Countering The Luntz Memo

Several of these incidences of parroting can be found on the Media Matters Action Network website by searching "Frank Luntz." Below are the 10 "rules" set by Dr. Luntz and just a few examples of why his messaging points do not address the real state of health care in the United States.

"Individualize. Personalize. Humanize."

Luntz Memo, Rule 1: "Humanize your approach.  Abandon and exile ALL references to the "healthcare system." From now on, healthcare is about people. Before you speak, think of the three components of tone that matter most: Individualize. Personalize. Humanize." [The Language of Healthcare 2009, by Frank Luntz, accessed 5/21/09, emphasis original]

When following this rule, conservatives rely on personal stories of people who live in other countries, ignoring tragic American stories resulting from the broken health care system.

BCBS Retroactively Cancelled Plan After Six-Year-Old's Tumor Surgery.  According to the Los Angeles Times, "when Steve and Leslie Shaeffer's daughter, Selah, was diagnosed at age 4 with a potentially fatal tumor in her jaw, they figured their health insurance would cover the bulk of her treatment costs. Instead, almost two years later, the Murrieta, Calif., couple face more than $60,000 in medical bills and fear the loss of their dream home...Shortly after Selah's medical bills hit $20,000, Blue Cross stopped covering them and eventually canceled her coverage retroactively, refusing to pay for treatment, including surgery the insurer had authorized in advance." [Los Angeles Times, 9/17/06]

After Caesarean Section, Company Told Woman She Would Be Insurable If She Had Been STERILIZED.  The New York Times reported on a woman who was turned down for private health insurance because her first child was delivered via caesarean section: "Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, [the insurance company] did not want to pay for it. A letter from the company explained that if she had been sterilized after the Caesarean, or if she were over 40 and had given birth two or more years before applying, she might have qualified." [New York Times, 6/1/08]

American Mothers Cannot Afford Asthma Medication For Their Children.  The New York Times reported: "Lisa A. Hylton, 29, from nearby Sharpsburg, said she had skipped twice-monthly refills three times this year on an albuterol inhaler for her asthmatic son, Hunter. Her husband, a pipefitter, had been working only intermittently and could not afford insurance during the idle stretches, Ms. Hylton said. 'It makes me feel like I can't supply for my young-uns.'" [New York Times, 6/3/09]

You Must "Acknowledge The 'Crisis'"

Luntz Memo, Rule 2: "Acknowledge the 'crisis' or suffer the consequences.  If you say there is no healthcare crisis, you give your listener permission to ignore everything else you say.  It is a credibility killer for most Americans. A better approach is to deny the crisis in your terms.  'If you're one of the millions who can't afford healthcare, it is a crisis.' Better yet, 'If some bureaucrat puts himself between you and your doctor, denying you exactly what you need, that's a crisis.' And the best: 'If you have to wait weeks for tests and months for treatment, that's a healthcare crisis.'" [The Language of Healthcare 2009, by Frank Luntz, accessed 5/21/09, emphasis original]

Americans Are Already Forced To Navigate The Bureaucracies Of Private Insurance Companies:

Insurance Bureaucrats Stand Between Americans And Their Doctors.  Dr. Howard Dean said on MSNBC: "Right now there is a bureaucrat between you and your doctor, and it's that private health insurance bureaucrat." [MSNBC via Nexis, accessed 6/17/09]

Currently, Millions Of Americans Cannot Even Afford To See A Doctor:

"Twenty Percent Of Americans Say They Have Delayed Or Postponed Medical Care, Mostly Doctor Visits, And Many Said Cost Was The Main Reason." According to MSNBC: "Twenty percent of Americans say they have delayed or postponed medical care, mostly doctor visits, and many said cost was the main reason, according to a survey by Thomson Reuters released on Monday." [MSNBC.com, 4/20/09]

Without Health Coverage, People "Are More Likely To Forgo Needed Medical Care And Incur Medical Debt."  A December 2008 report released by the Kaiser Commission on Medicaid and the Uninsured stated: "many workers find that after losing a job they are not able to afford the premiums required to continue employer-sponsored insurance through COBRA...Without insurance, these adults are more likely to forgo needed medical care and incur medical debt."  [KFF.org, accessed 1/14/09]

"Delayed Care Is Denied Care."

