Why has health care reform's public support fallen despite its push among a popular president and significant Democratic majorities in Congress?
It would have been hard to believe several months ago that the high flying president and the liberals in Congress would have had multiple provisions in different bills stripped out and that the public insurance option would be seemingly on the ropes.
Given the particular trouble the health care agenda is in, now is a good time to study the recent past to give some answers to how we arrived here.
Death Panels Autopsy
Sarah Palin and Republicans managed to poison the well over health care reform by likening end-of-life counseling to "death panels" and similar charges, even though they were so caustic that they were almost unbelievable from the start.
The accusations were false, but they had enough attention that Democrats had to respond by explaining what was being distorted. The government would pay doctors to talk to you about the options available at the end of your life, they said. Stripped of the demagoguery, the reality of this proposal was scary, as Charles Lane wrote. Republican attacks heightened awareness of this ugly truth, which killed it, and then cast a pall over health care reform.
Support for health care reform was dismal among senior citizens well before Palin twisted end-of-life counseling provisions into "death panels" and Republicans did much the same. A July poll showed adults older than 65 were the least likely group to think reform would benefit them, with 40 percent saying it would worsen their own care.
Just as President Bush's push to reform Social Security failed to convince seniors their checks wouldn't be reduced, President Obama did not assure the same group that their health care wouldn't be compromised. In both instances seniors feared they would lose when reform was even mentioned. While Obama lost seniors in 2008, many will probably vote next year, which means making them happy is critically important to Democrats in the election.
The Cash for Clunkers Example
"Cash for clunkers" probably damaged public support for health care reform. It looked like a pilot program for the government health insurance option because the public saw the government giving away something at no cost to customers, just as it may with public insurance. The public saw overwhelming demand for the program and its (temporary) termination. Many saw the news that the program would be halted because it didn't have enough money to meet demand and thought this is exactly what the government will do with "free" health care.
The rationing charge against government health care became more believable as people saw the government doing something like rationing in car dealerships while Democrats promised the government wouldn't do the same in hospitals.
The New Mainstream Media
Fox News, Rush Limbaugh, and the Drudge Report are now clearly part of the mainstream media. They have the same power to cover and elevate a story as do CNN, NPR, and The New York Times and are as important as their counterparts to how America gets its information. As such they force the press to cover stories that it may not otherwise spend time on, such as Jeremiah Wright or "Joe the Plumber" during the presidential election. Historian Rick Pearlstein wrote that in the 1960s the press didn't cover accusations as false and wild as "death panels" and the birther meme. Now they do, and it helped kill major portions of the health care agenda.
Social Networking's Potent Potential
Just as the merger of alternative and mainstream media have occurred gradually this decade, so too has the Internet's efficacy as a political media. We didn't bat an eyelash over Palin's choice of Facebook to make her infamous statement, but it would have looked undignified a few years ago if a national politician used the web like that.
Not only are Facebook and Twitter more legitimate, they have discrete power. Both send messages less obtrusively than e-mail, and require none of the financial or labor costs that managing e-mail lists do. Palin has no organization and spent no money to get her message out. While a website lacks a television channel's reach, it is friendlier to politicians' messages because people sign into Facebook or follow on Twitter because they want to hear from others. If they want to find a politician's speech on TV they must make the effort to search for it. As for political advertisements: no one watches TV for the commercials. By comparison, you need only to hit a one button one time on Facebook and you're guaranteed to receive messages with far less trouble than TV requires.