Commentary
The Non-Marketing Of Obamacare
- by October 8, 2013
Indeed, up until last week, it seemed to be the big story, since the economic well-being of the Affordable Health Care Act itself rests on enough young, healthy people signing up.
The theory is that this cadre of “Young Invincibles” in turn would subsidize the cost of insuring the mass of older, sicker Americans. (Should we call them “Vanquished Elders?” Or just “frequent users”?)
And my point was that the advertising until then was pretty underwhelming and confusing. Moreover, I thought these 20somethings were less “invincible” than “impermeable”: without a way to earn money at all, or if they were barely getting by, they weren’t going to pony up their hard-earned pay for any insurance program, period.
Forget the attempts to get down and get cool with faux music videos, or even scare them into signing up with snowboarding stunts gone awry. And yes, they’d take your brightly colored beer cozies and laugh in your direction.
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Then again, one difference with the kids of this generation is that they listen to their parents a lot more than Baby Boomers or Gen X–ers did; unfortunately, some have lived through the tough times of their parents’ layoffs, loss of benefits, and/or illness-related bankruptcies. That’s gotta be a more powerful experience than watching a Funny or Die video.
In a unique case like this, I thought the best advertising would be the product itself. Once enough Millennials had signed up, and tweeted, Tumblred, or made Vine videos about their own experiences, they’d influence their peers, who’d sign up, and so on.
Then along came the shutdown, and the opening of the online insurance exchanges on Oct. 1, and all hell broke loose.
I’ve never experienced such a pre-apocalyptic feeling. With a constitutional crisis, and possible economic Armageddon looming, we’ve experienced what amounts to a rolling coup against the Obama administration from House Republicans of the extreme ideologue kind. They’ve been called apostates, anarchists, and nihilists. Indeed, there’s a willingness to weaponize the shutdown -- regardless of collateral damage -- that has never made people on both sides angrier or more frustrated. Also frightened.
Meanwhile, even sadder, whatever side you are on, we can all pretty much agree that the online insurance exchange itself is one of the worst examples of a new product launch ever. The administration had two years to develop a system, and the result up until now is a slow, embarrassingly glitchy site. No amount of advertising in the world will help sell Affordable Care if people can’t sign up.
Meanwhile, even before the failings of the site became clear, the GOP anti-funders, backed in part by the Koch Bros, had its game on. Attacks were strategically planned and well executed, starting during the summer. Lines like “Obamacare is a trainwreck” came out of their playbook, and Speaker Boehner repeated it endlessly to great effect.
What’s clear is that the campaign to make Obamacare seem abominable is much better than the one actually trying to sell it. What gives? This came from the same guy who masterminded such an extraordinary, forward-thinking social media and ground game as a candidate in 2008 that he not only came from obscurity to be elected president ,but was also named “Marketer of the Year” by the ANA. As such, Obama edged out other brands like Apple ,Zappos.com., and Nike, global giants who know a thing or two about marketing.
For the sake of the country, I hope the site is heavily, and quickly, upgraded. Maybe the administration folks can call in a batch of unemployed Millennials to help improve the architecture and programming. If that job doesn’t come with benefits, they’d be prime targets for some fresh thinking about advertising, too.
Regarding the technical issues, thirty-four states, many of them among the poorest and most under-insured, did not set up their own online exchanges. Instead, these states decided to send all their millions of interested citizens to a single, fed-run website all at the same time. That is a recipe for disaster for ANY website - most assuredly a newly launched site that has not been stress-tested. The technical issues will be resolved, eventually. Regarding the marketing message for Millennials, that's going to be an uphill climb. Without getting too deep into the psychology behind the health care decisions of young people, I can tell you that the key is the mother. Young people never think anything bad is going to happen to them. Mothers always fear it will. A campaign targeted at Mothers, imploring them to get their kids signed up - even suggesting that the parents "gift" the premium to their kids if that is what it takes - would go much, much further in getting Millennials signed up than any "music video."
I too have a pre-apocalyptic feeling. I doubt the sincerity of any of the public debate. Indeed if the Obama marketing machine truly wanted to sell the idea, there would have been an attempt. So what if they fail to get millennials on board? What happens then? One payer, nationalized health care? Hmmm. Wasn't that the original plan?
Scott...you win Bingo, straight across the middle and maybe even coverall. There was a conspiracy headed by the Kroch brothers to destroy the economy and health of the US government (see NYT). If anyone else did it, Treason would be the word being screamed with demands for punishment. Although Cecily Strong on SNL expressed it best about the rush to the site.
