The American Debate: Democrats need a backbone transplant on health care

You may not have noticed, probably because Democrats were typically too busy enfolding themselves into the fetal position, but something quite historic occurred Sept. 23.

On that date, it became illegal for health insurers to kick sick people off their coverage.

It became illegal for insurers to deny coverage to kids with preexisting health problems.

It became illegal for insurers to slap lifetime caps on coverage, or to set strict limits on what they pay out annually for somebody's care.

And on that date, insurers were required to let kids stay on the parental health plan until age 26.

These basic consumer protections - a veritable patients' bill of rights - come to you courtesy of the health-care law that President Obama signed in March; in his words, such provisions constitute "reforms that generations of Americans have fought for, and marched for, and hungered to see."

Yet most Democrats, being Democrats, are congenitally incapable of selling their own best accomplishments. Last year, they allowed the Republicans to caricature health reform as a socialist plot; they allowed agitprop specialists like Sarah Palin to spread lies about "death panels." In this midterm-election season, Democrats are validating those caricatures by zipping their lips and running for the hills.

Last year, 219 House Democrats voted for the health-reform bill; this season, only three - Earl Pomeroy in North Dakota, Dina Titus in Nevada, and Steve Israel in New York - are hawking their yes votes in TV campaign ads. Last year, 58 Senate Democrats voted yes; this season, only one senator, Russ Feingold in Wisconsin, is spotlighting his vote, framing it as a way to help kids with preexisting conditions.

Pennsylvania Rep. Joe Sestak voted yes last year, but he has stayed mum about health-care reform in the TV ads that tout his Senate bid. He told the press the other day that, rather than talk about health care, "I'm going to run a campaign that's going to win." So naturally, the GOP's allies have filled the vacuum; a group associated with Karl Rove has put up a TV ad that accuses Sestak of "gutting Medicare" - a claim that the nonpartisan fact-checkers at PolitiFact have found to be "overheated" and "exaggerated."

Given all this Democratic timidity, it's no surprise that the party base is so demoralized.

Does the health-reform law have flaws? Absolutely. But a party with guts would know how to sell its strengths. Is the law highly complicated? Absolutely. But a party with smart messaging instincts would know how to frame its assets in simple terms that would resonate with voters. Heck, the Republicans do that sort of thing all the time. They even managed to sell us a war with Iraq despite the dearth of a well-documented rationale for fighting it.

Granted, most Democrats are afraid that if they talk up the aforementioned consumer protections, they'll tick off all the voters who care only about the economy. But by shaking in their boots, by refusing to engage on the issue with the middle-class independents who will surely benefit from those consumer protections, they are merely validating the GOP's cartoon mantra.

Granted, the health-reform law is not a slam-dunk political winner - but it doesn't poll nearly as badly as many Democrats seem to assume. The latest Washington Post-ABC News poll reports that 46 percent of Americans support it, while 50 percent oppose it. Those findings alone suggest that there is fertile ground for a simple, affirmative message. (If the Republicans were preparing to sell an issue that split nearly 50-50, they'd deem that to be a landslide in their favor.)

Meanwhile, in mid-September, the Kaiser Family Foundation Health Tracking Poll reported that 49 percent of Americans had a generally favorable view of the health-reform law, while only 40 percent felt otherwise. Also in September, an Associated Press poll, conducted by Stanford University with the Robert Wood Johnson Foundation, found that 30 percent favored the law, while 40 percent did not - but that was because a huge chunk of the naysayers were liberals who think the new law doesn't go far enough.

And whenever people are polled about the specific provisions of reform - such as the protection of kids with preexisting conditions, a ban on dropping sick people, and the other stuff that's now on the books - 60 percent majorities typically say thumbs up.

That's the potential Democratic sweet spot. An incumbent Democratic candidate could find a congenitally sick child - let's call her Susie - and put her on camera. Then the candidate's ad team could write copy for the narrator. Something like, "Congressman X voted last year to give health-care coverage to sick youngsters like Susie. The Republicans want to repeal help for Susie. They want to take her coverage away."

How hard is that?

Too hard for the timid, apparently. If the Democrats can't manage to run on their own accomplishments, why should the party base bother to vote? Given the prospects of a wipeout 16 days from now, Democrats have little to lose by standing up for themselves on an issue of historic import, touting consumer provisions that have already kicked in.

Perhaps it's high time that the Democrats rediscovered their inner Truman. Feisty Harry may have said it best: Given the choice between a Republican, and someone who acts like a Republican, people will vote for the real Republican every time.