Words Matter: What Public Health Can Learn from the Health Care Reform Debate

Robert Crittenden, MD, MPHFrancesca Holme, MPH

Objective successfully connect with the public, media, and/or legislators on public health goals

Goal a healthier next generation of Americans

Learn…• Effective communications strategies for

health reform• Ways to apply these strategies to public health• How to use health care reform as a

springboard for public health

Communication strategies for health reform

Why Connect?• Remember Harry and Louise?• The public = legislators

The Need for an Opening

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Tips for Connecting• Know your audience • Values + beliefs outweigh facts• Anger motivates us—fear shuts us down• Be proactive • Use personal themes• Know your opponents

Health Care as an Example

Remember: 93% of voters (2008) have health insurance

Health Care is a Core Value• Linked to:

The pursuit of the American Dream Our country’s destiny Our family’s well-being and future

• Voters talk about reform in moral terms yet reform as a moral issue is insufficient to move voters.

Photo by Azoreg: creativecommons.org/licenses/by-sa/3.0

It’s Personal

Americans think about health care and reform through a very personal prism:•Who will pay?•What will I lose?

Poll: Choice and Control

When it comes to health care reform, the top issue my friends need to be reassured about isA. Choice of plans they can afford

B. Choice to keep their doctor

C. Guaranteed coverage

D. A plan (public or private) with standard comprehensive benefits

Security and Peace of Mind

Voters (especially women) want care they can count on through life and economic transitions• Birth of a child• Job changes, part-time work• Major illness• Divorce• Relocation• Early retirement• Layoffs

Example

It will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t. And it will slow the growth of health care costs for our families, our businesses, and our government. It’s a plan that asks everyone to take responsibility for meeting this challenge – not just government and insurance companies, but employers and individuals.

Pres. Obama Sep. 9, 2009

Messaging Advice• Start your message with a story• Keep your message simple and

personal—don’t get pulled into the weeds

• Focus on values

Start with a Story• Start with solid form

• Problem, Tension, Resolution• Protagonist, Antagonist, Motives

• Use powerful and understandable metaphors• iPhone

• Show Americans solving problems

Example Story

I became a public health nurse because I

wanted to help people stay healthy. But our

health care system doesn’t make it easy for

me to do my job. Insurance companies

motivated by profit – not health – call the

shots while hard-working Americans suffer.

protagonist

antagonist

motives

problem

tension

motives

Example Story (cont.)

It doesn’t have to stay this way. Our leaders

have proposed a uniquely American

approach to health reform that reflects

what’s important to us: having health care

our patients can afford, and giving public

health nurses the tools we need to give the

best care.

resolution

Americans solving problems

Then Frame the Issues• Affordability• Choices• Control• Peace of mind• Responsibility/fairness

Application of values to public health

Poll: What Is Public Health

Write two to three words that best describes what public health is or does.

Enter your answer via text chat.

What About Public Health?

The public thinks prevention is the most important health reform priority. But keep in mind:

preventionpublic health

personalinstitutional

healthy kidsgovernment

program

personal

prevention

community

prevention

Healthiest next generation Responsibility Peace of mind Choice Affordability

Possible Crossover

Values

Public Health Challenges

Name an important challenge public health faces today, or a policy goal you would like public health to achieve.

Enter your answer via text chat.

Childhood obesity epidemic

Chronic illnesses

Lack of stable funding for prevention

Examples

Obesity Healthiest Next Generation

Chronic Illness Shared Responsibility

Photo by Kilbosh: creativecommons.org/licenses/by-sa/3.0

Funding Peace of Mind

Photo: Pediboi (creativecommons.org/licenses/by/3.0)

Possible Example: Peace of Mind

When we invest in prevention, all of us can rest easier: we know that the food we eat is safe; that we’ll be protected if there is a disease outbreak; and that help will be there for us during an emergency. Preventing disease doesn’t cost as much as treating an illness. But the peace of mind that comes with knowing that we’re protected is priceless.

Using health care reform as a springboard for

public health

Current Status of Reform: House

HR 3200Community prevention grants

National prevention and wellness strategy

Core public health infrastructure for state, local and tribal health departments

Public health workforce training and funding

Peace of Mind

Current Status of Reform: Senate

Senate Finance Committee BillMaternal, infant and early childhood visitationHealthy lifestyle programs for Medicare and Medicaid patientsChildhood obesity demonstration project

Healthiest next generation

A Historic Opportunity

Remember: the public is with you… if you connect.

It’s Not Over When a Bill is Passed

One of the great lessons I’ve learned from a life in politics is that no reform is ever truly complete. We must constantly keep moving forward.

Senator Edward Kennedy

Further Resources

http://www.herndonalliance.org

Check for current and future research and messaging… New research on messaging prevention soon to come!

Let us know if you have ideas.