Ill Communication: President Obama's Misguided Health Care Strategy

Is health reform falling victim to lackluster messaging and a poor campaign? Are there better alternatives? Let's play strategist!
This post was published on the now-closed HuffPost Contributor platform. Contributors control their own work and posted freely to our site. If you need to flag this entry as abusive, send us an email.

In 1998 I ran communications for one of the most stunning political victories of the '90s: Jordan Roberts' upset win as the first-ever woman Senator from the State of Confusion. The campaign was a simulation, part of an intensive five day campaign boot camp, but even though Roberts was fake (I had to play her in drag -- that's for another time) I learned the basic axioms of communication strategy:

1. You start with a goal (50 percent plus 1 vote) which reveals the target audience you need to achieve that goal (soccer moms from Sycamore and young voters throughout the State of Confusion).

2. Then you settle on a compelling message to sway that audience (Jordan Roberts will fight sprawl, preserve open space and is opposed to the dastardly Sycamore mine).

3. Then you win them over with tactics that reinforce that message. (We targeted community newspapers, canvassed every grocery store and built Roberts something called a "Web site")

Communications strategy is an art, and it follows the same formula for issues (environment, women's rights) as it does for elections.

I thought about Jordan Roberts while I watched President Obama's health care press conference. Obama is running a full court press to win health care reform, but the White House isn't following the formula. Surely there's a a strategy, but as I looked over the headlines from the presser the next day -- and at the wavering public support for health care -- I couldn't suss it out. Is health reform falling victim to lackluster messaging and a poor campaign? Are there better alternatives? Let's play strategist! Here's what we're looking at:

Goal: This should be easy -- the goal is to win House and Senate passage of health care for all Americans. But the White House is starting with one hand behind their back: "Health care" reform isn't written yet. There are drafts. There are committee proposals. But the details are in flux, so the White House is out hustling for a plan that doesn't yet exist.

Ezra Klein wrote a great piece today in The Washington Post about how the Obama administration's approach to health care reform has been to just do the opposite of what Bill Clinton did. In 1993, Hillary (and the White House) wrote ClintonCare. In 2009, the actual bill has been outsourced to Congress, which has left President Obama out there campaigning for an unfinished bill that someone else wrote. Where is the helpful Q&A that could assuage concerned voters? There isn't one, because there aren't any "A's" yet. It's a mess.

Audience: This is tricky. Because health care is something that impacts every American, you have to explain to every American what it is and how it will work. But the real audience is simple: You need to convince independent and centrist voters in conservative/center-leaning districts to raise a total shitstorm if their Representatives vote against health care. These are the people who are represented by "blue dog" conservative Democrats in Congress; it's also some of those pesky working class white voters that we thought would be racist against Obama but weren't. There are some signs that President Obama may be honing in on this audience (see message below) but the sense I get is that they are not yet pushing an aggressive strategy to pressure wavering legislators.

Message: A campaign "message" is the reason why people should support something, and Obama is pretty consistent here: We have to reform health care because we can't afford not to. He has tied his message to the economic crisis, and to the staggering costs of health care. If you go back to our audience, it's smart: the target audience is worried about the economy -- so the message responds to that.

The problem, of course, is that "Reform health insurance now because we can't afford not to" isn't exactly "Yes, We Can." (A message isn't as focused as a slogan, but you get my point -- there's no Will.I.Am video coming out of the conceptual need to reduce the tripling of health insurance premiums.) It's also not very "I feel your pain," and it's hampered because there isn't a plan on paper yet. So the message is muddled by fears of massive government spending. It's also a little Bush-ian, even though it's true: we have to do this or else.

Is there something better?

One of the few times during the presidential debates that I actually staggered up out of my chair and cheered was when Candidate Obama asserted that health care is a human right. I wonder if there isn't a bolder, higher-calling messaging platform that appeals to a moral framework as well as an economic one. Cost is important, but doesn't "we're Americans, we're heroes, we care for our seniors and our children and our neighbors, and so there are certain rights we all have in this country" trump "deficit reduction by 2017?" You can wrap in the economy -- health care has always been a right, now it's a necessity. It's a moral and economic imperative.

