Fear, Anger, Hope and Inspiration Will Decide Health Care Battle

A strong public option is critically necessary to accomplish the administration's goals of controlling health care costs by competing with private insurance companies, driving down rates and keeping them honest.
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The details of policy will not decide the outcome of the health care reform battle. In fact, the policy outcome itself will be decided largely by the interplay of four emotions that will drive the outcome of this essentially political battle: fear, anger, hope and inspiration.

The principal weapon of those who want to maintain the status quo is, as always, fear. The Republicans and their allies in the private health insurance industry are cranking up the fear machine like the producers of a good horror movie. They warn of a "government takeover of health care," "socialized medicine," "rationing" and the ever-frightening prospect that a "government bureaucrat" might stand between someone and her doctor -- or a needed medical treatment.

Of course fear need not be rational. I talked to a Blue Dog Democrat the other day -- one who favors a strong public option -- who told of scores of calls his office has received from older voters on Medicare, the government run health care program for the elderly and disabled. The callers were frightened of a "government takeover" of medicine. Former Senator John Breaux once told a story about a woman who rushed up to him in the airport to plead with him to "keep government out of her Medicare."

Fear immobilizes. And fear of the unknown crushes the desire for change, even in the midst of conditions that cry out for change. It has been used throughout history by those who profit from the status quo, and it becomes especially important when -- as is the case with health care today -- most people believe that the current system should in fact be changed.

Of course the insurance companies and the Right are not just using fear to move public opinion. Just as importantly, they are using it to frighten key Members of Congress into believing that an angry mobilized part of their constituency -- and donors -- will exact political retribution. For some Blue Dog Democrats that fear is being used to mask the fact the President Obama's health care proposals will produce some of their most profound benefits precisely within the districts they represent. In one notable case, the district has 150,000 uninsured citizens and only 900 families who would pay a surtax used to pay the costs of the House Democratic Health Care bill.

Anger, on the other hand, does not immobilize like fear. It energizes action. In politics, anger is almost always a necessary precursor to change and hope. American voters would not have been willing to take a chance on the change and hope offered by the Obama campaign in 2008 if they were not already furious with the administration of George W. Bush and its failed stewardship of our economy and foreign policy. That anger stemmed from the sense that everyday people could no longer look forward to better lives in the future. Obama resolved that anger into the hope that change could bring them a better life.

The powerful elements that dominate the Republican Party and the Conservative Movement also focus the anger of people who feel they are losing control or have been passed by, but instead of resolving that anger into hope, they resolve anger into fear of change -- and fear of people who "aren't like them."

To win the battle over health care -- and all of the other major battles required to fulfill the promise of change -- progressives must engage the anger of most Americans and do a better job mobilizing that anger than our right-wing opponents.

That means a populist message. It means focusing in on the insurance executives who are perfectly willing to deny health care to sick people so that they can make millions and millions of dollars and retire with massive golden parachutes. It means we need to frame the debate as a struggle between those with power -- and the majority of Americans.

And it means that, for Members of Congress, we have to channel that anger to induce fear -- the fear that failure to accomplish change will be more politically costly that voting for reform. In the end, the winning message to most Members of Congress is that health insurance reform is the high political ground. That is the message we must deliver to every Member over the August recess in no uncertain terms.

Hope and change will not win out if we don't engage populist anger. But success also requires that we paint a clear, positive picture of a future where ordinary Americans no longer have to worry that they may not have access to health care.

People aren't engaged and motivated by statistics or "policies." The prospect of an "insurance exchange" will not inspire people to take a risk on change. To win this battle we need to get people to imagine what it would be like if they no longer had to worry that if they got sick and then lost their job, they might also lose their health care. We have to remind them that 14,000 people are losing their health insurance every day -- and they could be next. They have to visualize the insurance company CEO who gets the $73 million golden parachute and received a salary of $5,585 an hour ($12.2. million per year).

In fact, to win this -- or any other major political battle -- we need to remember that changing people's opinions and motivating them into action is mainly about engaging their emotions -- hope, fear, anger, inspiration. That means we need to make the issues at stake palpable. People need to experienced them in the concrete, not as abstract concepts. They need to be turned into images, stories and symbols that can make people see, feel, hear and taste the issues, not just think about them.

That brings us to inspiration. President Obama's ability to inspire is an enormous political asset. Being inspired is basically the feeling of empowerment -- empowerment to overcome odds -- to overcome fear. In the same way a blast furnace turns iron ore and coke into steel, inspiration transforms fear and anger into hope.

We need to inspire the country that change is possible and will bring about a better health care system. We need to inspire Members of Congress that they can overcome their fear of insurance companies and special interests, and make history. We need to keep our own base inspired in order to keep them mobilized.

In fact, our ability to compete with the insurance companies and the merchants of fear is entirely contingent on our ability to keep our base engaged and energized. That is one of the critical reasons why, in order to be successful, a health insurance reform plan must include a strong public health insurance option.

A strong public option is critically necessary to accomplish the administration's goals of controlling health care costs by competing with private insurance companies, driving down rates and keeping them honest. That is why the insurance industry hates the proposal.

But a public option is also critical because it inspires our base. Like it or not, most progressives in America have lost faith in the private health insurance industry and its ability to provide health care at reasonable prices for all Americans. Many Americans joined the Obama campaign because they believed he -- and they together -- could make change in general, and change in the health care system in particular.

The public option has become a symbol for most of these activists -- the symbol of what defines real change. If the small band of insurance company-friendly Democrats forces the entire Party and the administration to abandon this critical element of the Obama plan, the campaign for health care reform will lose much of its ability to inspire activists to action. That would leave the playing field to Rush Limbaugh and his insurance industry friends who use fear to mobilize the right-wing base.

Progressives cannot afford to fail in our battle for health insurance reform. It is a critical building block for the long-term economic success of our country. It will also define for millions of Americans whether they can make change -- whether they can take the future into their own hands and make their own history. Our success in the health care battle will in great measure determine our ability to continue to generate the kind of inspiration that is so critical to our ability to win all of the battles that lie ahead.

Robert Creamer is a long-time political organizer and strategist, and author of the recent book: "Stand Up Straight: How Progressives Can Win," available on amazon.com.

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