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MEMORANDUM

To: Interested PartiesFrom: Frank LuntzRe: Health Reform Language HighlightsDate: Wednesday, October 28, 2009

OVERVIEW

“Those who cannot remember the past are doomed to repeat it.”

I was there in 1994. I saw what happened when a once-popular president tried to pushhealthcare legislation that Americans didn’t want or appreciate. I witnessed the electoralimplications when his administration tried to expand the role of government against the wishesof, well, almost everyone. And it’s happening once again.Let me be clear: this memo isn’t meant to be partisan and it’s not just for Republicans. Itis my hope, in fact, that they will share the contents of this document with their moderateDemocrat counterparts – those who care more answering to the people they represent thananswering to their leaders who are, quite frankly, pushing them off a cliff. Nancy Pelosi and Harry Reid’s recent insistence on including a massively expensive

“public”

option (in reality, it is a

“government”

option) has been met with a resounding thud bya majority of Americans. For some reason, advocates of government-run insurance are intent onincluding it in health reform even if its inclusion brings down health reform altogether. Whether this insistence on public/gov’t option is driven by ideology or by a misplaced belief in some of the more recent superficial polling on this issue is hard to know – and it’s just plain wrongOne thing is for sure – anyone who would place their political future in the hands of asingle survey question purporting to show that Americans want Washington to jump into thehealthcare business probably deserves to lose.Yet while the public/government option is getting all the attention it is becoming a side-showto the real issues driving this debate for most Americans:-- The fact that the current proposals will cost them more, personally – and theyknow it;-- Increase already ballooning deficits and looming national debt; and-- Further insert government into Americans’ lives and harm the quality of their care. (Don’t take my word for it – the NBC/WSJ poll last week says it all: 40% believe their quality of care will worsen, while only 21% think it will improve.)

Our research this month shows that:



Individuals believe this will add to – not reduce – their personal health care costs. We’renot alone. That NBC/WSJ poll is only the most recent to uncover this painful perception.The margin is HUGE:

47%

think

their costs

will go

thanks to “Barack Obama’shealthcare plan,” while

only 13%

think

their costs

will go

down.

This is NOT a goodsign for legislation that’s been sold as beneficial for the economy and promised to reducehealth spending. Various public and private cost reports have clearly seeped into thenational consciousness, despite Democrats' frantic efforts to discredit them. The longer the debate goes, the more likely people are to see healthcare costs rising, not falling.



Claims of deficit-neutrality are roundly rejected and even ridiculed. No one believes thatthe government will enact a massive new entitlement without costing Americans moremoney.

In fact – and quote this – by an incredible 61% to 14% margin, more peoplebelieve scientists will discover life in outer space than believe the current healthcareplan won’t add a penny to the deficit.

The President has clearly diminished hiscredibility by claiming this won’t add

“one dime”

to the deficit.



The intensity is with the opponents of the current legislation. Fully 25% of thosesurveyed said they would

“actively work to defeat”

members of Congress who vote for agovernment insurance plan, while only 8% said they would work to support them.



Overall

opposition

to the Congressional healthcare plan generally – and specifically toany kind of government-run insurance -- is, predictably, more intense in the states of centrist Democrats.



Seniors are soundly against the current plans. They aren’t buying that $400 billion incuts aren’t really cuts and they really don’t like the idea that Congress appears to be paying for health reform on their backs.



This legislation may have been more tolerable to Americans months ago, before thevarious stimulus, bailouts, etc. – but now it is much too much. Americans are deeplyconcerned that Congressional Democrats are over-reaching and heaping too much on thetable at the risk of bankrupting the country. The sense of fragility about the current

“jobless recovery”

is palpable – and you see it in the just-released consumer confidencenumbers – but some people aren’t listening.The bottom-line is that pushing through major economy-altering legislation in theabsence of any bi-partisan support is a recipe for disaster – either now or later. The fact that for most Americans the result of the legislation is expected to be higher taxes, higher premiums,and/or reduced services is not likely to engender great good-will after the fact.

SETTING THE CONTEXT

You STILL need to acknowledge the need for reform.

We’ve seen a small erosionin the public sentiment that there is a healthcare crisis. This is likely due to thehealthcare debate itself: the threat of a government takeover of healthcare has madesome Americans more appreciative of the healthcare they have right now.Even so, a clear majority of Americans believe healthcare in America still at least is

“seriously troubled and needs significant revisions.”

While Americans still perceive a genuine healthcare problem, they do not viewthe Democrats’ approach as the right solution.

Our language survey is consistentwith most national polls: half of all Americans (49%) now oppose the plan, whileonly 39% support it (and 12% remain undecided). This is almost a perfect reversal of where support for the President’s reform plan stood in the spring. Clearly, thelanguage of the opposition is resonating. But to identify the words, themes, andemotions that resonate most on the issue, our poll goes further.--

First, notice that

more than third

of Americans

strongly

oppose thelegislation (34%).

They are primarily, but not exclusively,conservative voters.--

Importantly, 48% of self-identified independents oppose thelegislation

(30% strongly), compared to only 40% who support it.The untold story of the past six months is the collapse in supportamong independents and moderates. Republicans always hated theObama approach, while Democrats were always in his corner. But tosee Americans in the political center turn from cautiously supportive toincreasingly opposed is the most significant political consequence of the debate.--

Seniors, obviously a key constituency, are in firm opposition to thereform plan (57% oppose, 36% support).

Back in April, they wereevenly divided.

More precisely, it is men aged 60+ who are theangriest.

Fully 47% of men 55 or older are

strongly

oppose theplan (61% are at least somewhat opposed).

Suggestion: So far, most of the ads featuring concerned patients have beenwomen. It’s time to include men in these ads, too. Treatment of prostatecancer can be delayed just as much as for breast cancer when the government takes over care – and American men deserve to know about that.

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MikalD1

On page 4, Luntz claims that, in the 60s, Percy Sledge sang "The Thrill is Gone." He's wrong there -B.B. King recorded the song in the 60s and had a hit with it in 1970 (despite there being several covers of Thrill, I find no indication of Sledge doing so) - and wrong about healthcare reform. There is ABSOLUTELY no need for for-profit health insurance companies to exist. Michael Dodson Shawnee, Oklahoma

reply10 / 30 / 2009