SELECT YOUR VOTE

Celinda Lake: As we moved from general principles, support was bound to narrow. The major thing we need is for the president to define the plan and what the middle class and small businesses will get. Also he needs to reassure seniors that their medicare benefits will not be cut. The current town halls especially with aarp are a good start

Lurita Doan: Americans are mostly wise and prudent, and as they learn the details hidden in the ObamaCare bill, support drops accordingly. You can expect support to decline even further as folks back home begin to learn more about the dodgy, social experiments that have been included in the 1000+ page bill. Expect public opinion to turn downright hostile as Americans get a load of items, such as those on pages 59 and 195, of the healthcare bill, which make it possible for the federal government to have direct, real-time access to all individual bank accounts for electronic funds transfer and all personal records. Or for that matter, the mandatory requirements on page 425, where the government will instruct and consult regarding living wills, and durable powers of attorney which erode individual liberty and appear to be a greedy ploy to track estate taxes. Americans are unlikely to welcome the mandate to provide all illegal aliens with free health care either: page 91Now might be a great time to scrap the whole mess. Congressmen, Senators, and even President Obama, should be encouraged to take a breath and read a bit more about how our founders formed America to escape the tyranny of a large, indifferent government and confiscatory taxes. Ours is a great story, and it is a pity that most of them seemed to have missed it.

Joshua A. Tucker: I suspect it has something to do with the fact the complexity of the issue area. Given all the different things that need to be done to reform health care, there is always going to be something simple for opponents to grasp on to ("public option = people die waiting for government bureaucrats to approve treatment!"), whereas explaining exactly why all of the different pieces are necessary requires a lot more time and patience. To counter this, I think Obama needs to remind people exactly why so many of them wanted health care reform in the first place, especially by pointing out the problems with the current system in as simple a manner as opponents of the reform point out problems with the reform plans (e.g., "people suffer tremendously when they lose their health insurance because they lose their job"). The press conference last week was probably a good step in this direction, and I suspect we’ll see more of this in the future.One other point to keep in mind. As much as the media (and public opinion scholars!) love public opinion numbers, at the end of the day these proposals are going to come up for a vote, and the numbers that are going to matter then are the votes in Congress. This is not the same game as following polls leading up to an election - in that case, eventually the citizens being polled go and vote in an election. Put another way, the only polls that really matter now are those being taken by the majority and minority whips in both houses of Congress.

Michael Kazin: When people are confused about the content of a bill and the opposition makes a simple, emotionally salient attack on it, they tend to turn it down.  Californians have demonstrated this time and time again when voting on initiatives. The very complexity and vague labeling of "health care reform" have helped put Obama and his allies in Congress on the defensive. Few Americans who are not health care wonks can say precisely what any of the bills would change.In addition, as the President said yesterday, Americans don’t trust the government to get anything right. This is the consequence of three decades in which conservative ideology was dominant — and more than four decades of perceived federal failures, from the anti-poverty program to Vietnam to Katrina and the invasion of Iraq. Passing some kind of health care bill won’t change this perception right away. Even six years into the New Deal, most Americans, according to the Gallup Poll, thought the government was spending too much money on inefficient programs. But if the new order of health care does seem to be working, it will be a big start.

Thomas W. Lippman: This is hardly my area of expertise, but just as a citizen I can sense that Obama is losing ground in the polls because of mishandled public relations. The White House has failed to make any political capital out of the true-life horror stories of uninsured individuals, or insured individuals whose insurance companies wouldn’t pay for their treatment.
See, for example, the article in last week’s Health section by Ken Bacon, former Pentagon spokesman, whose insurer rejected his chemotherapy schedule as "not medically necessary." Why isn’t Ken telling that story on TV at the White House? The administration has allowed opponents of health care overhaul to control the conversation.Consider the opposition to "rationing," which the opponents rail about all the time. The White House has failed to make clear that health care is rationed now — if you are in an HMO, that organization allocates resources to you according to its charts, not your desires.
Similarly, the "people want to choose their own doctors" mantra is heard everywhere — but in an HMO people don’t get to choose their own doctors. And often people with no coverage don’t get to choose any doctor. It may have seemed politically smart to leave all the heavy lifting on this legislation to the Henry Waxmans of the world, but Waxman is a distinctly unappealing character on TV. Karen Hughes would have had plenty of unfortunate folks ready for interviews, to spread the word about the need to do this.

