The Hardest Thing to Sell is a Free Lunch

An old Hollywood adage says that you can make a movie fast, you can make a movie cheaply and you can make a movie great, but you can’t do all three. Any claim to the contrary and would be financers start looking for alternative projects. Ironically, sometimes the hardest thing to sell is a “free” lunch.

This is the situation in which the President finds himself today. He is having a hard time selling a free lunch to the American people. He is promising that he can provide health care for everyone 1) without increasing our taxes, 2) without increasing the federal deficit and 3) without any rationing of health care. So far, the American people are not demonstrating an appetite for the President’s free lunch.

The first problem the President has is one of approach. It is simply a part of the American DNA to doubt anyone promising something for nothing. Common American warnings include if a deal seems too good to be true then it probably is, buyer beware, and there is no such thing as a free lunch. By promising the world and asking nothing in return, the President has triggered a skeptical defense mechanism that is an innate part of the consumer savvy American psyche. What’s the catch? What’s the angle? we instinctively ask.

President Obama might actually sell more people on health care reform if he were to drop his free lunch approach and try a more believable cost-benefits approach. He could say that he is asking everyone to take a modest increase in their tax bill, but in return he can deliver a health care system that provides access for more people without reducing our access to or our quality of care. After all, Americans may be skeptical of a free lunch, but we are also suckers for a good deal.

Unfortunately for the President, the second problem he faces is one of substance. The history of government involvement in health care is not on his side. Most voters are quite aware of the fact that the two major government run health care programs, Medicaid and Medicare, are on a collision course with bankruptcy. Each year they take a greater portion of the federal budget to stay operational. No one denies that this is an unsustainable path.

Many voters from around the country are also quite familiar with failed attempts by individual states to provide expanded coverage for little or no costs. For example, in 1994 the state of Tennessee attempted to reform its health care system largely because of the out of control costs of its Medicaid program. They implemented TennCare, a plan with a public option that they claimed could simultaneously cover even more people and yet would be budget neutral without raising taxes or cutting benefits (sound familiar?).

The end result was a disaster. Businesses did stop providing private insurance coverage and forced their employees to use the Tennessee public option instead. And far from being budget neutral, the TennCare program nearly bankrupted the state, required the citizens to pay higher taxes, medical benefits were slashed and 200,000 people had to be kicked out of the program entirely.

The states of Hawaii and Massachusetts have also each tried to provide more health care at lower costs. Although their approaches were different, both states saw the actual cost of their programs sky rocket beyond original estimates. Hawaii ended up cutting funding for their failed experiment after just seven months. Massachusetts is still holding on but seeing their health care costs rising faster than the national average, health insurance premiums rising faster than the national average and waiting times to see physicians on the rise.

President Obama may be able to gain some additional support for Obamacare if he changes his sales pitch. However, his greater challenge is going to be asking the American public to ignore government’s failed health care track record and to somehow believe that this time it’s different. Mr. President, you have your work cut out for you.