “all Obama, all the time,” in the words of the Washington Post. The president was “so active in advocating health care reform in September that some commentators suggested he was in danger of overexposure,” according to presidential scholar George C. Edwards III. Nothing worked; the Affordable Care Act became progressively less popular the more the president spoke about it and the more the public learned about it.
Champions of the Affordable Care Act, however, cannot handle the truth. They therefore seek refuge in the all-purpose, easy-to-apply We Have A Communications Problem explanation. This is self-deception of a high order. But when you’re allied with the Obama administration, it’s often the only excuse you have left.
and Wehner rarely comes near it, being mostly a spin nurse.
Yup… Note that individual parts of ACA are popular, but the entire act becomes effective only in 2014. So it is hardly surprising that the public is largely unaware of the benefits. n nMedicaid and Medicare were once controversial too, BTW. n n
I think the public understood only too well whre Dr. Emanuel wanted to take us: n nTo the UK, where hundreds of thousands are eased not so gently into the night when the reach an age society no longer finds them economically useful. n nLook up abuse of the 'Liverpool Protocol'. n nMakes Dr. Kevorkian seem an angel of mercy by comparison. n nOne more thing: Panels empowered to decide the emdical effectiveness or interventins based upon statistics will by definition reject payment fo techniques deemd to be effecgtive in only a small subset of patients. n nThis flies in the face of trends in cutting edge medicine, that show responses to interventions are often highly dependent upon an individual's genetics. n nLeft to progress along a truly scientific trajectory (as opposed to the politicized, economically driven medicine of the the Dr Emanuels of the world), interventions would become highly specialized to the patient. n nWe may now never get there, because the focus on 'evidence based' medicine, when we do not yet have all the evidence, will likely lead to the shutting down of whole areas of investigation. n nObama's and Emanuel's vision is a rationed, one size fits all future. Choose from menu items A, B, or C. No substitutions. No custon creations just for you. n nHello, Liverpool Protocol! Welcome to America!
I don't know that they could have sold Obamacare — but if they couldn't, what should have happened is that it went down to defeat. Obamacare was slammed through, practically in the dead of night, crammed all together so that there was no input allowed. It was all Obama all the time — but it was disdainful Obama. What was missing from the legislative process was people discussing the different parts and amendments and party differences and various alternatives at home with their families over drawn out news stories that would have enabled people to become comfortable with what it was all about and either come to believe in it or move Congress to vote it down if they didn't. That, I think, was Obamacare's only hope — and Democrats Obama, Pelosi, and Reid blew it by making the process undemocratic in the most polite terms and, in less polite terms, the most blatant case of dictatorial fascism in American history.
in the dead of night????????? n nperhaps the months of wrangling over it escaped your attention.
um, the law passed–it's on the books. Peter's take on its popularity may well be true, but somehow O continues to poll well in swing states and Romney the Repealer continues to show longstanding weaknesses as a candidate–over calculated fence straddling and a campaign entropically dissipating into a fog of Hello Kitty bromides as the Dems wage their anything-goes knife-fight death by a thousand cuts strategy. All things considered Romney's much-bespoke intention to repeal Obama care on the first day of his administration is stil a long-odds call not a sure-thing wager. It may collapse like a house of cards built by Ponzi and every red-blooded American outside the inside-the-beltway ivory towers of the pointy-headed intellectuals may think it's spinach and it stinks. But, here it would be. The administration doesn't have to defend it, it is delegitimating its opponents. It would be nice if O, since the thing is left on our doorsteps, would communicate the available insurance options for people who would otherwise find getting health insurance prohibitive or impossible.
It's perfectly reasonable for Obama to lack the understanding that folks don't like what he's selling. Four years ago, his persona, his history, the DNC and the mass media (but I repeat myself) sold him and his policies and Americans bought them in the most important poll of all. So why doesn't the magic seem to be working now? nI guess you only get to run as a demigod once.
foxtrot and besht, as far as I know, Obama's law takes away a lot of coverage from retired people. It sets up "death panels" that did not exist under Medicare. It makes the whole system much more complicated and therefore more costly. Covering uninsured people could have been done more cheaply and equitably than what Obama did.
