Sunday, July 21, 2013

"ObamaCare" Small Ball––The Republicans Are Winning the Battle Over the Big Idea

Last week the President waded directly into the national debate over "ObamaCare" by calling a big media event in the East Room of the White House to talk about the $100 rebates a small percentage of potentially eligible people are getting under the new health law.

Senate Republican Leader Mitch McConnell countered, "If you’re a family in Covington facing a $2,100 premium increase under ObamaCare, then, really, what would you rather have: a check for $100 or so, or a way to avoid the $2,100 premium increase in the first place?”

NPR's Julie Rovner had a story on Friday––"White House Muddles Obamacare Messaging Again"––that caught my eye.

She drew a distinction between how the administration has been going about unsuccessfully selling the new health law and the way the Republicans have been more successfully attacking it:


Still, there's a major difference in the way Republicans talk about the law and the way the president does, says George Lakoff, a professor of linguistics at the University of California, Berkeley and an expert on political messaging.

Lakoff says Republicans talk about the law as a moral issue. "Basically ... they say that democracy is about liberty, the liberty to pursue your own self-interest without you having to take care of anybody else's interests or anybody else having to take care of yours."
But when Obama talks about the health law — at least this week, says Lakoff — "his message was all about money."
And Lakoff says that's pretty much been the president's problem: He's mostly shied away from talking about health care on the same moral terms as have the Republicans.
I have been very surprised at the way the Obama administration has seemingly stood by helplessly while half of the states have rejected the Medicaid expansion. Here we have the opportunity to uniformly bring people who live under 138% of the federal poverty level into a rational system of insurance and the administration has not been able to paint that failing in moral terms.

And, yes I understand the Medicaid system is not sustainable. But Republican Medicaid reform proposals allowed to play out in the state laboratories could have shown the way to sustainability. See: The Medicaid Controversy––The Republican Governors Should Put Up or Shut Up

So, while the Republicans consistently win on the Big Idea––albeit in almost entirely negative terms because they don't have a comprehensive alternative to "ObamaCare," Democrats play small ball.

Perhaps Democrats can't get past small ball because The Affordable Care Act ("ObamaCare") itself is small ball.

It is not health care reform––it is an attempt at health insurance reform at a time when all of our health care system––Medicare, Medicaid, and private health insurance––is not sustainable.

"ObamaCare" is also lots of pages of health insurance market micro management––small ball if there ever was any. Now, the administration is tying itself up like a pretzel trying to figure out how to make it all work with time running out. All the while individuals, small employers and large employers are fretting over how the new law will impact them.

It shouldn't be a surprise that this administration, now buried in the minutia of injecting an extraordinary amount of micro management into a sixth of our economy, would think a $100 rebate for someone already paying thousands of dollars in health insurance premiums would be a major accomplishment.

I opposed "ObamaCare" in the first place because I thought it was a clumsy attempt at insurance reform and certainly not health care reform. Most importantly, I thought it was wrong to make promises––"The Affordable Care Act"––the law was never designed to keep.

Now the administration is in the final phase of trying to convince people this was all a good idea.

But, just exactly what was the idea?
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