What Democrats Should Say on Healthcare: It's a Story With a Hero and Villains

How can Democrats revive flagging public support for healthcare reform? Well, now that Congress is on summer vacation, the reformers must think about and reboot their campaign.

And they appear to have already started: In the last few days, the House Democratic leaders called for a new message strategy to build public support for healthcare reform. Speaker Nancy Pelosi of California has heated up the rhetoric by describing the insurance industry as the "villains" in the piece. Majority Leader Steny Hoyer of Maryland told reporters that the Democrats would develop a "more focused" message.

Both leaders are absolutely right. Democrats need to change the tone and content of their message in order to get the fundamental changes in healthcare that Americans need.

There are two ways to frame the battle over healthcare reform, the right way and the wrong way.

Conservatives would like to make the fight a question of whether government control of healthcare is a good or bad thing. And unfortunately, they have succeeded in making much of the debate over healthcare about the question of government control.

In a recent CBS News/New York Times survey, 7 out of 10 Americans said that they were somewhat or very concerned that the quality of their care would get worse in a government-run system. Another 3 out of every 4 people think that the cost of their own care would increase under government control. GOP scare tactics have had a big impact.

The question that Democrats should force the Republicans to answer instead is whether or not we need to completely change healthcare to keep America and Americans from going bankrupt. What Democrats should say is that the healthcare system is so fundamentally flawed that we should tear it down and build a better system from scratch.

The Times and CBS survey indicates that Americans want major reforms. Half the public desires fundamental changes and another third want to completely rebuild the system. Democrats should make this debate about whether the system requires major change or whether we should continue business as usual. That's a debate that liberals will win.

Now of course the only way to fundamentally change the system and reduce healthcare premiums is a public or patients' option that will end the monopoly that a small groups of insurers have in each state or area. If the private insurers have to compete with a patients' option, the cost of premiums will decrease. But the public option should not be the lead in the story.

Americans want change and that's why Barack Obama is president. The president understands this and he used the word "change" more than 20 times in his most recent press conference. But the serenity that served Barack Obama so well during the presidential campaign isn't powerful enough to stifle the fear about healthcare reform that conservatives have generated by spending $9 million on television ads.

Democrats need to get mad and tell a horror story. Every story needs a hero, a villain, and a threat to the beleaguered villagers. The narrative (beltway speak for story) should be about the hero (the brave, young president) who fights the villains (the greedy and immoral health insurance companies) who plunder and pillage the villagers (the hard-pressed American people).

Hopefully, this scary story will have a happy ending.

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