I have seen no evidence of death panels. Though yes there are formalized cost containment measures and these may formalize restricted access to therapies by the elderly down the road. And it does deep six the Advantage Plus Medicare option for running Medicare through a subsidized private insurance broker. That's gone. And built-in rounds of payment cuts to health care providers will drive even more doctors out of Medicare–and if they are cancelled than the financial hazard of Medicare gets even more pronounced. n nSo sure I personally see your argument about the Rube Goldberg administrative contraption that is ObamaCare. n nExcept that consistently private insurers have been reluctant to insure elderly or people with existing conditions who are not folded into a company plan where they work. If there had not been COBRA/.Hipaa legislation a lot of folks would not have any health insurance. It would be flat-out denied. Or they'd have "insurance" that wouldn't insure the conditions that require insurance in the first place for a probationary period. n nSure ObamaCare sucks. But up to now the Republicans have been floating the idea of less not more coverage for elderly, of shipping off Medicare to the states and letting the sick elderly enjoy the wonder of those insurers who are just chomping at the bit to compete for their business (they are not).Ryan suggests voucher subsidies but unless the elderly are hung out to dry their subsidy payments would balloon repeating our present fiscal problems. n nAs a senior citizen this is my position. Do you want us to die paupers in the alley ways of America? Then rave on about unshackling the private market to care for us because the private market doesn't want to take care of us unless they get big bucks and we don't have that money. And third-party insurers don't want to make up the vig for us.
Besht — I do see your point about those the insurance companies don't want to cover, which would always be those most likely to need insurance. It's a true point. I would also note that the care that is available to the poor (the care available by qualifying under poverty for sliding fee medical care) doesn't normally include tests to see what's wrong. One goes to the hospital, receives some blood tests maybe and any necessary prescription, or gets a break set or wound stitched up … but then one is sent on their way, maybe being told to see a doctor for follow-up or a specialist for tests for what the doctor suspects is wrong (which part isn't paid for). So, when anyone says medical care is already guaranteed for the poor, that isn't precisely the case. n
Part 2: n nI really like Ryan's vouchers to buy insurance to replace Medicare and Medicaid and expand it to the uninsured, because it keeps the government bean counters out of it; however, insuring those insurance companies would wish not to or deny outright for pre-existing conditions has to be done by law, I agree. I would add as a scary thought on insurance companies that it is not even rare for a company to eliminate an entire type of policy in order to issue a new updated policy that takes new regulations and adds customer desired benefits … except that once they cancel the whole class of policies, which isn't discrimination, they don't have to give you a new policy if you can't pass the physical!
you don't know quite far enough, Eli……the thing that passed is flawed in many ways, but pu-lease don't abuse us all with the 'death panel' lingo. that chock of shinola is grossly redolent of mendacity. n njust about every one of us having private health insurance is more subject to being "death panelled" than you might understand. almost no one has a private policy that's not explicitly capped.
The more people learned about it, the more it became reviled, all the selling in the world can't change something that was done by party hacks. The Demo's own it lock, stock, and barrel. It was a devil's bargain and November's election will be a bloodletting, and they know it.
Who can blame a portion of the public for being against Obamacare (aka Romneycare) when the Right is spending millions lying about it. It's an old tactic with them: n n"If you don't stop Medicare, one of these days you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free." n– Ronald Reagan
Ron was correct then and he's correct today more than ever!
he was a man of limited intelligence and questionable understanding then and he hasn't gotten any better, except in comparison to the geeks of today's republican party.
Mike is as stupid as the vermin who run today's Democ-rat Party and have made it into a facist party.
I might well be , but I'm not in their party nor do i admire them either.
you're describing only the end-game. there were months of public argument and many, many millions spent on all sorts of stuff designed to sway opinion and votes prior to that…… n n nbut anywho, quite enjoyed your comment and the link.
ty!
n nbut for sure I agree, this is the legislative debate that will not be silenced. still. today. here. there. I do passionately wish that Obama had not married a particular governing style of opportunistic cynicism with a legislative style of regulatory expansionism that seems, with the ACA to have arrived at an apotheosis of connect-the-dots amalgamation of whatever boards, mechanisms, shared pools, and arcane levels of administrative esoterica could be assimilated into the borg.
Keith, his facts are correct and that in no way equates to the crud about "death panels"
mankind for the most part are fools !!! and liberals are fools and idiot's !!!!!! , the country is "BROKE" and they are arguing about a program that this country cannot afford !!! , idiots and fools !!!!!!!!!
The president started out by declaring soaring insurance premiums unsustainable. If not arrested the nation's medical bill would break the country. That is what he said, and he added that fixing the problem was his responsibility. n nHis fix requires taxpayers to pay for the coverage of an additional 35 million people, and forces insurance companies to reduce coverage limits. This bends the cost curve up instead of down. In short, Obama has hung more jewelry around the nation's neck. It sparkles alluringly but at a cost that is even less sustainable than before. We have been made sicker, not healthier.