Luntz Memo, Rule 3: "'Time' is the government healthcare killer.  As Mick Jagger once sang, 'Time is on Your Side.' Nothing else turns people against the government takeover of healthcare that the realistic expectation that it will result in delayed and potentially even denied treatment, procedures and/or medications. 'Waiting to buy a car or even a house won't kill you.  But waiting for the healthcare you need - could.  Delayed care is denied care.'" [The Language of Healthcare 2009, by Frank Luntz, accessed 5/21/09, emphasis original]

Private Insurance Companies Often Refuse Coverage To Those Who Need It Most:

Common Diseases And Conditions Are Often Reasons For Coverage Denial.  The Minneapolis-St. Paul Star Tribune reported, "in Minnesota, the most common reasons for denial are obesity, mental health conditions, hypertension, diabetes and cardiovascular disease. But there are less well-known reasons insurers consider on a case-by-case basis: chemical dependency, allergies that require costly injectable drugs, a previous C-section, previous use of infertility medicine or something as simple as being pregnant." [Star Tribune, 1/10/09]

Insurance Applicants Rejected Based On Height And Weight.  In an article offering advice on what to do when you lose your health care, the Washington Post reported: "Insurers can decline to offer you a policy, exclude coverage for certain conditions or charge you high premiums. Those with serious conditions such as HIV, cancer or diabetes, as well as those with common conditions such as obesity, can feel the snub. 'In the past four or five years, I've had people turned down just because of height and weight,' says Jerry Patt, an independent agent in Gaithersburg who has been in the business for more than 35 years. 'They could be having no medical problems whatsoever, but their build was not acceptable.'" [Washington Post, 6/22/08, emphasis added]

"It's Not An Economic Issue.  It's A Bureaucratic Issue."

Luntz Memo, Rule 4: "The arguments against the Democrats' healthcare plan must center around 'politicians,' 'bureaucrats,' and 'Washington'...not the free market, tax incentives, or competition.  Stop talking economic theory and start personalizing the impact of a government takeover of healthcare.  They don't want to hear that you're opposed to government healthcare because it's too expensive (any help from the government to lower costs will be embraced) or because it's anti-competitive (they don't know about or care about current limits to competition.)  But they are deathly afraid that a government takeover will lower their quality of care - so they are extremely receptive to the anti-Washington approach. It's not an economic issue.  It's a bureaucratic issue." [The Language of Healthcare 2009, by Frank Luntz, accessed 5/21/09, emphasis original]

Vast Corporate Bureaucracies Are Actively Keeping Americans From Receiving Proper Health Care Coverage:

Major Insurance Companies Pay For Access To Private Medical Information.  According to a Business Week report: "Most consumers and even many insurance agents are unaware that Humana, UnitedHealth Group, Aetna (AET), Blue Cross plans, and other insurance giants have ready access to applicants' prescription histories. These online reports, available in seconds from a pair of little-known intermediary companies at a cost of only about $15 per search, typically include voluminous information going back five years on dosage, refills, and possible medical conditions. The reports also provide a numerical score predicting what a person may cost an insurer in the future." [Business Week, 7/23/08, emphasis added]

Insurers Use The Data To Deny Coverage And To Charge Higher Premiums.  According to a Business Week report: "Two-thirds of all health insurers are using prescription data-not only to deny coverage to individuals and families but also to charge some customers higher premiums or exclude certain medical conditions from policies, according to agents and others in the industry. Some carriers are also using the data to charge small employers higher group rates." [Business Week, 7/23/08]

"Government Takeover"

Luntz Memo, Rule 5: "The healthcare denial horror stories from Canada & Co. do resonate, but you have to humanize them.  You'll notice we recommend the phrase 'government takeover' rather than 'government run' or 'government controlled.'  It's because too many politician [sic] say 'we don't want a government run healthcare system like Canada or Great Britain' without explaining the consequences.  There is a better approach. 'In countries with government run healthcare, politicians make YOUR healthcare decisions. THEY decide if you'll get the procedure you need, or if you are disqualified because the treatment is too expensive or because you are too old.  We can't have that in America.'" [The Language of Healthcare 2009, by Frank Luntz, accessed 5/21/09, emphasis original]

The government will not absorb the health insurance market.  President Obama and other Democrats have been clear about the public/private hybrid system they are envisioning and the hopes that the creation of a public option will provide some much needed competition to the private health care industry.

