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

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

• Robert Crittenden, MD, MPH
• Francesca Holme, MPH

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Objective successfully connect with the public, media, and/or legislators on public health goals
Goal a healthier next generation of Americans
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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

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Communication strategies for health reform
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Why Connect?

• Remember Harry and Louise?
• The public legislators

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The Need for an Opening
Photo by Miuki creativecommons.org/licenses/by-sa
/3.0/
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Tips for Connecting

• Know your audience
• Values beliefs outweigh facts
• Anger motivates usfear shuts us down
• Be proactive
• Use personal themes
• Know your opponents

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Health Care as an Example

• Remember 93 of voters (2008) have health
  insurance

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Health Care is a Core Value

• Linked to
• The pursuit of the American Dream
• Our countrys destiny
• Our familys well-being and future
• Voters talk about reform in moral terms yet
  reform as a moral issue is insufficient to move
  voters.

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Its Personal

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

Photo by Azoreg creativecommons.org/licenses/by-s
a/3.0
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Poll Choice and Control

• When it comes to health care reform, the top
  issue my friends need to be reassured about is

A. 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
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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

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Example

• It will provide more security and stability to
  those who have health insurance.  It will provide
  insurance to those who dont.  And it will slow
  the growth of health care costs for our families,
  our businesses, and our government.  Its 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
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Messaging Advice

• Start your message with a story
• Keep your message simple and personaldont get
  pulled into the weeds
• Focus on values

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Start with a Story

• Start with solid form
• Problem, Tension, Resolution
• Protagonist, Antagonist, Motives
• Use powerful and understandable metaphors
• iPhone
• Show Americans solving problems

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Example Story
protagonist

• I became a public health nurse because I wanted
  to help people stay healthy. But our health care
  system doesnt make it easy for me to do my job.
  Insurance companies motivated by profit not
  health call the shots while hard-working
  Americans suffer.

motives
problem
antagonist
motives
tension
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Example Story (cont.)
Americans solving problems

• It doesnt have to stay this way. Our leaders
  have proposed a uniquely American approach to
  health reform that reflects whats 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
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Then Frame the Issues

• Affordability
• Choices
• Control
• Peace of mind
• Responsibility/fairness

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Application of values to public health
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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.

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What About Public Health?

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

public health
institutional
prevention
government program
personal
healthy kids
community prevention
personal prevention
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Possible Crossover Values

• Healthiest next generation
• Responsibility
• Peace of mind
• Choice
• Affordability

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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.

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Examples

• Childhood obesity epidemic
• Chronic illnesses
• Lack of stable funding for prevention

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Obesity Healthiest Next Generation
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Chronic Illness Shared Responsibility
Photo by Kilbosh creativecommons.org/licenses/by-
sa/3.0
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Funding Peace of Mind
Photo Pediboi (creativecommons.org/licenses/by/3.
0)
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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 well be protected if there is a disease
  outbreak and that help will be there for us
  during an emergency. Preventing disease doesnt
  cost as much as treating an illness. But the
  peace of mind that comes with knowing that were
  protected is priceless.

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Using health care reform as a springboard for
public health
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Current Status of Reform House

• HR 3200
• Community 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
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Current Status of Reform Senate

• Senate Finance Committee Bill
• Maternal, infant and early childhood visitation
• Healthy lifestyle programs for Medicare and
  Medicaid patients
• Childhood obesity demonstration project

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A Historic Opportunity

• Remember the public is with you if you connect.

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Its Not Over When a Bill is Passed

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

Senator Edward Kennedy
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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.