Barack Obama Is the Anti-Frank Luntz

by Tim Foley

categories: Comparative Effectiveness Research, Doctors and Nurses, Enemies of Reform, Obama and Congress

Published June 15, 2009 @ 08:39PM PT

If this is what President Obama can do while barnstorming the country for health care, I say, “Yes please.”

The talk of the town is Obama’s speech to the American Medical Association.  Much like Michael Jordan, another Chicago icon, Obama is known for rising to the challenge in big moments.  This speech was no different, and also owns the odd distinction of being one of his longest.  Yes, that’s right, Barack Obama used more words to pitch for fundamental change to our broken health care system than he did to spark new dialogue with the Muslim World in Cairo.  Take that for what you will.

It’s a tremendous shame that so much attention has been focused like a laser on the issue of medical malpractice.  Out of a 7,300 word speech, the president spent about 230 words on medical malpractice – about 3%, or only slightly more than the malpractice claims that actually make it to trial in this country.  And you know, he really didn’t say anything at all about it.  Yet if you looked at the commentary on CNN and MSNBC, you’d think that’s all he talked about.  The news, man… those folks just aren’t like you and me.

But the real story is that Barack Obama is the anti-Frank Luntz on health care.  (And in so being, he is also your new bicycle.) Much like the now-infamous memo by the famed Republican pollster on phrases and ideas to use to scaremonger and ultimate defeat the president’s push for health care for all led to an almost reflexive use of this language by anti-reform Republicans, let’s see how many pro-reform Democrats pick up the president’s myth-busting language.  Here are the highlights that struck me:

On the incentives in our system for more expensive care rather than better care:  “It's a model that has taken the pursuit of medicine from a profession -- a calling -- to a business.  That's not why you became doctors. That's not why you put in all those hours in the Anatomy Suite or the O.R. That's not what brings you back to a patient's bedside to check in, or makes you call a loved one of a patient to say it will be fine. You didn't enter this profession to be bean-counters and paper-pushers. You entered this profession to be healers. And that's what our health care system should let you be.”

This isn’t just a big deal for doctors, by the way (although most doctors I know loved this section.)  It’s a fundamental recognition that the free market approach to health care is a misdiagnosis.  Unlike selling cars or computers or hedge funds, health care is not just about making a buck.  It’s about healing the sick.

On the reasons to invest consistently in comparative effectiveness research:  “Now, let me be clear -- I just want to clear something up here -- identifying what works is not about dictating what kind of care should be provided. It's about providing patients and doctors with the information they need to make the best medical decisions. See, I have the assumption that if you have good information about what makes your patients well, that's what you're going to do.”  Obama has consistently explained comparative effectiveness research better than just about anyone else.  This goes double who have to go to semi-paranoid lengths of stretching the truth in their arguments.

On the need for insurance regulation:  “But what I refuse to do is simply create a system where insurance companies suddenly have a whole bunch of more customers on Uncle Sam's dime, but still fail to meet their responsibilities. We're not going to do that.”  This is only specifically referencing dispensing with business practices like pre-existing conditions, but could just as easily have been about the public health insurance option.   More to the point, in a country that’s already seen bailouts of Wall Street, bailouts of banks and bailouts of AIG with a dubious corresponding surge in those institutions responsiveness and patriotism, it’s encouraging to hear that health insurance companies aren’t next on the list.

On financing health care reform:  “Now, there are already voices saying the numbers don't add up. They're wrong. Here's why. Making health care affordable for all Americans will cost somewhere on the order of $1 trillion over the next 10 years. That's real money, even in Washington. But remember, that's less than we are projected to have spent on the war in Iraq. And also remember, failing to reform our health care system in a way that genuinely reduces cost growth will cost us trillions of dollars more in lost economic growth and lower wages.”  Obama has always been strong on the cost argument, in a way that I wish more Democrats were.  How does an opposition party that left us on the hook for two wars, a fractured economy and billions upon billions for bailouts have any credibility in suggesting that we can’t spend $100 billion a year to fix our broken health care system?

The president covered a lot in one speech – from payment reform to medical school debt, from the public plan to pre-existing conditions, from big picture prevention to the nitty-gritty on cost savings in Medicare.  If he just does that consistently on television and in person, we could well be on our way to re-establishing popular momentum that may even withstand the worst Frank Luntz-inspired commercial you can imagine.