Efforts to pass health care reforms are not new. Strategic use of mass media messaging to build support for changes to the U.S. health care system has been employed as far back as the early 1900s.

Here are but a few examples of presidential bids for health care reforms, heavily covered by newspapers such as the New York Times newspaper. President Franklin Roosevelt wanted laws passed in the 1930s that provided an income for the elderly, referred to as social security, and also wanted a form of universal health care access. He realized he could not get both laws passed, so he successfully built momentum for passage of the Social Security Act. This was probably a good decision, as the country was just coming out of the Great Depression. Harry Truman advocated for National Health Care but the American Medical Association waged a successful communications campaign against what it called “socialized medicine.” President Eisenhower was not a strong advocate for new health care programs; however, the passage of the Kerr-Mills Act of 1960 proved to be a forerunner to Medicaid. President Kennedy was a strong promoter of National Health Insurance and pushed the “Medicare” concept, which was passed under President Johnson via the Medicare Act of 1963.

As the public grew restless under media scrutiny of rising costs for public health insurance, U.S. leaders responded. President Nixon introduced health maintenance organization (HMO) legislation to control costs in 1973. President Ford withdrew all reference to national health insurance in his State of Union Address in 1976, while President Reagan instituted DRGs (diagnosis related groups) during his tenure.

President Clinton focused national attention on health care reform (that was at least as extensive as any domestic policy debate the nation had experienced in decades. President George W. Bush’s presidency saw the 2003 enactment of the Medicare Modernization Act, arguably the most expensive and expansive piece of social policy since the establishment of Medicare. President Obama saw the passage of the Affordable Care Act, which is continuously challenged by Republicans.

The actions of each of these presidents were influenced by communications campaigns from other politicians, lobbying organizations, and media portrayal of the state of health care.

Review the Patient Protection and Health Care Affordability Law.

Respond to the following:

1. How are organizations communicating with their providers and the public about the ACA? Where do you see the focus of these communications campaigns being placed? (You can look at your own organization’s website, the website of a health care organization in your community, or local newspapers.)

2. How do you believe that the law will affect you as a professional, your organization, and the ways in which your organization communicates with patients in the next five years? Where do you see clear opportunities or threats of the ACA? How should the organization communicate about these to prepare employees and the public for what lies ahead?