Rory Cooper: Geez, where to start? For one, millions of Americans do not want to lose their private health insurance. The President’s plan guarantees this will happen. Two, everyone knows the Left really wanted a single-payer system, and when you fight for something you only begrudgingly want, you lose. Three, they should have never placated the extreme environmental agenda first with Cap & Trade, which exposed the high tax, high spend, low yield policies of this President. Four, Members of Congress voted ‘No’ to place themselves into the public plan and Americans know what is good for the goose is good for the gander.
Five, Americans don’t appreciate Chicago-style arm twisting, or politicians who don’t read or understand bills they’re voting on. And finally, Six, you have Harry Reid comparing it to the Post Office. Turn it around? Well, there is nowhere to go but up. Drop the public plan, work across the aisle on real reform efforts and Obama can still be the hero.

Greg Dworkin: He’s actually not losing the battle, just losing momentum. This “losing the battle“ is a construct of Washington media, and unfortunately so colors the reporting that nuance is lost. It will then be a Big Headline by Serious People when reform is passed at the end of the year. A more accurate headline is “Obstructionists raise doubts and slow down but don’t stop health reform.”A good example of over-simplification is the oft-repeated “Americans are happy with their health care.” This is a story that Politico and the blogs punctured with a report that Americans are very nervous about their health care (see ‘Insecurity,’ not satisfaction, with heath care system) And reading within the trio of yesterday’s release of polls one sees the hope mixed with anxiety that Americans are feeling. TIME reports: “Forty-six percent of respondents said it was "very important" that Congress and the President pass major health reform in the next few months, and an additional 23% said it was "somewhat important." Only 28% found the immediate effort either not very or not at all important. In a separate question, more Americans said it would be better to pass "major reform" to health care (55%) rather than "minor adjustments" (43%).” NBC/WSJ says “When given a fairly detailed description of the plan they are pushing, Americans registered strong approval, with 56% saying they favor the plan versus 38% who oppose it.” And  CBS/NY Times says “By a margin of 55 percent to 26 percent, respondents said that Mr. Obama had better ideas about how to change health care than Republicans in Congress. In the TIME poll , “Fifty-six percent said they supported a "public health insurance option" to compete with private plans.“

Guy-Uriel E. Charles: The President is clearly battling the effective counter-messaging of the Republicans and those opposed to healthcare reform. The counter-message is clear and simple to articulate: if you buy the President’s plan you will have costly government-run healthcare. By contrast, the Administration continues to struggle to communicate its message in clear and concise terms. A recent NBC/WSJ poll shows that once the principles of the Administration’s health care proposals are explained to voters, they support it by a strong majority. But trying to explain those somewhat complex principles is challenging. I think the Administration was initially thrown off course by the expressed desires of the American public for health care reform. People want health care reform, but they are also risk-averse.I am struck by the way the President’s argument for healthcare reform attempts to appeal almost exclusively to the self-interest of Americans: this is what healthcare reform will do for you. Moreover, each iteration of the Administration’s healthcare message appeals to an a narrower set of our self-interests. I am surprised by the absence of a moral argument. You don’t hear the President talk about healthcare reform as a moral right in one of the richest countries in the world. Or about the importance of making sure your neighbor has healthcare even if you have health insurance that you’re happy with. What you hear about is exclusively how healthcare reform not only will not take money out of your pocket, but it will put money back into your pocket. I’m sure that the President’s poll tested message was deemed most effective. But I think it is a mistake to appeal only to our self-interests on this issue. This is a President that was elected in significant part because of his perceived ability to get the American public to think beyond the narrow confines of our self-interests. He was elected in part because of his ability to inspire us to see something better for all of us.

In my view, the most significant limitation of an appeal to voters’ self-interest is that each iteration of the message appeals to a narrower principle of self-interest. An argument based upon self-interest is an explicit invitation to bargain. This is why the President’s message now is essentially: you (the voter) can have better healthcare but it won’t cost you anything. I’m sure this strategy works in the short-term, but I’m dubious that it strategy will work in the long-term. At some point, even the most self-interested buyer becomes skeptical of a salesperson who wants to sell them a very valuable item for nothing if only the buyer would sign on the dotted line.

Fred Barbash: See Gallup’s "Benefits of healthcare reform a tough sell for Americans," NYT’s "New poll finds growing unease on health plan," and WSJ’s "Support slips for healthcare plan."

