Why reformers are losing on health care -- and how they can win back the debate

We're now two weeks into the Town Hall Uprising that hasrocked members of Congress coming home for their August recess. The signs andscreeds have been uncannily similar: "Obamacare" will kill your grandma.Bureaucrats will choose your doctors. We're headed towards socialized medicine,a slippery slope towards communism in the USA.But whether coming from a hot-headed protester or a formergovernor of Alaska, the rhetorical bombs share at least two things in common:One, they have little basis in reality. And two, they have little if anythingto do with real health reform.

Health reform isn't being debated in the country's TVscreens and town halls -- it's being swift-boated. And just like the infamous2004 TV ads by deep-pocketed right-wing operatives had little to do with Sen.Kerry's military honor, the current assault reveals more than anything the abilityof powerful interests to fan lingering resentments --especially in places like the South -- to serve their bottom line.

Consider Exhibit A: Sarah Palin's so-called "death panels." Theformer VP candidate's charge that the Democratic health bill would lead to euthanasiaof the elderly and disabled -- while clearly not based in fact -- quickly becamethe right's number one talking point against reform. The rhetorical air war ledby Glenn Beck, Rush Limbaugh and other fiery pundits gave cover to groundtroops at town hall meetings, like the woman in Raleigh, NC who equated Obama with Hitler and labeled him "DoctorDeath."

Facing South and other media fought to bring the debate back to reality, withsome success. On Monday this week, our reporter Sue Sturgis broke one of themost important stories of all: The fact that a leading champion of end-of-lifecare was actually a pro-life Republican -- Sen. Johnny Isakson of Georgia.

Facing South's piece on Isakson quickly got picked up by TheHuffington Post and Firedoglake, which then led Ezra Klein of The WashingtonPost to interview Sen. Isakson -- who said the notion that the health reformbill included death panels was "nuts." By the next day, PresidentObama was noting the "irony" that a GOP had promoted a concept thatBeck suggested would lead to eugenics and Fascism.

But in the hot-house health reform debate, cold hard facts don'tlast for long. Momentarily stunned by evidence of bi-partisan support forend-of-life care, Republicans like Iowa's Sen. Chuck Grassley -- the "moderate" who is part of six senators leading reform negotiations -- still couldn't resist the temptation to pander: On Wednesday, Grassley claimed "you have every right to fear" government will "pull the plug ongrandma."

Who needs reasoned debate when you can terrify seniors and inflame the base? (Today, Sen.Isakson refused to make a statement on Grassley's claims, fearing it could be "misinterpreted.")

The lesson here is clear: In the "anything-goes" war overhealth care, powerful interests are going to do and say whatever it takes tostop reform. And the interests are very powerful: Remember all those "Hands Offmy Health Care" signs you see brought by bused-in protesters? Those comecourtesy of Patients First, a front group for the corporate lobby American forProsperity that previously advocated for its business donors to oppose the economic stimulus and tobacco regulation.

How to turn this situation around? It would be helpful if the media would move beyond the "he said,she said" style of reporting which gives outrageous distortions equal time withreality-based arguments.

But reform advocates can't count on point-by-point factchecks -- or complaining about the other side's unfairtactics -- to change the debate.

The larger issue is that they're losing a political power struggle. Considerthe media: Progressives still have no answer to the right's near-totaldominance of talk radio, a vital conduit that informs and inflames millions oflisteners, delivering ready-made talking points to an army of grassrootsprotesters and TV pundits.

The right is also winning the ground war: As much as progressiveswring their hands about "town hall mobs," their quick and effectivemobilization reveals how badly reform advocates have been out-organized. Anorganizer for one of the leading pro-reform groups frankly admitted to me thatit took "about a week" for them to realize what was happening and develop astrategy to counter the opposition at Congressional events.

And then there's the main theater of battle: Washington. Healthinterests are now spending over $1.4 million a day to lobby on Capitol Hill. Over3,000 lobbyists -- about six for every 535 members of Congress, the majorityrepresenting the health industry -- are exerting their influence, including arevolving door of over 350 ex-Congressional staff members.

The industry is also shoveling tens of millions in campaigncontributions to Congressional PACs and lawmakers - according to a recentDemocracy North Carolina report, $5.2 million to the 15 representatives andsenators in the Tar Heel state alone. They're leaving nothing to chance: Sen.Richard Burr, one of the industry's most reliable allies, still raked in $420,782from the pharmaceutical industry alone between 2003 and 2008 - the most of anyU.S. Senator.

These interests have every incentive to allow the healthreform debate to turn into a confused mud wrestling match. The more they can sow doubt and turn people off, the greater their chances of derailing -- or more likely, dilluting -- change.

Amidst such chaos, onecan see why health reform advocates want to depict themselves as the voice ofreason, advocates of calm and civil discourse (although a recent Gallup pollsuggests that the right's rabble-rousing isn't hurting their cause: 38% ofindependents said the protests made them "more sympathetic" to the oppositionview, while only 16% said it made them "less sympathetic.")

But if the last two weeks have taught us anything, it's thesad fact that "reasoned debate" won't decide the future of health care in ourcountry -- not in an environment of high-decibel backlash and high-powercorporate influence. Pro-reform advocates will only succeed when they fullyharness their biggest strength: power in numbers.

At the end of the day, the future of health care reform willturn on whether advocates can channel the political clout of the millions whostand to benefit from reform. From the netroots to the grassroots, it will taketireless organizing and bold tactics to be heard. When pro-reform forces reachcritical mass in size and visibility, politicians will be reminded that theyneed not only money but also votes to survive.

It's at that point -- when leaders are convinced that thepolitical costs of ignoring reform outweigh the benefits of embracing it -- thatadvocates of reform will be able to seize this once-in-a-generation opportunityto change health care in our country.