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Not in Public

September 10th, 2009

“The Public Option” has been one of the most hotly contested parts of the health care debate over the past few weeks.  First it was on the table, then off, then back on. It was basically the ping pong ball of the 2009 health care reform conversation.

A historical review of policy proposals in recent history shows that once an issue is named or given a catch phrase, and opponents or the media can attach some connotations to it, it’s pretty much a ticking time bomb.

President Obama health care speech to Congress

President Obama’s speech last night to a joint session of Congress was his chance to regain control of this political hot potato and frame it exactly as he wanted, changing the conversation away from the “public option.”  He started out well, introducing an “insurance exchange:”

“We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance. It’s how everyone in this Congress gets affordable insurance. And it’s time to give every American the same opportunity that we’ve given ourselves.”

Unfortunately, he all too soon reverted to back to the “public option” tag for the concept:

“But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange.”

Back to the start. “Insurance Exchange” sounds capitalist (appealing to Republicans), like a new idea (appealing to Democrats), and trustworthy (appealing to all).  Most importantly, it is something that Obama could’ve owned – with the right supporting mechanisms and talking points in place that could be initiated immediately following the speech.

The fact of the matter is that in debates like this one, words matter the most.  And in a speech that had roughly 5,650 of them there weren’t two or three that really reframed the issue and gave the President the tool he needed to move closer to his goal.

We’ll see what the public has to say about that.

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