President Obama: "Keep The Private Sector Honest, Because There's Some Competition Out There."  During the Health Care Summit at the White House, Senator Grassley commented to President Obama, "there's a lot of us that feel that the public option that the government is an unfair competitor and that we're going to get an awful lot of crowd out, and we have to keep what we have now strong, and make it stronger." President Obama replied: "The thinking on the public option has been that it gives consumers more choices, and it helps give -- keep the private sector honest, because there's some competition out there. That's been the thinking. [Health Care Summit, Transcript via Talking Points Memo, 3/5/09; emphasis added]

"A Public Plan Would Provide An Essential Option" For Americans.  Harold Pollack, public health policy researcher at the University of Chicago's School of Social Service Administration and faculty chair of the Center for Health Administration Studies, wrote in an op-ed: "A public plan would provide an essential option--and an equally essential backup--for millions of Americans living with chronic illnesses or disabilities." [The New Republic, 3/10/09; emphasis added]

Currently, 94% Of Health Care Markets In The United States Are Dominated By One Health Insurance Company - Meaning That Americans Are Living With No Choices About Who Provides Them With Health Coverage.

Only A Few Insurance Companies Dominate The Market, Leaving Americans With Limited Choices In Health Care. According to the American Medical Association, 94 percent of United States health care markets are considered highly concentrated, meaning that one company or a small group of companies control a great deal of the market. [American Medical Association, "Competition in Health Insurance," 2008 Update]

Conservatives Often Neglect To Acknowledge The Fact That Americans Want A Drastic Change To The Current State Of Health Care In The United States.

More Than 70% Of Americans Polled Want An Increased Governmental Role In Health Care.  According to CNN, "seventy-two percent of those questioned in recent CNN/Opinion Research Corporation survey say they favor increasing the federal government's influence over the country's health care system in an attempt to lower costs and provide health care coverage to more Americans, with 27 percent opposing such a move." [CNN.com, 3/5/09]

More Than 60% Of Americans Think The Federal Government "Should Guarantee" Health Care For All Americans.  When asked, "Do you think the federal government should guarantee health care for all Americans, or don't you think so?" during a CNN/Opinion Research poll, a majority of Americans, 62%, said "should guarantee," 38% said "don't think so," and 1% "unsure." [CNN/Opinion Research Corporation Poll, 5/14-17/09]

Plurality of Americans Polled Think Health Care Is The Most Pressing Issue For Congress And The President.  According to a New York Times/CBS News Poll conducted February 18-22, 2009 and based on 1,112 respondents, when asked "Beside the economy, which of these domestic policy areas do you want the President and Congress to concentrate on MOST right now - health care, global warming, education, or Social Security?" the respondents' answers were: 40% Health Care, 5% Global Warming, 27% Education, 22% Social Security, 4% Something Else/Combination, and 1% Didn't Know.  [New York Times/CBS Poll, 2/09]

The Majority Of Americans Want An Obama-style Mix Of Public And Private. According to a poll conducted by Lake Research:

• 60% of Americans favor "providing access to affordable, quality health care for all Americans even if it means raising taxes."
• 71% of Americans favor "providing access to affordable, quality health care for all Americans even if it means a major role for the federal government."
• 73% of Americans prefer "having a choice of private health insurance or a public health insurance plan." [Lake Research poll, 01/09]

"Healthcare Quality = Getting The Treatment You Need, When You Need It."

Luntz Memo, Rule 6: "Healthcare quality = 'getting the treatment you need, when you need it.' That is how Americans define quality, and so should you.  Once again, focus on the importance of timeliness, but then add to it the specter of 'denial.'  Nothing will anger Americans more than the chance that they will be denied the healthcare they need for whatever reason.  This is also important because it is an attribute of a government healthcare system that the Democrats CANNOT offer.  So say it. 'The plan put forward by the Democrats will deny people treatments they need and make them wait to get the treatments they are allowed to receive.'" [The Language of Healthcare 2009, by Frank Luntz, accessed 5/21/09, emphasis original]

Under The Current System Of Health Care Delivery In The United States, American Citizens Do Not Always Get The Treatment They Need When They Need It.

American Families Already Faced With Cancer Diagnosis Also Have Difficulty Paying For Health Care.  According to a Lake Research Poll: "Half (52%) of families with a person under 65 who has had a cancer diagnosis say they have had difficulty paying for health care costs.  Additionally, close to half (47%) of those currently receiving cancer-related care has had [sic] difficulty affording care." [ACSCAN.org, 5/20/09]

Rather Than Waiting In Line, Americans Simply Do Not Get Care. As Ezra Klein argues in the Los Angeles Times, "although Britain and Canada have decided that no one will go without, even if some must occasionally wait, the U.S. has decided that most of us who can't afford care simply won't get it." [Los Angeles Times, 4/7/09, emphasis added]