Brilliant, and spot-on. I vote for Barbara to try to bring the two sides to the negotiating table.
Barbara, you've nailed it again. An administration that mastered contemporary marketing, data and technology practice to get re-elected has once again failed to apply their learning to execution - and on their signature program. Just more wasted opportunity, ineffective communications and dysfunctional government. Maybe it's time to create a cabinet level CMO post.
Brilliant, Barbara. Love your suggestion at end to have unemployed millenials fix the web site.
As a long time Obama supporter (or perhaps I'm more of an 'anti' when it comes to the antediluvian nutsos on the right) I have been underwhelmed by the way they attempt to gain public support of almost anything. I wish that a smart advertising person had a top level position in this government.
This morning I learned that the Tea Party attendees are now denying the nasty nature of default. No surprise. They deny global warming and almost everything else with science or fact behind it. These are the true Goebels (Joseph not George) of our time. Tell a big lie, tell it loud. Tell it often. And then the masses will come to believe it.
The obvious benefits of 'Obamacare' are clear. Without something like it the health care system of this country will collapse under its own weight. I don't understand why we outsource health care when we don't outsource (say) the actual fighting done by the military (although we seem to outsource a lot of other miliatry responsibilities). But communications should be outsourced. Reagan got it and got the Tuesday Team. Brilliant communicators, they got an over the hill actor elected President. Why can't a smart guy like Obama figure this out?
What gives? Well, it's pretty simple. There is no Constitutional crisis and no economic apocalypse looming. Remember the sequester and that apocalypse? Non-existent (now we have politicians who don't deserve credit crowing how the deficit is falling - no thanks to them).
There are certain facts about the ACA which are fundamentally flawed and cannot be fixed, because they are issues related to rights of individuals. I have yet to have anyone explain to me why the ACA can force people to buy something they don't want. People say "car insurance" - except you only have to buy liability insurance, that is the threat you may injure someone with a deadly weapon known as a car. The same context does not exist with health insurance. Indeed, Justice Roberts clearly states as much when he defined the Commerce Clause in a very full fashion, and called the ACA what it really is - a tax. As a tax, it's Constitutional, and therefore perfectly within the rights of the House to defund (well, within the rights anyway, but being a tax makes it even more so). I'm no ideologue. I support the democratic process. But I don't understand why I'm being asked to provide money for birth control and abortions when these aren't my responsibility (sorry, don't buy the 'betterment of society' nonsense). I take care of my health, but this new system will actually encourage people to not take responsibility for themselves, at little or no cost to themselves. After all, it's better to not pay the 'fee' (tax) and still get your care. Which is precisely why medical costs are still set to climb significantly and precisely why so many non-partisan studies show the costs of the ACA will further increase the deficit.
I'd like to know what part of the Constitution tells people they get to tell me how to live my life and how to spend my money just because 50.1% of the nation says it's what they want? That's marketing - understanding the nature of the Constitution and why the government has overstepped its bounds on this and many other issues. The Constitution was a document designed to LIMIT government - not give it rights to expand into a nanny state.
FWIW, on the off chance that someone thinks I'm a pro-lifer, I'm not. I support pro-choice causes. But I don't support a national system paying for items which are an individual's responsibility, which happens to also include health. The real issue we're seeking to solve for is the nature of catastrophic care. Several Eastern European nations have actually done significant work in this area, finding market based options which benefit most. This work has been overlooked by the US in its attempt to move toward the fatally flawed 'single payer' model.
What all of the marketing and much of the criticism has ignored is that one facet of the Affordable Care Act is it allows kids to remain on their parents policies until they are 26. So all of this griping that young adults are going to shell out thousands of dollars for care is really kind of ridiculous.
It's much more affordable to keep them on their parents' health plans if at least one parent has a full-time job. So many of these new enrollees who have low wage jobs are not going to have to go broke shopping the open market. They may contribute towards the insurance costs their parents shell out, which would be fair, but they will not be left with just catastrophic options and bills they cannot pay.
Plus young, healthy people do get sick. In the past year I had one teenager break a foot and dislocate a shoulder and another diagnosed with an eating disorder. Without insurance, it would have been impossible to cover the cost of their care.
The cost of adding a child to a family policy is not over the top - it's just practical. Obamacare's "marketers" should really be pointing out that he's helping families protect their kids in that transitional time between college and finding a full-time job. Not that he's forcing them to get health insurance.
I think it's a bona fide law, not a tax. And once it's running, it will work-- look at Romney's healthcare deal in Mass. for a precedent!
