Columns » Ernest Dumas

Selling lies on health care



If Republicans seize the White House and Congress, they should name the Washington national airport for the man who was responsible.

That would not be Karl Rove, Sheldon Adelson, the Koch brothers, or any of the legions of billionaires who jammed fundraisers in Aspen and the Hamptons and doubled the previous biggest political treasury in history to get it done.

Instead, let's make it the Dr. Frank Luntz National Airport.

Luntz is the beefy Republican political consultant and pollster who stole the hearts of the superrich 20 years ago when he showed that if they called the popular inheritance tax on rich estates "the death tax" it would become instantly unpopular because people would think a tax was imposed on mama's death and would take away even the poor widow's mite. In 10 years, Congress repealed the estate tax, and the nation breathed a sigh of relief.

In the early spring of 2009, as congressional committees gathered for the year-long process of writing a law to extend health insurance to everyone, Luntz assembled focus groups to see what catchphrases would turn Americans against the process. He sent his analysis to Republicans in Congress and the money groups that were ready to fight the bill, whatever it would be. A few of Luntz's slogans created visceral reactions.

"Cut Medicare benefits" was one. Mention of "government takeover of health care" upset everyone. So did the suggestion that "government bureaucrats," not patients consulting with their doctors, would make health decisions. "Rationing" caused people to see red. "Bigger national debt" scared them, too.

So, Luntz advised the party that whatever Democrats came up with, Republicans should avoid specifics and use those terms to describe the reforms. Never mind that the bill would do none of those things. Luntz had written a best-selling book on the theme that in politics facts do not matter as much as what people think they hear.

Republican leaders followed his plan to the letter, and the Chamber of Commerce and insurance, pharmaceutical and right-wing organizations pumped hundreds of millions of dollars into media advertising and mailers to the homes of seniors warning of the draconian effects of the coming health law.

As always, the tide smothered the lame truthtelling that the authors of the Affordable Care Act, like Arkansas's politically inept Blanche Lincoln, offered. Obamacare became immensely unpopular and swept Republicans into Congress in 2010. The party is banking on its promise to repeal Obamacare to swing the presidential and congressional elections.

Republican leaders have never wavered from Luntz's strategy. They stick to the script and skirt arguments over Obamacare's actual provisions. House Speaker John Boehner said last week that if people wanted to preserve the precious doctor-patient relationship they had to elect Republicans who would repeal Obamacare.

The slogans describe nothing about the Affordable Care Act. Take the threat to seniors. The law makes no cuts in Medicare benefits. Instead, as you would expect a bunch of Democrats to do, it adds a laundry list of new assistance for seniors: lower prescription drug costs, free preventive-care screenings like mammograms and colonoscopies for the rest of your life, and bonuses for family doctors and nurse practitioners who treat the elderly at any age.

Yes, the law does phase out the huge taxpayer bonuses to insurance companies that since 2004 has guaranteed them big profits if they sell Medicare Advantage plans.

The senior scare was aided by Sarah Palin's cry in 2009 that the law created "death panels" of bureaucrats who would decide whether Grandma should die rather than get life-saving treatment. It was a complete hoax, and Palin later would say she never meant it literally, only that if all the poor people became entitled to medical care there would not be enough care for everybody, which would lead to rationing and the elderly sick would have to be dispensed with.

Hoax or not, others picked up the death panel idea. An Internet story quoted a hospital emergency room executive in Tennessee as saying that starting in 2013 Obamacare required everyone over the age of 75 to go before a local ethics committee for a decision on whether they could be given life-saving surgery. The doctor who was quoted immediately denied saying it or that the law provided any such thing, but the message went viral. It is received wisdom now that Obamacare somehow pulls the plug on people who reach 75. I'm four months away.

Here is what the "government takeover of health care" amounts to: The government stops insurance companies from ending coverage when people get acute illnesses like cancer, prevents them from denying coverage to people with pre-existing conditions, stops them from ending insurance for critically ill children and limits their profits and overhead to 15 or 20 percent of the premiums they collect. More than that and they must rebate the money to customers. Millions of rebate checks will go out next month and every August hereafter.

But, as Luntz had explained, facts don't matter much.

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