Got Health Care?

Democrats Struggle to Market Obamacare to Skeptical American Public

Democrats are presented with an almost impossible problem: how to make the law palatable. By Judith Grey.

Jewel Samad, AFP / Getty Images

However the Supreme Court rules on Obama’s Affordable Care Act in June, one thing is for certain—right now, every Democratic consultant in the country is scrambling to figure out a way to make the plan more popular.

It’s a quintessential marketing dilemma—how do you sell something that people fundamentally aren’t crazy about?

According to a recent New York Times/CBS News poll, just 36 percent of Americans approve of the legislation. And while some of parts of the law—allowing young adults to remain on their parents’ insurance plans until the age of 26 and requiring insurance companies to cover people with pre-existing conditions—are deemed highly favorable by the public, the overall plan has a 47 percent disapproval rating.

In the early 1990s, when milk processors and dairy farmers realized that vitamin D wasn’t a compelling enough reason for people to buy milk, their advertising agency, Goodby Silverstein, advised them to focus, instead, on the cookie and then pose the question “Got milk?” It worked. Milk sales increased dramatically.

Can a similar tactic be used to sell health care? Indeed, can anything at all be done to make the plan more attractive to consumers?

According to Lawrence O’Donnell, the answer is no.

“You’ll find that it is impossible,” he said of the marketing of health-care reform. “And that is the most important thing to know about this law, this idea, and this area of thought in American politics.”

O’Donnell should know. Now the host of his own news and opinion program on MSNBC, he was a former legislative aide to Sen. Daniel Patrick Moynihan and the staff director of the United States Senate Committee on Finance in 1993, the year Hillary Clinton proposed her health-care plan.

“It is unmarketable and always has been since Medicare,” said O’Donnell. “Medicare was marketable because it was understandable. I have never met anyone, outside of the government, who can describe what the new health-care law is. You cannot market something that is indescribable.”

On the matter of the public’s familiarity with the law, O’Donnell is absolutely correct. According to a recent study conducted by Celinda Lake, a leading Democratic pollster who has conducted extensive research on health-care reform, “only about one in four likely voters say they know a significant amount about the new law.” And unsurprisingly, “those who have paid the most attention are the voters who are most against it.”

“This territory invades basic American principles,” O’Donnell added. “It always has. And it’s a problem.”

Republicans, of course will argue that any government effort to enforce a mandate is unconstitutional, an infringement on personal freedoms.

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To underscore this point, I contacted a conservative copywriter I know and asked if he could think of an ad Republicans might run in the event that Obamacare is upheld. (He wished to remain anonymous.)

Presuming that the only way this could happen was in a 5-4 decision, he emailed me the following script:

“Announcer: Thanks to Barack Obama, today, in America, the government can force citizens to buy what they tell them to buy. This time, it’s health insurance. You either buy it, or you get hit with a penalty by the IRS. Who knows what it’ll be next time.

But Obama didn’t do it alone. In a narrow 5-4 decision, a left-leaning Supreme Court made it the law of the land. The next president will likely have to fill one or two vacancies. Do you want it to be by more who share Barack Obama’s contorted view of America? Of the Constitution? Of what it means to be free? Or someone who thinks the Founding Fathers got it right when it comes to what the government can force people to do?”

A commercial that attacked Hillarycare, “Harry and Louise,” made a similar argument, claiming that when the government gets to “choose, you lose.”

If Obamacare is overturned, however, it might not be as simple for the Democrats to strike back with a comparably single-minded advertising approach.

Robin Hafitz, CEO of Open Mind Strategy, a consumer insight company based in New York, argues that the first thing Democrats would have to do is change the title of the law.

“The strategy for naming health care has always been off,” she said. “Anything with the word ‘care’ in it is obviously—to Foxamentalists—about helping poor people and that’s not something they’re interested in.”

Hafitz suggested that Democrats should start marketing the health-care law “by calling it something else,” proposing new names such as “health protection legislation,” “health freedom legislation,” and “health leadership legislation.”

Celinda Lake, the Democratic pollster, said the problem lies in how the policy is framed: “Women are not paying any attention at all.” According to Lake’s studies, “women are 80 percent of the health-care voters and 80 percent of the health-care decision-makers.”

“They see it as a political issue, not a consumer issue,” she added.

Unlike O’Donnell, however, Lake is confident about ultimately eliciting a positive response to Obama’s health-care plan. “They need to get information out about the plan’s specific benefits through a variety of channels, including word-of-mouth, health-care providers, and public-health offices,” she said. “We really need to turn up the volume.”

“Ironically, it may not be that harmful if the mandate is overturned,” she added. “It will turn down the noise and allow people to really focus on what the plan does.”

Lenny Stern, a founding partner of SS+K, the New York-based youth marketing agency of record for the Obama campaign in 2008—and reportedly part of the team working on the president’s reelection bid this year—echoed Lake’s forecast.

“I think it’s going to make people realize that there were a lot of benefits to this,” Stern said of Obamacare being overturned. “And it might actually create even more grassroots support for pushing a reform through beyond where the courts may land. It may create an even stronger base for future reform.”

Arguing the case for reform isn’t a “lost cause,” said Stern, who has been involved extensively in marketing and communications efforts for health-care and public-health issues: “In any situation, people almost always zero in on ‘What’s in it for me?’ You know, the WIIFM?”

“I think, to date, the challenge has been, how do you create an emotional connection around reform that was still a theory and not a practice?” Stern said. “You have to bring real stories about how lives have already been changed in a positive way. Trying to tell those stories is imperative because that’s how people emotionally understand the impact.”

A creative director who spoke with me on the condition of anonymity said he is disillusioned with Stern’s approach, however. Experienced in both consumer advertising and in the political arena on the Democratic side, he made the overarching observation that “the advertising on the left isn’t as visceral as advertising from the right. It doesn’t seem like it connects with core, overriding values or American beliefs.”

“If Democrats are going to make a health-care ad, it’s going to be about health care,” he said wearily. “If the Republicans make a health-care ad, it’s about liberty, it’s about socialism, it’s about the heart of what America was founded on and believes in.”

O’Donnell framed the Democrats’ problem slightly differently, if not more apocalyptically.

“What you’re saying to America is that there are 45 million people who need another government financial-assistance program,” he said. “So your fundament pitch is altruism. But America has run out of altruism. They ran out of altruism 30 years ago.”