Roger Pilon: It should hardly surprise that President Obama is losing the battle for public opinion on health care. His inflated promises got him elected. But enough Americans are now focusing on those promises to realize that they’re empty. We don’t know how we’re going to pay for Medicare’s promises, looming just ahead, yet Obama is promising vastly more. He’s up against reality, and Americans know it.As Politico reports this morning, the congressional coalition that looked like it was forming yesterday is already breaking apart, with liberals like Jerrold Nadler and Barney Frank saying they won’t vote for the current watered-down “deal.” They and their cohorts seem perfectly happy to live in their tax-the-rich dreamworld. But that dream leads inevitably (taxation has its inherent limits) to rationing healthcare for everyone. I’ve just returned from two weeks in Europe, where the complaint is that they can’t get the miracle drugs that Americans take for granted. Their socialized health care systems can’t afford them (or won’t pay for them – the decisions are political, after all). More and more Americans are coming to understand that that’s what’s in store for us under Obamacare, and that’s why he’s losing the battle.

There are huge problems with America’s health care system, but further socializing the delivery of health care is not the answer. To the contrary, as in so much else, the socialization of what is, in the end, a private good, is at the root of our present problems.

Julian E. Zelizer: It is not clear that he is losing the battle of public opinion. The public still supports him, they trust Democrats more than Republicans to solve health care, and there is support for some kind of reform.
Nonetheless, support for the current health care reform plans has slipped and Republicans have gained ground attacking any health care plan by Democrats as a big government takeover. President Obama has not done nearly enough to counteract these attacks. He needed to enter into the public debate more aggressively and do a better job selling his vision of health care. This is essential or Democrats will lose. When Republicans charge that this will destroy health care, he needs to offer a more compelling argument.President Obama needs to use August well. Rather than Martha’s Vinyard, he needs to spend the month putting the legislative pieces together for the public and help citizens—and just as importantly legislators–understand how a major intervention by the federal government can produce good outcomes.

He will also need to make a huge decision about the bill currently in the Senate Finance Committee. It is very likely that he will face a major choice in September. On the one hand, he can insist on a bold measure that fundamentally reforms health care. On the other hand, he can accept a severely watered down compromise that gives him a short-term victory but does not have a major impact on the problems facing health care and creates disillusionment about reform.

Victoria M. DeFrancesco Soto: President Obama is not losing the battle for public opinion on health care, at least not yet. Currently the public is reacting to the back and forth wrangling in the Congress. The American public is getting a close-up shot of how the sausage is being made and this is exactly what Obama wants.The failure of the Clinton health care reform was largely due to the lack of congressional participation in the drafting of the reform. Obama has learned from the mistake of the Clinton administration and actively encouraged the participation of Congress. Whether this route will prove successful is another matter.

Currently we do not even now what health care position is the front-runner. The polls are tracking the congressional drama. Once a health care option is hammered out then we can judge if the administration’s battle for health care was one or lost, but we haven’t even reached half-time, we still have two more quarters of play time ahead of us.

Bradley A. Blakeman: President Obama is losing the battle with the American People on healthcare because it is not healthcare that requires immediate attention it is the economy. We are experiencing the worst economy since the Great Depression. I did not say those words the President did. Why then is he not focusing the majority of his attention and spending his political capital on accomplishing success on the economy? If the “stimulus” would have worked as promised and unemployment did not rise past 8.5% and the monies approved had been spent as intended, the President could have gotten his healthcare plan approved. The American People are loosing their trust in the President’s ability to focus, prioritize and deliver on the issue of most importance. It’s all about the economy. Americans do not see healthcare as a crisis, they do see the economy as one. When Members return home to their districts, I believe their constituents are going to give them an earful on the economy. They are not going to be concerned at this moment on healthcare. Healthcare will have to wait unless and until there is significant improvement with our economy. It is sheer “stupidity” for the President and his Administration to be so out of touch . I suggest the President have some beers with average Americans and maybe he will be enlightened as to what most concerns them.

Lanny Davis: There are really only three core messages that must be addressed and, for some reasons apparent and some not, the White House has failed to clearly and concisely communicate them on a consistent basis: choice, quality, and cost.

Since these were the three insufficietly addressed concerns that brought down the 1994 health care plan by the Clinton Administration and congressional Democrats, maybe the White House needs to hit the "reset" button, take the 1,000 waterfall bill, and pit ot through the garden hose and narrow the message down to addressing these three core issues.

