Last week, we likened the low-visibility conflicts over regulatory measures to trench warfare. This week, the military metaphor of choice is proxy war. Republicans in the Senate are using the nomination of Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services to resurrect many of the themes they sounded during the legislative debate–especially the fiction that health care reform will lead to rationing.

Yes, folks, the death panels are back–if not explicitly, then by (heavy) innuendo.

Why? Because Berwick, currently the head of the Institute for Healthcare Improvement, has made the near-treasonous observation the U.S. health care system is not, in every respect, the best in the world (World Health Organization rankings be darned).

And he had the temerity to express admiration for the British National Health Service. Admiration for the NHS means support for comparative effectiveness research, which is akin to endorsing rationing, which is achieved by death panels, which lead to socialism—get it?

But the GOP attack on Berwick is not motivated, at least exclusively, by wounded national pride, sour grapes over the party’s failure to kill health reform, or even by policy differences. Rather, it is a cold political calculation aimed especially at raising the fears of seniors, who (as we repeat almost weekly) will have a major say in which party controls Congress in 2011. Right now, that calculus appears to be working.

Life in Chicken Little Land

Chicken Little

If the election were held today, the picture would look pretty scary for Democrats. Although overall voters seem pretty evenly divided on who should control Congress, the enthusiasm gap definitely favors the Republicans. According to Cook Political Report, of the 30 “toss up” House races, 28 are currently held by Democrats, setting Republicans up for significant gains in the House. In the Senate, Republicans could pick up as many as six or seven seats.

What does this mean for health care reform? Well, we should be prepared to live in Chicken Little Land for quite a while to come, fielding Y2K-style warnings of impending doom until the sky fails to fall in 2014. (Of course, that’s only if we first get past the Mayan calendar end-of-the-world prediction in 2012.)

Of course, a lot could happen between now and then, and most of it is outside of the control of health care advocates. What we can do—and must do—is keep on telling the truth about reform, making special outreach efforts to those who are most vulnerable to misinformation.


Watch Jimmy Kimmel and T-Pain’s musical spin on some of the President’s health care reform messaging.

–Michael Miller, director of strategic policy

photo credit: ffg on flickr