The Obama Administration's framing of the health care reform debate is almost a case study in how NOT to do framing.
1. Obama elevated bipartisanship over effectiveness. Early in the debate Obama laid down a marker that he wanted a bipartisan bill. And Republicans have been beating him over the head with it ever since -- watering down the legislation until it is nothing but a giveaway to the insurance industry, promising to filibuster, and asserting that Obama needs 80 votes in the Senate in order for the bill to be considered bipartisan. Obama should have said, 'I want an effective bill, that increases coverage while lowering per capita costs -- I don't care how we get there.'
2. Republicans asserted that the health care reform bill should not add to the deficit and Obama accepted that frame. That's ridiculous and the real killer in this debate (as we'll see below). Everyone knows the health care bill will not be budget neutral. That's like saying the military should be budget neutral -- not. gonna. happen. Obama should have said: 'Government should provide a certain basket of services to the people -- universal health care, effective military, Social Security for old folks. We pay for that basket of essential services with a basket of revenue sources including taxes and fees. There is never a one-to-one relationship between a particular program and a particular revenue source. In a democratic society the question is, What is the essential basket of services a government should provide -- and health care is clearly one of the essential things government should provide.'
3. So if the health care bill has to be revenue neutral -- where are the savings going to come from? Medicare. Republicans knew they created a ticking time bomb in the "budget neutral" framing and it finally blew up this past week. Once Obama accepted the cost neutral frame he had to go find the savings somewhere -- and he found it in proposing to control the rising cost of Medicare. Obama promised that he could save $400 billion dollars by controlling Medicare costs through increased efficiency. Seniors heard that as a "$400 billion cut in Medicare" -- which is what set off the "death panel" hysteria. Obama should have said: 'Democrats have been champions of senior citizens forever. It was Democrats who passed Social Security and Medicare and it was Democrats who fought off recent Republican attempts to kill Social Security and Medicare. Democrats will always fight for retirement and health security for seniors. Yes, we need to control long term health care costs, but that's a conversation for another day and I look forward to hearing the Republican plan to control those costs.'
But here's the thing, Team Obama does not make framing mistakes. They have perhaps the best messaging operation in the entire world. Al Gore and John Kerry screw up framing because they don't know how to do it -- Team Obama does not screw up framing. When they screw up like this it's likely because their stated agenda (universal health insurance) does not match their private agenda (just getting something passed and getting re-elected with the help of health industry $).
Obama gets away with making basic framing mistakes that would hobble a less charismatic speaker. But the truth is, he is so gifted, even with all of the mistakes listed above -- he still might be able to get a decent health care bill passed.
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