Charles W. Calomiris: President Obama is losing the battle because his healthcare policy proposals are bad and his disingenuous portrayal of them has been exposed as such. His proposals would increase the cost of healthcare, reduce its quality, and reduce the control individuals have over their lives — a lose, lose, lose — and would fund this disaster with higher taxes (as if his other proposals on cap and trade, spending, and tax policy hadn’t already created enough adverse consequences for economic growth). He pretends that the consequence of his healthcare proposal would not be to drive private insurers out of business and create a new government-imposed and administered set of standards for healthcare provision, when the proposals obviously would achieve that unwise objective. The Obama healthcare plan is nonsensical economics, and is out of step with Americans’ common sense and values; the public dislikes the Obama plan because they can see this proposal for what it is: bad economics and a significant erosion of personal freedom.

James G. Gimpel: I don’t think the answer to this question is very complicated: people don’t want to pay more for something that will likely be lower quality than what they currently have.

Timothy Stoltzfus Jost: First, I am not sure I accept the premise. Polls still show substantial support for the idea of reform in general and if questions are asked fairly for specific parts of it. This morning’s polls, for example, show that twice as many Americans favor a public plan as oppose it. They also still believe the Democrats have better proposals for reform than the Republicans.
Support has certainly eroded in recent months, however. I blame this largely on the media. The media loved Obama during the election season but his initiatives have received largely critical coverage for several months now. The mainstream media has covered health care reform as a political story, paying far more attention to the daily political battle than to substance. At the same time, the right wing talk radio and cable news propaganda machine has been spreading lies about reform proposals which the responsible press has not forcefully rebutted.Americans are innately suspicious of government and its ability to help them. Most Americans are healthy and reasonably well insured, and worried that things could get worse rather than better. . Most are also, however, a pink slip away from losing their coverage and a car accident or heart attack from finding out how limited their insurance coverage actually is.

No one, least of all the media, is telling Americans what reform actually means to them. If reform is adopted and you are in a family of 4 and you earn less than $88,000 a year, you will get help with your premiums if you lose your insurance. You will have the option of a public plan that will probably cost less and give you more choice of provider than private insurers. You will no longer face denial of insurance because of a preexisting condition or rescission of your current policy when you get ill. You will be secure in your health coverage no matter how uncertain your life may otherwise be.

This is the message Obama needs to get out. His campaign machine needs to be mobilized again over the next month to get this message out. But it would sure help if the media would do its job–providing Americans with the facts on how health care reform will actually affect them.

Darrell M. West: Fear trumps reason. Opponents have made the argument that government is taking over health care, costs will rise, and patients will lose choice of their medical providers. Democrats need to get serious about cost containment to dispel these myths. We need serious reimbursement reform that alters the incentives care-givers currently have for volume business and more toward a focus on quality health outcomes.
 
 We also need to use health information technology to change organizational routines so that duplicative tests are eliminated and efficiencies are gained through improved administrative processes. The president is shifting his sales pitch from the 18 percent without health insurance to improving the quality of the service for the other 82 percent with health insurance who are upset with insurance restrictions, pre-existing conditions, and lifetime limits.

Despite all the political problems, 55 percent of Americans believe President Obama has better ideas about changing health care, compared to 26 percent who feel that way about congressional Republicans.

Theda Skocpol:  As one who has studied repeated political battles over health care reform in America — this has been going on for a century — I think it is premature to say that "Obama is losing the battle for public opinion." He is still more trusted than any other actor in this repeat drama to come up with good solutions — and that opens the door for him to give a major speech in the early fall.
The problem the President and the Democrats have faced over the past six weeks is the intersection of continued worries about the economy with the spectacle of Congressional bargaining and posturing as two houses of Congress and five committees chew all this over. That sews confusion in the public, opens the door to the kind of scare campaigns that always occur when health care profits are at stake, and makes it hard for Obama and the Democratic leaders to explain a "plan" because they do not yet have one.Despite all this, we are closer to comprehensive health insurance and care reform than we have been in a hundred years because so much progress has been made on overlapping bills in Congress. We can be pretty sure that all this is going to come to up and down votes in the fall. The next month until Labor Day may or may not be as decisive as the press narrative is claiming. A lot of people will check out and to some degree overdose on the scare campaigns. Democrats and friendly groups will have a chance to explain especially the House bills to people in the districts and states — and there will be fewer opportunities for Congressional posturing in the national media during a recess. Obama et al in the administration will have some opportunities for their new approach — probably belated — to stressing protections for all insured Americans.
Most important of all, most citizens/voters will still want to hear what Obama has to say in September. That is when the crunch will come — for him, as he has to choose among Congressional initiatives, and for the rest of us. He will have one more chance to give a highly visible explanation and exhortation — hopefully in a setting where Henry Louis Gates and the Cambridge police will be nowhere to be seen! Democrats in Congress will be bombarded and will face an anxious public to the end. But they know that doing nothing would be the worst for them, so they will do something. Remains to be seen if it will be good for average people as opposed to established interests.

