The Long War to Save Healthcare.

Photo by Cooper Smith on Unsplash

It looks like the Republican Party’s war on the nation’s health is back on, and with a vengeance. Why, no one can quite articulate. Maybe that’s the reason victory has always found one way or another to slip through their fingers.

The only explanation that ever sounded rational, albeit darkly, was Senate Majority Leader Mitch McConnell’s early statement that he was out to wreck every accomplishment of Barack Obama. The current occupant of the Oval Office is even more brutishly clear in his pursuit of that objective.

So even after a string of humiliating defeats there is fight left in the Republicans. Like any war, the endless attacks will do great harm to the lives of a great many people. And like any war, victory will be decided by larger matters than the immediate battle.

The president has signed his executive order and blown huge loopholes in the protections of the Affordable Care Act. The hypocrisy of his party, which was so recently harrumphing in outrage at the very idea of government by executive order, is come to full bloom.

What’s the right countermove for the Democrats?

Over the past months I’ve been writing about how the Democrats have a rare opportunity right now to borrow some thinking from the advertising world, and re-brand the party in a way that elegantly steals the GOP’s thunder.

You can read the whole analysis here:

The executive summary is that the Republicans have abandoned much of the high ground they once occupied in the American psyche. They’ve stepped into the abyss, and seem determined to dig it even deeper. This leaves a lot of useful political landscape for the Democrats to own.

To sum it all up in one positioning statement, the Democrats have an opportunity to stand for truth, justice and American values.

These might seem like broad and abstract notions. That’s what makes them useful for focusing a message that counters the unceasing Republican attacks on the Affordable Care Act. They can become big, symbolic banners to rally around at a time when the most significant threat to the Democrats is their own tendency to split into factions squabbling over how far to the left or the center the whole thing needs to be pushed.

Using the idea of party as brand, we can sidestep questions like that and put two unifying principles at the front of the fight to save healthcare.

One is centered on justice. In a modern society like ours it is wrong to deprive people of decent medical care. This is where the Republicans’ legislative efforts kept falling short. They could never get past the fact that millions would have their healthcare taken away under the Republican proposals.

The other is centered on truth. A healthcare plan should cover the medical treatments people need to live decently healthy lives (see the basic Obamacare protections). Anything less is a lie.

This is where the latest Republican efforts to weaken the Affordable Care Act run into trouble. The president’s executive order relies on warmed over ideas that were discredited as worthless scams back in the 1990s. Think of them as the Trump University of healthcare.

I got conned myself years ago, when I bought one of the short term insurance plans the president wants to bring back. My son was taking a year off from school. I wanted to make a point about being responsible and maintaining coverage, especially given his knack for snapping things like wrists and collar bones at the snowboard park. I talked to a reputable insurance agent and he set us up.

It was only later that I read an article describing how the plan I’d bought for my son was a rip-off that made artful use of the old preexisting conditions dodge, and rarely paid out a dime in medical bills. Luckily my son never needed his worthless insurance. But I was astonished at how a system with so much riding on it could be so lax.

The nation breathed a healthy sigh of relief when the final Republican effort to repeal and replace the Affordable Care Act fizzled in Congress. Now in one short week, in what felt more like governing by temper tantrum than by any sort of rational policy, they’ve used executive actions to deprive women of access to birth control, reopen the door to dangerous junk insurance plans, and scrap the cost-sharing payments that help stabilize individual insurance markets. And those are just the headlines. It all comes just as the 2018 enrollment season is set to open, and threatens to put the entire market for individual insurance plans into a tailspin.

It is possible the Affordable Care Act can’t survive that sort of blitzkrieg. It is even possible the president’s reckless disruptions will spread into the larger employer-based insurance market. People forget how bleakly dysfunctional the whole system had become in the years before the Affordable Care Act.

If the Republicans do enough damage my prediction is we’ll ultimately end up with some sort of single payer system. They haven’t offered any other workable alternative for what happens once they finish dismantling the current system and create a giant vacuum at the center of the way we deliver medical care. But until we get there it could mean dark years for a lot of people with medical conditions. A long war indeed.

Right now, the task at hand is to stand up for the healthcare we have. Maybe even find some smart ways to improve it. The Democrats don’t have a lot of real political power. But there are the courts, and highly visible ways to sue the administration over its actions. There is a public comment period that comes with writing the regulations that will carry out the new executive order. It should be made very public indeed. There is still hope for the ongoing effort to reach a bipartisan compromise in Congress that would fix some of the problems in the insurance market. A good bill would limit some of the president’s ability to wreck havoc in the healthcare market.

Most important, there is the high ground that’s been given like a gift to the Democrats, and the two unarguable principles the party can plant like flags flying high on the hill.

It’s unjust to deprive people of healthcare.

It’s a lie to sell healthcare plans that are little more than worthless junk if you’re unlucky enough to need them.

These two principles can serve as a guide to what the party can and cannot compromise as it reaches across the aisle to find a bipartisan healthcare law. They can unite and amplify the party’s voice as it fights to minimize the loss of coverage and improve rather than tear apart the system. They can give people something to hold on to in what might be a long struggle.

This is ad agency thinking, not political thinking. Using the emotional power of a brand to connect with the mass public in a way that inspires action. At a time when politics have become so toxic, I suspect that would make it a tactic even more surprising than the week-long attack on healthcare launched by the Republicans. It might be exactly the medicine we need.