My two cents-- Just because it was "rammed through" doesn't make it okay for Congress to harm hundreds of thousands of innocent people and soldiers and their families (not to mention, possibly, our entire economy and our security) and shut down the government. It is a "hostage" situation, over a hissy fit, IMHO. Why not give this law, as approved by the Supremes, a chance, and if it fails, the Republs can make Dems eat crow, rather than bombing the village (in this case, the USA) to save the village FROM HEALTHCARE?
@Aimee
I agree the ability to stay on parents' insurance policies until age 26 will help keep the number of uninsured young people down. However, there are still LARGE numbers of people - many with families of their own - who voluntarily choose to be uninsured. I have not seen the newest numbers, but a few years ago an Employment Policies Institute study showed about 20 million people in the U.S. earning $55K+ choose not to buy health insurance. They've already weighed the decision and made their choice. Only a well-crafted strategy and message has any hope of changing their minds (that or a much stiffer penalty for remaining uninsured).
@Rick
Whether you realize it or not, you've been contributing to other peoples' birth control and abortions all along. Uninsured people - lots of them - get pregnant, get abortions or even deliver babies every day. Lots of those babies are born with incredibly expensive health issues. Lots of the mothers have incredibly expensive complications. We've all been paying for this in the form of taxpayer-supported health care and higher premiums and health care service costs for our own care. The ACA is intended to get everyone contributing to the system in some way - even if its only by paying a fine for choosing irresponsibility.
You nail this, Barbara. The marketing of this important, groundbreaking new law is astonishingly abysmal. Good grief.... they drafted the thing, got it passed as law, and now can't somehow rise to the occasion and market it in a quasi-decent, effective way? This should be the least of it, yet it's so wanting and so clearly needed.
Monihan's response is a good one but flawed. There are lots of things we are told to buy or pay for that we'd prefer not to buy or pay for...like taxes for instance. We are the only civilized country without a single payer health system. Our costs are rising out of control and are not sustainable as the baby boom ages and needs even more care. Lawyers have formed a sophisticated way of framing the ACA but any way you put it it's necessary for our long term fiscal health until we finally wake up and deal with health care the way we deal with the military. Both are of national importance.
The issue here isn't the legality or the verbiage but why the Obama administration is so clumsy about how to tell the story to the public.They did an excellent job this week explaining the new $100 bill.
@Jerry-- I agree! I was taken by all the publicity that the $100 got, too!
When you talk politics you always open a can of worms. Here's what it all boils down to. There is this law. It passed through the Senate and the House of Representatives, where it was democratically approved and then signed into law by the Executive Branch of our government. Now a small faction of people have tried to undermine the law of the land by bringing the country to its knees through technical and sadly legally sanctioned gamesmanship. The use of the word coup in your description is completely accurate. What is happening right now is NOT DEMOCRACY. No matter what way you try to package it. It's terrifying. Scary on an economic level, perhaps. But more than that, it shows huge gaping holes in what is supposed to be our democratic process. Ultimately intimating the failure of this 237-year-old experiment called the United States. I don't care who's president or what the issues are, you don't shut down the government or threaten the financial stability of this great nation to try to stop a democratically established law. You need to approach the repeal of that law through the democratic process. And if that doesn't work if you can't get the votes to do what you want, sorry, but that's democracy. Get one with it.
Why bother marketing something people are forced to pay for?
Well, that drove a lot of comments!
If your product looks like a duck and walks like a duck then trying to tell people it's a swan with marketing doesn't matter.
Right now ObamaCare looks like a duck that can't swim, walk of fly..
(If just getting registered is this hard, imagine what it will be like to get (health care) service)
Marketing isn't only to sell something. It's also a teaching tool. Given the misinformation out there and the costs we all have paid (and will continue to pay) because of misinformation, some smart marketing could have been a real cost saver.
A plot, i.e., to take down the stability of the US government is treason. This is a plot and that has already been proven. Who will be willing to stand in the way at emergency rooms to turn away people who decided health care was not for them and insist they pay for their care in cash/credit card ? If they can't prove they have the credit or cash, they don't get the car loan. This would include gunshot wounds and your invincible kid who has tennis elbow or brakes a bone. Thousands of dollars people, thousands of dollars. Say goodbye to your house.