Al Cross: Obama is losing ground because it’s a complicated subject that engenders skepticism among the public and is easy to distort, and I suspect because people increasingly get their information these days from sources that are superficial (TV) or partisan. In part, the news media are to blame; the market for opinion in this country has been increasing for more than a decade, and the market for fact has been decreasing, as an increasing number of outlets fractionalize the audience and seek some sort of distinctive niche.That is easier to develop by presenting opinion rather than fact. Perhaps more importantly, facts are expensive to gather and present. In this case, in one sense we actually have a shortage of “facts” and a surplus of opinion because there is no one piece of legislation on which to focus. A recipe for confusion and stalemate. Perhaps this week’s negotiations will clarify things.

One more point: Note this week’s Wall Street Journal story about ads in the health debate bolstering local TV stations. How many of those stations will spend some of that money to prepare and air reports explaining the legislation and the issues? Very, very few. Cuts down on the story count and bores viewers.
 

Dean Baker: First, it is not clear that President Obama is losing the battle for public opinion. The latest polls still show that the public trusts him far more than the Republicans to deal with health care. However, there is no doubt that the public has much greater concerns about his proposal than two months ago.
Some of this slippage was inevitable. No one expected that the various interest groups and the Republicans would just roll over and let the bill pass. They have been firing full force and it has had an impact. In addition, any proposal like this will always sound better in abstract than in the particulars. Yes, there will be some costs and yes, some people may not always be able to get whatever treatment they would like. So, it is not surprising that some people would be less enthusiastic in their support.
 However, part of the problem is that the Obama administration has not always made the case as clearly as possible in terms of what people will under his proposal. First and foremost, the 85 percent of the under age 65 population who are already insured will gain security that they don’t currently have. As it stands, if someone gets a serious illness that causes them to lose their job, in most cases they will also lose their insurance.
Under President Obama’s plan, these people will still be able to get insurance at an affordable rate, thanks to both community rating and the generous subsidies in the plan. This is a second point that most people have not appreciated. While the right-wing media (e.g. Fox and the Washington Post) have eagerly touted the "huge" cost of the subsidies, they have not pointed out that these subsidies effectively increase the incomes of tens of millions of families. So the public has seen the pain, but not the gain. President Obama will have to make very clear to tens of millions of low and moderate income families that health care will cost them much less money under his plan.
His plan will also be a huge boon to small businesses, especially if it includes a Medicare-type public plan option. Small business owners would no longer have to worry that their insurer will raise their premiums by double-digit amounts year after year or wade through various complex plans to find a better alternative. They could just go with a public plan that provides good care and go back to running their business. These are the sorts of points that President Obama will have to pound home in the weeks ahead if he is going to get his plan through Congress.
The enemies of reform are making sure that the public hears all the negative aspects of the plans in their full exaggerated form. President Obama must ensure that they also get the positive side.

Amitai Etzioni: Obama focuses on the unisured, which to most in the white middle class and working class means taking from me and giving to “them.” Just the way these classes reacted to welfare and Medicaid.

Obama must call attention to the fact that most of those who are insured—can lose it in a jiffy. Because they lose their job, or their new job does not provide much insurance, or because the corporations welsh on their commitments. About 12,000 Americans are loosing their health insurance every day. In short, health insurance should become like the rather popular Social Security and Medicare—not openly transfer payments but a benefit for all.Obama’s other arguments just undermine his credibility. It is hard to believe that his plan will cut health care costs, that otherwise the economy will not recover etc etc.

James Carafano: Taking a SWAG: They call it SWAG-a Scientific Wild A** Guess. My SWAG is that most Americans don’t like what they are hearing and disagree with the president that getting it done fast is more important than getting it done right.

The future economic viability of our nation is on the line and with it our capacity to keep the nation safe, free, and prosperous…we should only accept "reform" that leaves Americans substantially better off.

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