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First there was Frank Luntz. Now, Celinda Lake is trying to do for the Dems what Luntz did for the GOP. Lake, a longtime Democratic strategist, has been hard at work crafting the right words and phrases to persuade the public that Dems really do have their best health care interests in mind. For months, politicians, advocates, and especially the president have talked about âaffordable, qualityâ health careâa Lake-fashioned phrase that has caught on big time. Reporters have repeated these words without providing any context about what they meanâthat is, if they mean anything. Insurance premiums lower than $12,000? A guarantee that your doc will never make a mistake? Take your pick. Those words are as hollow as a straw. Theyâre supposed to be.
In early June, a memo circulated from the Herndon Alliance and Lake Research Partners telling advocacy groups and other interested parties precisely what words they should use to counter Republican messages as health reformâs verbal war begins. The Herndon Alliance, which calls itself a non-partisan coalition, has partnered with some 200 organizations, including former single-payer advocates, think tanks, foundations, advocacy groups, businesses, and health care providers. The Alliance claims to âprovide value-added services to partner organizationsââi.e., helping them develop communications strategies. Lake has worked closely with the Alliance in crafting messages its partners can use. She has counseled the Alliance’s partners against using the term âuniversal coverage.â Maybe thatâs why itâs not talked about much anymore. Similarly, she tells activists never to say “Medicare for all.” Instead, they should say “choice of public and private plans.”
You might say that the memo was the Lake version of a Frank Luntz message that was leaked to Politico in mid-May. Luntzâs memo quickly raced through the blogosphere, with liberal bloggers hotly debating what it meant for reform prospects. In the memo, Luntz counseled Republicans to humanize, personalize, and individualize their approaches by using personal stories, and to talk about eliminating waste, fraud, and abuse as the ways to reduce health care costs. Luntz also told GOP politicians to acknowledge there is a health crisis but to blame it on the government; to demonize âpoliticians,â bureaucrats,â and âWashington;â and to use the term âgovernment takeoverâ whenever they can.
Lake advised her followers to parry that message by saying:
Itâs time to stop playing politics and solve the health care crisis. Health care reform will give you the freedom of choice to keep your current plan including keeping your current doctor, or choose another private plan, or the choice of a quality affordable public health insurance planâŚ. Health care will be affordableâit will cost less and cover more. It will be a uniquely American solution that gives you peace of mind of knowing you will always have quality, affordable health care.
Lake says that frame is âso effectiveâ because it taps into the publicâs key expectations for health reform, such as the choice of keeping your current plan and doctorâthe president uses that one; affordability (paying less and getting more)âlots of groups are using that one; and finding a uniquely American solutionâinsurance companies and Sen. Max Baucus have used that one. But wait a minute. Didnât the phrase âuniquely American solutionâ surface with Bill Clinton? In the early 1990s, as Clinton began to craft his plan based on managed competition, he framed it as his âuniquely American plan.â How many uniquely American plans can there be?
Whether Luntz is a bad guy or Lake a good gal is beside the point. The real takeaway is what journalists can learn when they write about health reform from this moment on.
Lesson One: Democrats play the same game as Republicans. What weâre seeing is a game of spin vs. spin, and a reporterâs job is to sort it all out for the public.
Lesson Two: Recognize Lakeâs focus-group tested words when an interview subject stays on message and keeps talking about affordable, quality health care. Itâs best to avoid quoting someone who uses those words unless they have something more significant to say. Reporters shouldnât be used as propaganda ministers.
Lesson Three: Be on the lookout for other empty, Orwellian terms. If you find them, same advice applies.
Lesson Four: If you must use these terms, please add context. Lake advises: âDonât just say âbring costs down,â and that ââIt is better to say âhealth care reform will make health care AFFORDABLEâit will cost less and you will get more.ââ Hey guys, thatâs not likely to happen if the current nostrums for reducing medical costs remain the only ones on the table. As for getting more? The current trend in health insuranceâshifting costs from insurers and employers to policyholdersâmeans thousands are getting fewer benefits, not more.
Lakeâs memo advises that advocates should not compare the U.S. to other countries, or assert that America does not provide quality health care; neither should they mention that the U.S. is thirty-seventh in the world in health outcomes. Does Lake want to hide the fact that the U.S. performs poorly? My goodness, she almost sounds like a Republican!
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