WRT to young people having babies with no access to prenatal care and then having those babies need expensive (and uninsured) medical support: I spent many years as a member of the support group for the NICU at Cedars
-Sinai and I saw the consequences of little or no prenatal care first hand. It can be devastating on both the mothers and the infants. EMTALA requires that no one be turned away from an ER, regardless of their ability to pay. So who pays? Every single person with insurance pays. The ACA will go a long way to fixing that because nearly everyone will have some level of health insurance. @Rick. You're full of it. Obama ran for his second term on his record, which includes the ACA. He was resoundingly reelected, by over 5,000,000 votes. People want accessible health care. The ACA is the law, upheld by SCOTUS. Congress and the Tea Party have to get over themselves. A minority of a minority, they're attempting to overthrow the duly-elected government of the US. As Paula says, it's treason.
You are completely right that the against crowd has done a more effective job than the for crowd. Young people require medical care too - from injuries, accidents, diseases, and pregnancies. It should be easy to sell that message with an effective marketing campaign. The Problem is that the against crowd has been consistent with their negative sound bites, and the for crowd has not used sound bites. They need good headlines, and there are plenty of people that can write them.
Treason is a silly word to describe opposition. The point of having a division of powers within the federal government is that each branch can decide independently what it wants to do or not do, regardless of what the other branches do, when exercising the powers specifically granted to that branch by the Constitution. The money voted by the House of Representatives covered everything that the government does, except for ObamaCare. The Senate chose not to vote to authorize that money to be spent, because it did not include money for ObamaCare. The Republicans have done a horrible job of marketing this fact and will probably capitulate.
Wow. So much collectivism & socialism. The price tag of Obamacare alone should be enough to deep-six this; ballpark $1.8 trillion. All for 15% of the population to get insurance. Why not reform Medicaid and not touch the rest of the country. Congress voted to be exempt from it. BOTTOM LINE: if you provide to people what they should be providing to themselves, they'll cease to be concerned with that component and expect it, along with their children.
Social Security was 1% tax that has it's own fund; far from it now. Gov. entitlement programs don't stop. They get folded into others or stand alone. It gives more power to goodies givers in government, so they can buy votes and their base is rapidly reproducing. Remember the promise that was made by BO: "if you like your healthcare program and doctor, you can keep it." Hundreds of thousands are losing theirs.
Annual GDP: $17 trillion
Federal budget 2008: $2.5 trillion
Proposed budget: $3.5 trillion
Federal debt: $16 trillion + and growing
Working long days from January to June solely to cover your tax burden each year isn't freedom, it's servitude. We live in a republic and those who don't have net dollars going to the Gov. shouldn't be allowed to vote for that Gov. Period. Otherwise, they'll vote other peoples money into their wallets all day long, because it's not fair that others have what they want. What a frightening childlike mentality. Take responsibility for you and your own and not take from others trying to do the same. We're being fitted for bigger yokes for the willfully unsuccessful and lazy. "Don't say 'yes', if you can't say 'no'." - Emily Haines
What should scare the brown bread out of people is that the Federal debt is ~5 times the size of its annual revenue and growing. Some seriously big goodies need cut and this is one of them.
The problem with cutting is that cutting ACA doesn't make the cost of treating people go away. They go to emergency rooms (and we all end up paying inflated costs) anyhow or they find other ways of beating the system. ACA at least has everyone accountable to some degree. But that's not what this chain is about. It's about whether the administration are or are not good marketers. So let's leave the political rants to Fox and MSNBC and others and focus on the question at hand.
@John Casey
You begin your diatribe against ACA with an utter falsehood. Congress did not exempt themselves from the ACA - and there are myriad sources that confirm that fact (see below for just one, Forbes). Furthermore, your assertion that citizens without financial means should be disenfranchised runs counter to the very Constitution upon which this country was founded.
http://www.forbes.com/sites/rickungar/2013/04/25/is-congress-really-attempting-a-last-minute-end-run-to-exempt-itself-from-obamacare/
Regardless of your political views on the ACA, there's no denying that from a technical standpoint it has been pretty badly botched: almost two weeks and the online interface is still a mess. That's pretty disgraceful considering they had two years to get this ready. And while it's true that 34 states chose not to create their own exchanges, it was pretty clear from early on which states those would be -- meaning there was plenty of warning about the scope of the task. Any CMO who presided over a rollout of an e-commerce solution this screwed up would be fired along with their whole team.
Gotta get those healthy millenial youths into the plan..........wouldn't hurt either if they looked at med or nursing school as more desirable than MBAs and finance either............the real marketing challenge would be seducing these target audiences: Congressional staffers, AFL-CIO members, Senators and random others who have secured exceptions...