Barack Obama is making an enormous mistake on the most important initiative of his presidency. In recent weeks, Obama has stressed that healthcare reform is the essential ingredient for the success of his economic-recovery plan. Yet the president, easily the most gifted White House communicator since Ronald Reagan, has the message all wrong.
"Our businesses will not be able to compete, our families will not be able to save or spend, our budgets will remain unsustainable unless we get healthcare costs under control," Obama said in his May 16 radio address. He has said the same thing on many other occasions, almost always stressing the threat of runaway cost. When Obama talks healthcare, it's cost, cost, cost.
But that's not what people want to hear or at least not all they want to hear. Of course, they complain about the expense of medical treatment, but controlling cost is not their top healthcare concern.
"Americans will prioritize cost over quality right up until the moment they realize that it's their quality that they are sacrificing," writes the Republican pollster Frank Luntz in "The Language of Healthcare 2009," a brilliant new analysis of the public's healthcare concerns that also serves as a road map for defeating Obamacare. Basing his conclusions on extensive polling and focus-group research, Luntz writes that the public is very worried that a government takeover of healthcare Obamacare will result in politicians and government bureaucrats making decisions about what kind of care patients will receive and when they will receive it.
"Nothing else turns people against the government takeover of healthcare more than the realistic expectation that it will result in delayed, and potentially even denied, treatment, procedures and/or medications," Luntz writes. "When asked which was a higher priority spending less on healthcare or being treated in a timely fashion timely treatment beat cost almost unanimously."
People know that delayed and sometimes denied care is a way of life in other countries with national healthcare systems. And when they hear the president's repeated emphasis on cutting costs, they sense there's no way Obamacare cannot result in delayed and denied treatment. Luntz urges Republicans to make that the focus of their challenge to the president's plan. "It is essential that 'deny' and 'denial' enter the conservative lexicon immediately," Luntz writes, "because it is at the core of what scares Americans most about a government takeover of healthcare."
I called Luntz to discuss his memo. He didn't want to talk about it in partisan terms. Instead, he stressed that whoever wins the healthcare debate will "have to have a solution that addresses the individual nature of healthcare as well as the healthcare system itself, and have to have a solution to the uninsured problem that does not destroy personalized, humanized healthcare for everybody else."
And what might Barack Obama make of the memo? "If he's smart, he'll use it to amend some of his policies to address the concerns that the American people have," Luntz told me, "and he'll move congressional Democrats toward the center on issues like doctor/patient relationships and access to the right medications."
There is evidence that Democrats know they have a problem. On May 13, top White House aide David Axelrod hurried to the Capitol for a meeting with party leaders who are worried that the White House is losing the early message war. One participant, Sen. Richard Durbin, told reporters that Luntz's memo was "an interesting catalyst for us."
But the president continues to talk about cost. It's a trap he has made for himself. Without the savings Obama claims will result from healthcare reform, the crushing debt of the president's other spending priorities will become unsustainable. He has bet everything on his ability to cut healthcare costs. If that doesn't work, it all falls apart.
There's a consensus among the Washington punditocracy that healthcare reform will succeed this year because the time is simply right. But it's almost June. Obama and his Democratic allies have not even introduced a reform proposal, and yet the president says, "We've got to get it done this year." And all the while, he is sending out the wrong message on what really matters. Unless the White House changes course and pays more attention to what Americans really want, Obamacare will lose.