Health Reform Brainstorming, Cindy Mann, Mingling with Outside the Beltway Folks Top Highlights of Conference – Say Ahhh! A Children’s Health Policy Blog

Children’s health advocates from 21 states descended on Washington to participate in the Georgetown CCF Finishline/Narrative Conference.  The highlight was a visit from our favorite health policy guru and newly installed Medicaid/CHIP Director Cindy Mann.  As usual, she lit up the room with her youthful energy and passion for children’s health issues.  We were all thrilled that she took time out of her busy schedule to visit with old friends.  

I love these conferences – no really, I do.  Besides the fact that you can usually count on three square meals and lots of snacks, I like the energy and renewed enthusiasm I get from mingling with outside-the-beltway types.  I also like the thought provoking questions and brainstorming that happens all to infrequently in our work.  While health reform is working its way through the legislative process, trying to get a handle on it is a bit like trying to catch a greased-pig (maybe not the best word choice).  New developments were occurring on both sides of the hill at a rapid pace during the conference so it was a great time to really focus and get the perspectives of all the health experts in the room on what it could mean for children’s health coverage. 

Besides those big issues, there were some smaller, more concrete lessons learned.  For me, the conference served as a reminder of the importance of thoughtful word choices in messages (note poor word choice above — I guess I have a ways to go in that department) .  While I don’t agree with Frank Luntz on most policy matters, I do agree with him that words matter.  

For example, many of us previously used the term “woodwork” effect to describe the fact that when states expanded health coverage programs many of the new enrollees were actually lower-income and had been eligible but un-enrolled prior to the expansion.  Some of us thought the term had negative connotations so we coined the phrase “welcome mat” effect to equate it with the fact that when people feel welcome, they’ll come to your door.  

Another reminder came from a participant from North Carolina when he described their battles to create a “medical home” model.  That term was shunned decades ago as the public thought they were trying to somehow insert themselves between parents and their children.  

A participant from the West Coast described how the public has become  so fed up with hearing about state budget woes that they had to drop that term from their messaging altogether.  They get much better results when using terms such as “economic crisis”.  

A participant from Illinois, John Bouman (the wise sage), pointed out that given the recent uptick in criticism of broader health reform, we need to frame our criticisms within the context of positive statements about the need for reform.  (We don’t want to allow the forces opposed to health reform to hide behind children.)  When I returned home, I pulled out a memo from the Herndon Alliance and Lake Research Partners providing dial-tested messages that work and thought I would share them with you.  The four underlying themes that American voters care about are:  choice of health plan and doctor; control of their health care; affordability; and peace of mind. 

Here’s a summary of “the best overall progressive message frame” to counter opposition:

It’s 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 plan.  Health care reform will stop the insurance companies from denying coverage for an illness you had 5 years ago or some other pre-existing condition, or denying you care because of your age.  Health care will be affordable–it will cost less and cover more.  It will be a uniquely American solution that gives you the peace of mind of knowing you will always have quality, affordable health care.

This frame is so effective because it taps into the key values the public places on reform:

  • Quality, affordable health care;
  • Choice of keeping your current plan and doctor;
  • Affordability;
  • No more insurance company abuses such as denying for past illness or age;
  • Peace of mind; and
  • A uniquely American solution.

Most recently opponents have been trying to defeat health reform as an “Obama experiment” that is moving too fast and costing too much.  These are all ridiculous arguments as the plan is based on what works and Congress has been grappling with this issue for six decades.  On the cost front, I defer to the communicator in chief President Obama who said:

“So make no mistake, the status quo on health care is not an option for the United States of America. It’s threatening the financial stability of families, of businesses, and of government. It’s unsustainable, and it has to change.”

And because nobody uses words that work better than Obama, another quote:

“The cost of our health care has weighed down our economy and our conscience long enough.  So let there be no doubt: Health-care reform cannot wait, it must not wait, and it will not wait another year.”

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