Tactics: Here's where I find some real fault with the Obama administration.

  • Why did President Obama insist on a press conference, instead of an Oval Office address, which gave reporters a chance to parrot Republican talking points and put him on the defensive? An Oval Office address is usually reserved for foreign policy, but this certainly rises to the occasion and fits nicely with a moral and economic imperative argument. Maybe he could have ended his address with some online questions?
  • Why is Vice-President Biden, the administration's point man on middle class issues, getting draped in medallions in Georgia and Ukraine instead of out campaigning for health care?
  • Where is any useful shred of information about how your health care will be impacted at

The biggest tactical concern I have, though, stems from how President Obama ran the general election. In 2008, they mastered the art of the "local" media hit. They talked under the national press, with local ads about issues that pertained to voters in specific states. Nuclear waste in Nevada, DHL outsourcing in Ohio, etc. Given that the entire objective here is to get a set of very specific legislators to support your bill, why isn't both the media and the online apparatus ramped up to put political pressure on those legislators? The lead "blue dog" reticent Democrat on health care is Congressman Mike Ross, from Arkansas' 4th District. So where is the Joe Biden sit down interview with Hot Springs Fox 16? Let's do it.

My guess is that the White House -- in an effort to look bi-partisan and not to stake the entire presidency on health care -- doesn't want to knock the heads of wavering legislators in their own districts and appear overtly political. But if health care really is that important, isn't this the time to do it? Senator Ben Nelson from Nebraska is the worst on health care. I'd love to see President Obama at the biggest church in Omaha -- where he was the first Democrat since 1964 to win an electoral vote -- launching his crusade -- yes, I said it -- for health care. Yes, we can.

The team that mastered "local" seems to have lost that page in the playbook.

So, What Would I Do? Well, I'm not David Axelrod, the president's chief political strategist. And I'm not on the treadmill everyday at 5 a.m. perfecting my rock-hard ass from years of ballet dancing like Chief of Staff Rahm Emmanuel. Maybe I should be. But if I were running communications on health care for the White House, here's what I would do:

1. Wait it out this week while the House hopefully (no given) passes a bill. Then I would take that bill and create a series of online and offline materials that explain succinctly how it would impact your health care. I want that Q&A. I want an awesome PSA that goes everywhere. If they can get Secretary of Health Kathleen Sebelius on the field with The Washington Nationals mascot to encourage flu vaccinations, they can get a 2 minute video outlining the basics of Obamacare.

2. Shift the message, from "do it now or the economy will tank" to the moral and economic imperative a can-do country has to provide first-rate health care argument. Launch the crusade.

3. Set out on a campaign-style, legislative-targeted barnstorming tour for health reform. Do events in Blue Dog districts. Put Joe Biden on NBC-Omaha. Get your best spokespeople. Michelle should be out there; Biden; Bill Clinton, maybe? In Cleveland on Friday we saw flashes of Candidate Obama. It's a good start.

(Also, except for Chelsea Clinton's wedding, President Obama needs to can the Martha's Vineyard vacation.)

4. Get all the advocacy groups on the same page with 1-3.

5. When we're back in September, give your Oval Office address and make it your best speech ever.

Also? We could use a little cultural currency around this. Shepard Fairey did an awesome windmill that MoveOn is pushing, but September means college and high school kids back on campus and looking for some way to get into trouble -- lets put them to work like it was 2008.

All that is easier said than done. I've run some winning campaigns since Jordan Roberts, but none as vexing as health care. And Jordan wouldn't have won if I didn't look so good in a dress. But as a student of campaign strategy, and an ardent progressive who wants to see a generation-defining health care plan up on the policy Mount Rushmore right next to Social Security, I am concerned that President Obama's communication strategy is not up to the task.

Health care is about sick people -- dying, suffering people, and also about healthy people -- thriving, vibrant people -- and not just about "get it done now to keep costs down" and muddled East Room pressers. The congressional recess this week is a chance for President Obama to regroup and reset his strategy. My hope is he hits the road with the urgency, passion and political (even partisan) communications savvy this issue deserves.

Note: This post first appeared at, which the author co-edits.

Support HuffPost

Popular in the Community