Many Americans Have Been Priced Out Of Health Care.  As Ezra Klein points out on his blog: "If you look at waiting times, you'll see that relatively few Americans wait more than four months for surgery, which helps folks claim that America doesn't ration care, and makes our system look pretty good on the waiting times metric. Here's what they don't tell you: When you look at who foregoes care, the international comparisons reverse themselves. About 23% of Americans report that they didn't receive care, or get a test due to cost. In Canada, that number is 5.5%." [Ezra Klein blog, The American Prospect, 12/5/08, emphasis added]

Protect "The Personalized Doctor-Patient Relationship"

Luntz Memo, Rule 7: "'One-size-does-NOT-fit-all.'  The idea that a  'committee of Washington bureaucrats' will establish the standard of care for all Americans and decide who gets what treatement based on how much it costs is anathema to Americans.  Your approach?  Call for the 'protection of the personalized doctor-patient relationship.' It allows you to fight to protect and improve something good rather than only fighting to prevent something bad."  [The Language of Healthcare 2009, by Frank Luntz, accessed 5/21/09, emphasis original]

Private Insurance Companies Often Refuse Coverage To Those Who Need It Most:

Americans Face Denials For Coverage From Insurance Companies Every Day.  Americans are already facing the denial of treatments from their private insurance companies, according to the Wall Street Journal. As Diane Archer, director of the Health Care Project at Institute for America's Future recently argued in the New York Times: "As any doctor will tell you, when a private health insurance plan delays or denies a physician-recommended service, it is deciding who gets care and what kind of care people get." [Wall Street Journal, 9/25/08; New York Times, 5/8/09]

"Pre-Existing Condition Exclusions" Included In Coverage After An Individual Has Gone Without Health Insurance.  According to the Kaiser Commission on Medicaid and the Uninsured: "If an individual is uninsured for 63 days or more, pre-existing condition exclusions can be imposed by their new health plan for most health conditions for which treatment, advice or diagnosis were received in the six months prior to enrolling in an employer-sponsored insurance plan. Insurers can typically refuse to cover medical care related to pre-existing conditions for up to one year." [KFF.org, accessed 1/14/09]

Health Care Disparities Are Rampant Across The Country And The Construction Of A National, Public Option Would Help Address These Inequities.

In March 2008, the Commonwealth Fund published a report titled, Racial and Ethnic Disparities in U.S. Health Care: A Chartbook.  According to the report:

• Non-English Speaking Patients Report Poor Relationships With The Doctors Who Treat Them. "Adults whose primary language is not English are more likely to report that their providers sometimes or never listened carefully, explained things clearly, respected what they said, and spent enough time with them." [CommonwealthFund.org, accessed 2/12/09]

• Physicians Primarily Serving Black Patients Reported Difficulty In Providing High-Quality Care For Their Patients. "Primary care physicians that primarily cared for black patients were more likely to report difficulty in providing high-quality care than physicians who primarily cared for white patients. Specifically, these physicians reported they were less able to provide access to high-quality subspecialists, to high-quality diagnostic imaging, to nonemergency hospital admissions, and to high-quality ancillary services." [CommonwealthFund.org, accessed 2/12/09]

• "Distrust Of The Medical Community" A Factor In The Quality Of Care For Minority Patients. "Besides language factors, distrust of the medical community may also prevent the delivery of truly patient-centered care. Black and Hispanic patients reported lower confidence and less trust in their specialist than white patients." [CommonwealthFund.org, accessed 2/12/09]

Blame The Health Care Crisis On Government "Waste, Fraud, And Abuse"

Luntz Memo, Rule 8: "WASTE, FRAUD, and ABUSE are your best targets for how to bring down costs.  Make no mistake: the high cost of healthcare is still public enemy number one on this issue - and why do many Americans (including Republicans and conservatives) think the Democrats can handle healthcare better than the GOP.  You can't blame it on the lack of a private market; in case you missed it, capitalism isn't exactly in vogue these days.  But you can and should blame it on the waste, fraud, and abuse that is rampant in anything and everything the government controls." [The Language of Healthcare 2009, by Frank Luntz, accessed 5/21/09, emphasis original]

Even The Insurance Industry-Funded Council For Affordable Health Insurance Admits Government-Administered Medicare Is More Efficient Than Private Health Insurance.

