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A Prescription For Stephanie Cutter

Obama's New Adviser On Health Care Outreach Should Call The Doctor

Memo to Stephanie Cutter

Re: White House health care messaging strategy


Congratulations on your new assignment as "assistant to the president for special projects," which, according to last week's White House announcement, means you will advise President Obama on "the communications and outreach strategy for the implementation of the landmark health insurance reform legislation."

That's a big job. I would like to paraphrase the famous scene from The Graduate and offer you one word of advice:



Let me explain. By now, you are no doubt all too familiar with the challenge you face. Most surveys show that more Americans continue to oppose the health care reform legislation than support it, and those most likely to vote this year oppose it even more.

Worse for your task, the yearlong legislative debate produced no shortage of "communications." The president addressed a joint session of Congress, held a nationally televised bipartisan summit on health reform and held campaign-style rallies. Interests on both sides spent over $200 million on television advertising. For more than a year, large majorities of Americans said in Pew Research Center surveys that they were following the debate about health care reform "very" or "fairly" closely. When health reform finally passed, Pew's Project for Excellence in Journalism found that it ranked "among the most covered weekly stories" since it started tracking mainstream media coverage in 2007.

Yet the latest monthly tracking poll released last week by the Kaiser Family Foundation finds that all the attention only served to increase the number that say they are "confused" about the new health reform law, from 48 percent in December to 55 percent now. On a different question, more than half (56 percent) say they do not "have enough information about the health reform law to understand how it will impact you personally."

All of that is a long way of saying that there are limits to what you can effectively communicate at this point through traditional media channels. Yes, according to a Gallup poll in March, nearly half of Americans (49 percent) trust your boss, President Obama, "to recommend the right thing for reforming the U.S. health care system," more than Democratic (37 percent) or Republican (32 percent) leaders in Congress. But perceptions of Obama are sharply polarized. The Americans that trust Obama on health care are mostly Democrats that support reform.


Moreover, as detailed in a massive new report from the Pew Center, trust in government itself -- and in the government agencies at your disposal -- is around "its lowest levels in half a century." Not surprisingly, that distrust is especially pronounced among those opposed to health reform; 88 percent say they trust the federal government only some of the time or never. But distrust is nearly as high even among the 13 percent who were unsure about health reform in March; 77 percent trust the government only sometimes or never, only 4 percent trust it "just about always."

Which brings me back to doctors.

For all their cynicism about government and the news media, when it comes to health reform, most Americans trust their doctors.

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