Over the past weekend, Ceci Connolly of WaPo contributed a classic example of modern MSM journalistic writing, a piece that looked like it had been written by tying together a bunch of index cards with a minimum of prose, a “clop-clop style,” and a near absence of any semblance of logic or transition from one paragraph to another. Let’s take a look at some of Ceci’s minimalist and disjointed paragraphs from the viewpoint of fixing the President’s messaging by communicating and advocating “Medicare for All.”

”Now, as lawmakers begin to flee Washington for a month-long recess, the White House team is retooling its message and strategy, hoping a more modest approach will reinvigorate Obama’s signature domestic policy initiative and give him a first-year victory for Democrats to carry into the 2010 midterm elections.”

Obama’s retooling of message and strategy to fit a more modest approach will not reinvigorate health care reform among health care activists, but will make them feel further betrayed by the Administration. It may reinvigorate health care in Congress by picking up some Blue Dog support. It may even serve to pass something called reform, but the health care activists will not consider it a victory because it will keep them under the thumbs of the insurance companies, and neither will the public which, evidently, would be mandated to pay high prices for uncompetitive private insurance plans, without even having access to a public option, which would, most probably, be a victim of the new, more modest approach. The result would not be victory for the Democrats in 2010, but losses sufficient to hinder the prospects of further reforms in every area in which it is needed.

”Legislative wrangling, a well-coordinated Republican opposition and the sheer complexity of an issue that consumes nearly one-fifth of the nation’s economy have taken a toll on the president and his bold ambitions. Polls show that support for Obama’s handling of health reform has declined as anxiety deepens about its effect on middle-class, insured Americans.”

Of course, the sheer complexity of the issue is created by Obama’s leaving it to Congress to write a bill, and the workings of lobbyists to get it to write a bill that will satisfy most of their interests. That’s what produces a 1039 page bill. The toll taken on the President is of his own making. A “Medicare for All” solution comes over as a fairly simple “issue,” easy to explain, and results in a bill of 30 pages or so. Moreover, anxiety “about its effect on middle-class insured Americans,” is alleviated because Medicare for All would guarantee them insurance for basic health care, along with choice of any Physicians in the Medicare network. And that network would undoubtedly be easily augmented once Medicare for All was a right of everyone.

Some physicians would refuse to accept Medicare patients, and some middle-class people might have to give up physicians they like. But given the well-documented broad support in the physician community for single payer plans, this is not likely to be a serious problem for most people who will probably be able to keep their Doctor provided he/she really cares about his/her patients; and the risk of having to find a new Doctor is far less than the current risks of denials of service due to pre-conditions, rescissions, bankruptcies, and other effects of the present health insurance system.

”. . . With the debate shifting from partisan-charged Capitol Hill to the kitchens, diners and churches of America, Democrats are under pressure to counter the GOP’s "risky experiment" story line. . .“

Of course, the risky experiment meme goes right out the window with Medicare for All, since it can easily be countered by using Medicare, and Tricare, experience and by holding town halls in Australia, Canada, France, and New Zealand on their experience with single payer insurance.

”. . . His patient, hands-off style — reminiscent of his methodical primary campaign last year — has frustrated some anxious Democrats but stands in stark contrast to Clinton’s unsuccessful strategy of crafting a 1,300-page bill in secret and then pressing lawmakers to approve it. . . .”

The President’s letting Congress write the bill may be in stark contrast to what Clinton did, but the result is not. That is, Clinton came up with a horribly complex 1300 page bill that no one can fully understand. Congress and Obama are likely to produce a horribly complex, roughly 1050 page bill that no one can fully understand. Why is there no stark contrast in these outcomes? Because both bills refuse to legislate Medicare for All, and therefore they go through marvelous gyrations to safeguard the interests of the insurance companies.

”. . . Axelrod acknowledged that two critical constituencies — senior citizens and women — need to be reassured that reform will translate into the "security and stability" that Obama promises. "That’s work that we need to do," the adviser said in an interview. . .”

And, if Obama were to commit to “Medicare for All,” both problems would disappear, since everyone knows that Medicare is secure and stable, or, at least, will be kept that way, come what may, by the US Government.

”. . . The Obama brand — long the envy of politicians of every stripe — has weakened as voters examine a record that has thus far entailed huge government spending to help the economy, said McInturff, who was a key strategist in the defeat of the Clinton plan. . . “

Obama’s brand has weakened because he hasn’t done very much to ease the problems of Main Street. People know that, and are seeing him as an elitist who is spending a lot of money on people who don’t need any. But the cost of Medicare for All, is a cost that’s worth it for people, because it means real and guaranteed health care, and no more worries about that. Want to bet that the Obama brand would suddenly strengthen if he pushed through Medicare for All?

Finally, as is increasingly true these days, the framing of WaPo writers like Ceci Connolly is reprehensible and lacks integrity and objectivity. Most stories one sees there these days don’t correspond to reality in a meaningful way, even when they are factual. They are so selective in the facts they use in their stories, and so framed, that their narratives always reflect what the Washington "smart money" thinks is going on, though sometimes with a little twist to make everyone think they are free thinkers. That’s why Obama’s rise was such a surprise to them, and why they have so little capability to anticipate Black Swans. Writers like Ceci Connolly will always frame the political scene in a way that suggests that President Obama will be brought down to earth. They would never acknowledge the possibility that a real change in the direction of messaging might occur, because they themselves would never modify their own frames, to think about the unanticipated. Obama’s switching to Medicare for All is unanticipated. It would a surprise; a Black Swan. But it could happen. It depends on how badly he really wants to win on health care, and not merely create a bailout for the insurance industry.



Joseph M. Firestone, Ph.D. is Managing Director, CEO of the Knowledge Management Consortium International (KMCI), and Director and co-Instructor of KMCI’s CKIM Certificate program, as well as Director of KMCI’s synchronous, real-time Distance Learning Program. He is also CKO of Executive Information Systems, Inc. a Knowledge and Information Management Consultancy.

Joe is author or co-author of more than 150 articles, white papers, and reports, as well as the following book-length publications: Knowledge Management and Risk Management; A Business Fable, UK: Ark Group, 2008, Risk Intelligence Metrics: An Adaptive Metrics Center Industry Report, Wilmington, DE: KMCI Online Press, 2006, “Has Knowledge management been Done,” Special Issue of The Learning Organization: An International Journal, 12, no. 2, April, 2005, Enterprise Information Portals and Knowledge Management, Burlington, MA: KMCI Press/Butterworth-Heinemann, 2003; Key Issues in The New Knowledge Management, Burlington, MA: KMCI Press/Butterworth-Heinemann, 2003, and Excerpt # 1 from The Open Enterprise, Wilmington, DE: KMCI Online Press, 2003.

Joe is also developer of the web sites www.dkms.com, www.kmci.org, www.adaptivemetricscenter.com, and the blog “All Life is Problem Solving” at http://radio.weblogs.com/0135950, and http://www.kmci.org/alllifeisproblemsolving. He has taught Political Science at the Graduate and Undergraduate Levels, and has a BA from Cornell University in Government, and MA and Ph.D. degrees in Comparative Politics and International Relations from Michigan State University.