Obama Policymakers Turn to Campaign Tools on Health-Care Reform

WASHINGTON (By Ceci Connolly, Washington Post) December 4, 2008 — Barack Obama's incoming administration has begun to draw on the high-tech organizational tools that helped get him elected to lay the groundwork for an attempt to restructure the U.S. health-care system.

Former senator Thomas A. Daschle, Obama's point person on health care, launched an effort to create political momentum yesterday in a conference call with 1,000 invited supporters culled from 10,000 who had expressed interest in health issues, promising it would be the first of many opportunities for Americans to weigh in.

The health-care mobilization taking shape before Obama even takes office will include online videos, blogs and e-mail alerts as well as traditional public forums. Already, several thousand people have posted comments on health on the Obama transition Web site.

"We'll have some exciting news about town halls, we'll have some outreach efforts in December," Daschle said during the call. And tomorrow, when he appears at a health-care summit with Sen. Ken Salazar (D-Colo.) in Denver, Daschle said, "we'll be making some announcements there."

It is the first attempt by the Obama team to harness its vast and sophisticated grass-roots network to shape public policy. Although the president-elect is a long way from crafting actual legislation, he promised during the campaign to make the twin challenge of controlling health-care costs and expanding coverage a top priority in his first term.

Daschle, who is expected to become the next secretary of health and human services, is waging the outreach campaign by marrying old-fashioned Washington-style lobbying and cutting-edge social-networking technologies. Although he has yet to be formally nominated, he has already met with more than 100 insiders, ranging from union leaders and the seniors group AARP to hospital executives and representatives of corporate America.

"In the last three days I've exchanged three sets of e-mails with him," said Ron Pollack, executive director and vice president of the advocacy group Families USA.

The Obama team, which recruited about 13 million online supporters during the presidential campaign and announced its vice presidential selection via text message, is now moving to apply those tools to the earliest stages of governing.

"This is the beginning of the reinvention of what the presidency in the 21st century could be," said Simon Rosenberg, president of the center-left think tank NDN. "This will reinvent the relationship of the president to the American people in a way we probably haven't seen since FDR's use of radio in the 1930s."

In seeking to translate its political skills to policymaking, the incoming administration faces potential legal and political pitfalls. It is not clear, for instance, whether Obama can legally use his list of campaign supporters in the White House; the database would probably become government property. So far, the transition team has gotten around that issue by encouraging people to register on its Web site, Change.gov. Those names and e-mail addresses go into a new database, which can be tapped to generate activities such as house parties, YouTube videos and viral discussions to rally support.

Daschle's telephone call, which was not open to the news media, and his speech in Denver tomorrow provide hints as to how the new administration might tackle major health-care legislation.

"President-elect Obama believes that change really comes from the ground up, not from Washington," Salazar said in an interview. "The drumbeat for change is one which goes across every single state -- red, blue and purple. That kind of a drumbeat will be very effective in achieving the change needed on health care."

The Obama team chose to begin its high-tech grass-roots experiment on the issue of health care because "every American is feeling the pressure of high health costs and lack of quality care, and we feel it's important to engage them in the process of reform," said spokeswoman Stephanie Cutter.

It started with a simple 63-second video posted on Change.gov, in which health advisers Dora Hughes and Lauren Aronson posed the question "What worries you most about the health-care system in our country?"

That triggered 3,700 responses, from personal tales of medical hardship to complaints about "socialized medicine." The cyber-conversation was interactive, allowing individuals to reply to one another and rate responses with a thumbs up or down. The top-scoring comment, a pitch for a "paradigm shift" toward prevention, had 82 thumbs up.

The Obama technology gurus then built a "word cloud" showing the 100 most frequently used words in the responses. The cloud's biggest words -- indicating those used most -- include "insurance," "system," "people" and "need."

"The Obama administration has learned that listening may be even more important than talking, because it diffuses opposition," said Andrew Rasiej, co-founder of Personal Democracy Forum, a nonpartisan Web site focused on the intersection of politics and technology.

Obama used the same strategy during the campaign, Rasiej said. When many of his most liberal supporters became enraged that he voted in favor of a surveillance law, Obama assigned staffers to monitor and respond to comments posted on the campaign's Web site. After a sort of cyber-catharsis of complaints, the controversy died down, Rasiej observed.

"It will be a lot easier to get the American public to adopt any new health-care system if they were a part of the process of crafting it," he said.

By moving early, Daschle and Obama are also applying a central lesson learned in past failed efforts to overhaul the health system, said Andrew Stern, president of the Service Employees International Union.

"This is an opportunity to deepen the education work and build the ultimate coalition for change before it's demonized or people try to oppose it," he said.

After the first health comments poured in to the transition Web site, Aronson made a second video, this time with Daschle, seated in shirt sleeves and a tie.

"We want to make sure you understand how important those comments and your contributions are," Daschle says into the camera. "Already we've begun to follow through with some of the ideas."

Daschle praises the suggestion of creating a "Health Corps" of volunteers, modeled after President John F. Kennedy's Peace Corps.

Aronson, who was a congressional health aide to incoming White House chief of staff Rahm Emanuel, then recounts the story of a small businesswoman struggling to provide affordable health insurance to her workers.

Says Daschle: "When I was in the Senate, it was stories like that, probably more than all the factual information, that really moved you to want to act."