Mixed messages bolster GOP's case

It’s one of the most persistent — and potent — Republican arguments against health reform: that President Barack Obama and fellow Democrats want a U.S. government takeover of health care.

And what evidence do they have to back it up?

Obama said so. Just check out YouTube.

“I happen to be a proponent of a single-payer, universal health care plan,” then-U.S. Senate candidate Obama said at an AFL-CIO event in 2003, using the terms that commonly refer to a government-run health insurance system.

“Everybody in, nobody out, a single-payer health care plan, universal health care plan — that’s what I’d like to see,” he said. “But as all of you know, we may not get there immediately, because first we’ve got to take back the White House. And we got to take back the Senate, and we got to take back the House.”

Obama has said repeatedly that he doesn’t now support a single-payer system — where the government is the sole provider of health insurance across the country. And he says he isn’t interested in a government takeover of health care, only a public insurance option that would provide competition with private insurers to “keep them honest.”

Yet critics of Obama-style reform have been able to exploit the mixed messages to sow doubts about Obama’s true intent in pushing a trillion-dollar overhaul of the health care system — with powerful evidence, captured on videotape, to back up their claims. And that mixed message came through again in his address to a joint session of Congress last week, when the president said he favored a government-run insurance option but wouldn’t demand one.

You don’t have to go back to 2003 to find leading Democrats supporting a so-called single-payer health system. The most damaging examples are from this year.

Consider comments made by House Financial Services Committee Chairman Barney Frank (D-Mass.) in July: “If we get a good public option, it could lead to single payer, and that’s the best way to reach single payer. … I think the best way we’re going to get single payer, the only way, is to have a public option and demonstrate its strength and its power.”

Statements such as Frank’s are like finger­nails on a chalkboard to public-option supporters, who spend their days trying to convince Americans that a government-run plan will not end private insurance as we know it or lead to a single-payer system.

“It’s not helpful, it’s not smart and it’s not the truth. But you can’t help what members of Congress say, and if they’re going to say that, the best you can do is explain to them that it plays into a larger socialized medicine health care narrative,” said Jacki Schechner, spokeswoman for Health Care for America Now, a progressive group working to pass the public option.

Not surprisingly, conservatives love it when Democrats say the public insurance option could lead to a single-payer system. The message plays right into their argument that the public option will lead to a government takeover of health care. Keith Appell, a spokesman for the free-market health care group Conservatives for Patients’ Rights, said the Democrats’ pro-single-payer messages give the conservative argument more credence.

“It confirms exactly what we’ve been saying in the best way possible. It comes out of their own mouths,” he said.

Opponents’ “government takeover” line of attack seems to be working. Polls show the public is inclined to believe the critics; nearly half the respondents in a recent Washington Post/ABC News poll said they believed Democrats were promoting a government takeover of health insurance.

Obama and Frank aren’t alone in their support for single payer.

In July, when a single-payer supporter with a camera asked Sen. John Kerry (D-Mass.) whether that plan was the best solution, he said, “I personally would start with single payer on a personal level, but we don’t have the votes.”

Rep. Jan Schakowsky (D-Ill.) told a crowd in April that a public option would put the insurance companies out of business, adding that she is a supporter of House legislation that would create a single-payer system. She’s not the only one; about a third of her Democratic House colleagues have co-sponsored the bill.

“I know that many of you here today are single-payer advocates, and so am I,” said Schakowsky, a member of the House Democratic leadership. “I’m a co-sponsor of [H.R.] 676, and those of us who are pushing for a public health insurance option don’t disagree with the goal. This is not a principled fight. This is a fight about strategy for getting there, and I believe we will.”

With supporters of the public option mixing their messages on what the public plan will do, Americans watching at home could be excused for being confused, if not downright skeptical.

And that skepticism may help explain why supporters of health reform are having such a tough time dispelling the myths and scare tactics spread by opponents. While largely squashed, the falsehood that reform would create death panels to authorize euthanasia still has not been put to rest.

Other opposition claims are not so easy to debunk.

For instance, Democrats argue that proposed Medicare cuts will not reduce seniors’ benefits, but the insurance industry says that slashing roughly $150 billion from Medicare Advantage plans, as proposed, will force insurers to increase premiums, reduce benefits and, in some cases, eliminate entire plans.

The waters also are muddy on Obama’s push to fund more comparative effectiveness research to determine which drugs and procedures offer the best value and outcomes. Supporters compare it with a Consumer Reports for medicine, but opponents worry it is the first step to a world where government will limit patients’ choices based on research results, leading to rationing of care.

It’s a concern that feeds into conservatives’ larger argument that reform will lead to a government takeover of health care. But some Democrats who have voiced support for a single-payer system and a public option seem unconcerned that the mixed messaging could be used as fodder by their opponents.

Asked whether Americans are right to be skeptical of a public option with so many Democrats on the record in favor of a single-­payer system, a White House spokesman pointed to Obama’s remarks at an Aug. 11 town hall in New Hampshire.

“I have not said that I was a single-payer supporter because, frankly, we historically have had an employer-based system in this country with private insurers, and for us to transition to a system like that, I believe, would be too disruptive,” Obama said at the town hall. “There’s nothing inevitable about [the public option] somehow destroying the private marketplace, as long as … it’s not set up where the government [plan] is basically being subsidized by the taxpayers.”

But Frank acknowledges that a public option could lead to a single-payer option, saying that he’s trying to exploit an inconsistency in the argument of conservatives, who he claims are trying to have it both ways.

Opponents can’t argue both that a public plan will wipe out insurance companies and that it will be an expensive, bureaucratic failure, Frank asserts. Either the public option works and becomes so popular that people leave their private insurance for the public plan, leading the country down the path to single-payer, or it’s a miserable flop and people stick to their private insurance, and nothing changes.

“My way works better. Simply saying ‘No, no, no, it won’t’ [lead to single payer] doesn’t work,” Frank said. “I think I have the best strategic argument here.”

 
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