Government-Administered Medicare Is Actually More Efficient Than Private Insurance. The Council for Affordable Health Insurance, "a research and advocacy association of insurance carriers," published a report stating: "Administrative costs are lower under Medicare than for private health insurance." The report added, "our best estimates indicate Medicare at slightly above 5% of total Medicare cost in 2003, whereas the government currently reports about 2%... The private market administrative costs are expected to remain at about 9% of total private insurance cost, excluding premium taxes, commissions, and profit. With such items, private costs would be slightly under 17%." [CAHI, Medicare versus Private Health Insurace: The Cost of Administration, 1/6/06]

Health Care Should Be "Patient-Centered Rather Than Government-Centered"

Luntz Memo, Rule 9: "Americans will expect the government to look out for those who truly can't afford healthcare.  Here is the perfect sentence for addressing cost and the limited role for government that wins you allies rather than enemies: 'A balanced, common sense approach that provides assistance to those who truly need it and keeps health care patient-centererd rather than government-centered for everyone.'" [The Language of Healthcare 2009, by Frank Luntz, accessed 5/21/09, emphasis original]

What Could Be More "Patient-Centered" Than Ensuring That EVERY American Has Access To Affordable, Quality Health Care? 

In Uncertain Economic Times, A Public Plan Is "Backup Insurance" For The United States' Largely Employer-Based Insurance System. According to the Economic Policy Institute: "Another reason that the health system needs a public health insurance option is that it serves as backup insurance for all Americans. While a majority of Americans are covered by employer-sponsored health insurance, many do not have access. Even among full-time workers, 17% do not have insurance. Furthermore, many people lose coverage each year when they leave their jobs and then pick it up again at a later time, spending at least brief time periods without insurance. Aside from the risks of being uninsured, these individuals and families also must deal with the disruption of changing providers, and the lack of continuity in their care. Though employer-sponsored health insurance is the backbone of the American health insurance system, it is not an effective backstop particularly in this time of high unemployment. A public health insurance option would offer a plan Americans could depend on." [EPI.org, 5/13/09]

Public Plans Already Compete With Private Plans And "Set A Benchmark" For Care. The Los Angeles Times said: "The federal government already provides health insurance to about 83 million Americans through Medicare, Medicaid and other public programs, including those offered by the military. Private insurers, meanwhile, face growing criticism for refusing to cover people with preexisting conditions and dropping coverage for sick customers. 'This is a benchmark that will set a high standard that private plans have to meet,' said Jacob Hacker, a political scientist at UC Berkeley who advocates a public option." [Los Angeles Times, 5/10/09]

Fears Of A Public Plan Putting Private Plans Out Of Business Are "Overblown." According to the New York Times: "No matter how fair the competition between public and private plans might be at the start, [critics] warn that the government would find it irresistible to rig the outcome through its regulatory and pricing powers and its ability, in a pinch, to subsidize the public plan with taxpayers' money. That fear seems overblown. Innovative, nimble private plans with well-integrated service systems might outperform any government plan, just as some now outperform Medicare through better coordination of services, stronger preventive care and broader benefits. A new public plan is neither the cornerstone of health care reform nor the death knell of private insurance. It should be tried as one element of comprehensive reform." [New York Times, 4/6/09; emphasis added]

"Tell Them What You're For"

Luntz Memo, Rule 10: "It's not enough to just say what you're against.  You have to tell them what you're for.  It's okay (and even necessary) for your campaign to center around why this healthcare plan is bad for America.  But if you offer no vision for what's better for America, you'll be relegated to insignificance at best and labeled obstructionist at worst. What Americans are looking for in healthcare that your 'solution' will provide is, in a word, more: 'more access to more treatments and more doctors...with less interference from insurance companies and Washington politicians and special interests.'" [The Language of Healthcare 2009, by Frank Luntz, accessed 5/21/09, emphasis and ellipses original]

The Republicans Plan To Tax Employer-Based Health Coverage To Fund A Tax Credit To Families That Is Meant To Help Offset The Costs Of Health Care - A Tax Credit That Is Nowhere Close To The Amount Needed To Purchase Health Coverage For The Average American Family.

Republican Plan Allots $5,710 Tax Credit For Families To Purchase Health Coverage. "The Patient's Choice Act of 2009 would restore equity in the tax code and give every American, regardless of employment status, the ability to purchase health insurance by: Providing an advanceable and refundable tax credit of $2,290 per individual or $5,710 per family." [Patients Choice Act, 4/09, emphasis added]

Health Coverage For A Family Of Four "Nearly $12,700."  According to the National Health Care Coalition: "The annual premium for an employer health plan covering a family of four averaged nearly $12,700. The annual premium for single coverage averaged over $4,700." [NCHC.org, accessed 5/19/09; emphasis added]