The Government Control Card Still Plays Well

The Politifact Lie of the Year in 2010 was awarded to the term "Government Takeover." Government Takeover or Government Control in various forms emerged from Republicans, health insurance association consultants, and certain media outlets. A brief attempt at naming the new health design as "public option" lost out. The spin doctors succeeded beyond their wildest dreams. The first Democratic agenda moved on the defensive and in many ways never recovered.

The best interventions are the simple ones. The Government Control card played well from start to end. It will be interesting to see if Republicans are going to be perceived as in control and if Democrats can return the favor. This is, of course, a reason why America is difficult to govern.

The Government Control card has indeed been played by both sides dating back many political campaigns. The latest and most successful example paved the way for a simplistic and powerful campaign 2010 to 2014 with the results as we have seen. Successful political candidates profited by "We really do not want to disclose what we are for, but we are against government control, Democrats, government programs/spending, Obama, and Obamacare." Linking any and all together worked well. No one really listened to much of anything else apparently.

In the last few years, health care moved from backstage to center stage. This made the simple strategy even more effective.

Democrats had more than enough time to catch on. There were also any number of attack points that could have moved the debate in a different direction. But Democrats were divided from each other, from Democratic leaders, and from Democratic concepts.

The Democrats needed a major push to "take down" or appear to take down Wall Street, Banking, and other "perceived abusers". Going on the attack is preferable and is easier than defense, as Democrats found out. More and more defensive is a prelude to failure.

The Democrats were not willing to take on health insurance companies, Wall Street, or Banking. No one was adept enough to appear to take on these or others who have damaged America and Americans.   No Democrat could explain why Americans were being deprived a better piece of the pie, but the Republicans had many explanations. If you do not tell people how their lives will be improved, they will vote for someone else (or allow others to take control).

Multiple Democratic failures in health policies and in health appointments made matters worse. Americans began to feel more experimented upon with rapid change, more chaos, and less stability.

Many of the Democratic attempts had good intentions. Good intentions may or may not work out. Unfortunately they can also take quite some time. Many of the concepts that result in a more equitable nation are difficult to communicate well, and Democrats have failed most of all in communication.

Belief in Government Control plus belief in the inevitability of Wealthy Control plus voter suppression was a powerful combination.

Health care where needed faces similar challenges. Long slow steady improvements in economics, health, and education are difficult to sustain - but offer the best hope for a narrowing of divisions and overall progress as a nation.


Politifact Lie of the Year 2010 - Government Takeover

Rotten Apples, Rotten Support, or Rotten Media?

Improving Health Care is Not Likely for 2600 Counties

Global Fails Local But Local Focus Succeeds Globally

Domino Decline By Design - as ERs Close, Those Nearby Face Challenges, as Small or Rural Hospitals Close or Practices Where Needed...

Declines in Health Care Delivery Despite Increases in Health Spending - If We Keep Accelerating Non-Delivery Costs, We Can Continue to Remain Behind Health Care Demand


Blogs indicate that primary care can be recovered and should be recovered.

Dr. Bowman is the North American Co-Editor of Rural and Remote Health. He was the founding chair of the Rural Medical Educators Group of the National Rural Health Association and the long term chair of the STFM Group on Rural Health.

Comments

Post a Comment

Popular posts from this blog

Another Fine CMS You Have Gotten Us Into

Perhaps we are indeed back to the time of Another Fine Mess (Laurel and Hardy). In a mad rush to implement innovation and to save all possible costs, CMS is creating complications for people that it is most responsible to protect. As PBS and Ken Burns celebrate the legacy of The Roosevelts, it is tragic to see what has become of over a century of effort involving Social Security, Medicare, Medicaid, and health care equity. The United States has one of the most complex health designs and clearly the various designers often know not what they are doing to others. More cartoons and comedians would find this a ripe area for material if not for the suffering involved. Health and Human Services has a huge role across Social Security and US health care. CMS or the Centers for Medicare and Medicaid Services has a dominant role to play in the design of health care in the United States.  CMS can be progressive or regressive. Interestingly CMS has chosen to appear to be progressive and in
Read more

The Essential True Reform Restores Primary Care and Much More

The list of distractions from True Reform are impressive. For decades True Reform has been specifically avoided as primary care worsens within practices and from outside. The demise is most specifically about the financial design. Unless there is a focus on True Reform, there is little hope for Basic Health Access. This may not make as much sense to those outside of family medicine. Family physicians not familiar with AAFP may also be clueless. If you think that you can fix primary care with more technology, more rearrangements, more types of health professional graduates, or more expansions of training - think again. None of these have any hope of working without financial design changes - major changes. The following are various concepts that dominate the discussions at AAFP and primary care meetings and media releases of associations and foundations and institutions. Members, staff, media releases, programs, and personnel have been reviewed.  There is little about Tru
Read more

Innovation Is the Problem Not the Solution for Worsening Health

Image
Innovation is good. Innovation worship is not good. Innovation application without scientific testing or clinical trials is unethical regarding clinical interventions and should be just as prohibited with regard to health policy. Clinical trials can harm hundreds or thousands. Innovative policies can harm millions. It takes a reasonable understanding of health care, health care outcomes, social determinants, and the investments that most improve social determinants to understand the consequences arising from the innovative nightmares past, present, and future. If you review the information sources with a critical eye, you too may find that the innovative policy designs have been disruptive to care, have hurt health care where health care is most needed, have reduced access to care, and have resulted in distortions in the literature. Indeed what is accepted and published in journals seriously lacks consideration of alternative hypothesis, lacks inclusion of many pages of limitatio
Read more