Saturday, February 3, 2007

How to Talk About Universal Health Care Insurance: Part 2

In How to Talk About Unviersal Health Care Insurance: Part 1 I talked about how the main crisis is not health care delivery, rather it is health care insurance.

This conversation was sparked by the response to another diary of mine published in December, How to Talk to Small Business People . Almost all the responses from small business people mentioned health care. They told me they are looking for a good way to get affordable health care insurance for themselves, their families and their employees. Of course these responses came from small business people who are progressive enough to comment and / or post on Daily Kos.

This diary is for people who want to advance the cause of Universal Health Care Insurance by persuading others. So let's get started...


If you have seen any of the other How to Talk to diaries, then you know the drill. If you are new to this, here is how we go about the task of talking to people already on our side. The purpose is to give them the tools to persuade people who should agree with us, but don't, that our ideas are the better ones.

The first thing to do is to define the values that relate to the task at hand. Here is my list of values applicable to this subject:

  • Community
  • That the promise of America is equal opportunity for all and special privilege for none
  • Mutual Responsibility
  • Inclusion
  • Work and Family

We then have to incorporate those values into an argument that fits into these tasks:

Define the Overarching Strategy

Define the Terminology

Mangle the Memes

We start with the strategy.

Define the Overarching Strategy

When you talk to the other side, you should start with your goal in mind. So first, you need to define your goal. Only then can you determine the best overarching strategy to achieve your goal without compromising your values.

As in most of these tasks, our goal is to persuade people who should agree with us but do not yet. We need to do this in a way that does not lose our audience at hello. The target community must receive our message in a way that resonates with them on a personal level. This can best by done by research and real world examples. First, some research.

Some of the best and most persuasive resarch done in this field has been has been done by physicians%20themselves.%20 This research covers topics ranging from the huge administrative cost of our current system, taxes and who actually pays for these costs, and the sad fact that we already pay for national health care insurance, but don't get it.

If that isn't impressive enough, consider the research done by medical students . If the physicians already working in the health care delivery system and the medical students working to join them are in agreement, why would anyone else tell them that they are wrong?

Define the Terminology

Defining the terminology is akin to choosing the battlefield. If you let the other side define the terminology, you will be fighting your battle on the other guys’ battlefield. Any tactician will tell you that he who determines the battlefield has the much better chance of winning the battle.

We also must remember our audience. We are not preaching to the choir here. Out goal is to reach out and create a majority coalition in support of Universal Healthcare Insurance. Our target audience to get this coalition into the majority is twofold:

  • Small Business people who already know how hard it is to obtain affordable health care insurance in the current inefficient market.
  • Middle class taxpayers who mostly already have health insurance through their jobs.

The best way to reach this audience is to craft arguments where our values intersect with theirs. As we saw in Part 1, the census bureaus's research brought us these two telling tidbits:

  • 73% of the uninsured in the workforce worked sometime during the year.
  • 63% of the uninsured who worked during the year worked at companies with fewer than 100 employees.

This data give us the first things we can say about Universal Health Care Insurance - Most people who are uninsured are actively in the workforce. We are not talking about some giveaway program going mainly to those who are unwilling to work. We are talking about folks who work for a living just like you and I. Also, nearly 2/3rds of the uninsured in the workforce work for small businesses. This is just one more area where small businesses get the short end of the stick in this country.

So who are the uninsured? They are folks in our community who mostly work for small businesses. One would think that in a country that values entreprenuership, work and family, that we would take care of our workers and their families by making sure they all have equal opportunity to access quality, affordable health care no matter the size of the business they work for.

The other argument that should resonate particularly with small business people is the inefficiency of the current system. Health care insurance is ridiculously expensive, particularly so for folks who are not part of large byuying groups (big business, unions, professional associations, etc.). One of the reasons for the heavy cost is that the private insurance delivery system is incredibly inefficient in delivering the product. Small buisness people know better than most how crucial it is to control costs. The big business of health insurance delivery seems to believe thay can just pass these cost along to us.

What most of us don't know is that the government is already paying the lions' share of health insurance costs in this country.

the amount of public health spending in the U.S. is greater than the combined public and private spending of nations which provide universal comprehensive health insurance. A single-payer system could provide such coverage to all Americans with no need for additional health dollars.

So we could provide equal opportunity for an all inclusive health care insurance sytem without spending additional tax dollars. Is that not a win-win for middle class taxpayers and small business people?

So why do we not already have such a sytem?

Mangle the Memes

The first thing to understand is that there is a powerful lobby in this country that is determined to maintain the status quo. One of the main ways this lobby goes about maintaining the status quo is by demonizing the alternatives. So let's talk about what we are not suggesting.

We are not talking about socialized medicine. Remember, this discussion is about health care insurance. The main problem is not with our health care delivery system. So do not let anyone get away with telling you that it is.

We are not talking about some inefficient government bureacracy deciding who gets what health care procedure and when. In fact, an efficient health care insurance system will put even more of the choice for health care decisions back into the hands of the doctors and their patients. Doctors and patients will take back the decision making from some faceless private insurance bureaucrat.

How do we do that? With a single payer universal health insurance plan, we would wring the waste out of our health care insurance delivery system. Turns out this is a case where private industry is less efficient than government.

administration consumes 31.0 percent of U.S. health spending. Average overhead among private U.S.
insurers was 11.7
percent, compared with 1.3 percent for Canada’s single-payer
system and 3.6 percent for Medicare.

Who would have thought that the US government provides health insurance administration at one third the cost of private insurance?

We have a mutual responsibility to include working families in the health care insurance system. Healthy communities are productive communities. W can provide equal opportuity for access to affordable health care insurance at no additional costs to taxpayers. Ultimately we will have the luxury of seeing health care insurance costs falling for everyone.

So, get away from the keyboard and get out into your communities. Deliver thse messages to your elected officials and other opinion leaders in your community. A concerted netroots / grass roots campaign for single payer universakl health care insurance could get this issue past the tipping point.

What are you waiting for, someone else to do it? Start today.





3 comments:

fladem said...

This was really a great summary.

When I lived in Vermont, Howard Dean made a run at universal health care.

This summary would have been very useful during that debate/

BTW - How do I post a story. I would like to write something on the current tax revolt.

king said...

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