Jolt The System

Grass-roots Efforts To Help Shape Health Care Reform Must Begin Now

Nearly a century has passed since initial discussions began in the United States about the need for national health insurance - and we're still talking about it. Now, President Barack Obama and House leaders have committed to a July 31 deadline for moving a health reform bill through the House. This bill focuses on three core principles: reducing rising health care costs, allowing Americans the ability to choose their own doctors and their own plans, and ensuring quality, affordable health care for all Americans.

This past weekend marked a crucial step on the road to those goals: the launching of community forums focusing on health reform and supported by the president's volunteer network, Organizing for America. As communities become engaged in the health reform debate, the discussion should be on what we must do nationally to provide the sustained effort needed to overcome the ideological barriers that have hindered the passage of national health insurance for nearly a century.

Supporters of health reform must rally their collective strengths to unveil a specific, common platform on which the American public can base an informed opinion about the most promising policy. In the 1990s, the Clinton plan failed to win support from key advocacy groups that could have provided a connection between the federal government and the local community. The same mistake must not be made this time. Building alliances across America will help unify the movement's vision and offer a road map to guide its direction. Savvy leaders of this movement must identify target groups among policymakers, professionals, the news media and the public to decide on the best tactics to monitor opponents' actions. These leaders can work on distilling the health reform issue into a core message that is easy to articulate and promote.

Once strong alliances with influential political supporters and major public health interest groups have been formed, advocates must build robust coalitions to initiate public debate in an array of news media. Only then can coalitions adopt key talking points that enable all "faces" of the health reform movement to represent and defend a universal front for equal access to care. The coalition must diligently work to gather and respond to misleading information in a timely manner as it is presented in the public domain - again, something that didn't happen with the Clinton plan.

While many health advocacy groups lack the financial resources to compete with their opponents, advocates must explore alternative avenues to present pertinent information to the public. Text and video messaging, blogs, Facebook and Twitter are among the inexpensive tools that can enhance the dissemination of information among like-minded interest groups and the general public.

Communities need to move the health reform issue away from the discussion of policies that focus on the disenfranchised and more to a policy designed for all Americans. Current health insurance policies tend to focus on reducing the number of uninsured Americans, on expanding Medicaid, Medicare or the Children's Health Insurance Program, instead of on expanding private health insurance to include people not in the labor force.

Comprehensive health reform will never succeed if the core debate is focused on developing incremental policies at the margin to append to the current health insurance system. And it will not succeed without the committed participation of community advocates.

Llewellyn J. Cornelius is a professor at the University of Maryland School of Social Work. His e-mail is [e-mail]. Kieva A. Bankins is a research specialist at the school's Ruth Young Center and a student in the organizational leadership doctoral program at the University of Maryland Eastern Shore. Her e-mail is [e-mail].