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10 Rules of Populist Power -- The Progressive's Guide to Raising Hell

This excerpt from Jamie Court's new book offers ten simple rules that can help an awakened public see and seize the outside opportunities for creating change.

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The power of the campaign was in its cumulative impact. Every day, another story. Legislative staff and the media paid attention. The drumbeat built. We defended against the assault on injured patients’ legal remedies.

A few years later, the time came to go on the offensive for the legal rights of HMO patients. We warmed up the fax machine again. The HMOs spent millions on television advertising to stop us. Here’s how CNN’s Brooks Jackson described the “HMO casu­alty of the day” campaign at the time: “The industry has its adver­tising too, but far more effective is this shoestring consumer group. A fax a day to keep the HMOs at bay.” The patients-first tactic fueled landmark HMO patients’-rights reforms throughout the nation.

More recently, I saw the “people-first” principle work when one woman with a compelling story was able to fell a whole industry. It’s the case of “Dana vs. Goliath.”

With health insurance costs skyrocketing in 2006, insurers hatched a plan to remove themselves from the patients’-rights laws that were passed in forty-four states in the late 1990s and early 2000s. The industry explained that the insurance companies wanted to “reduce their costs of compliance” so insurance would be cheaper. It sounded simple enough to President Bush and Congress, who were about to enact the plan. Attorneys general, governors, and state insurance commissioners complained, but it looked like the industry had the votes.

Then Dana Christensen came to Capitol Hill with my Consumer Watchdog colleagues Carmen Balber and Jerry Flanagan.

Christensen had been working with my consumer group to warn against the very type of “junk health insurance” policy that we feared would become the norm if state regulation were bypassed. She and her husband, Doug, had been technically insured, yet Dana was left with $450,000 in unpaid medical bills when her husband died of bone cancer.

The fine print in her insurance policy had no limit on “out-of-pocket cost.” So she had to pay most of the costs of his chemother­apy and cancer care. On his deathbed, Doug asked Dana to divorce him so she would not have to be liable for the medical bills. She refused. In the end, only because of a lawsuit under state law, which prevented fraudulent representations, was Dana able to recoup the cost of those bills from the insurer.

Dana flew into Washington on Monday, on the heels of a PBS NOW news story about her case that aired the previous Friday. She held a press conference with Senators Edward Kennedy and Richard Durbin, then lobbied other senators. The power of her story stopped the legislation dead in its tracks.

“What’s the point of paying for health insurance and then, when you need it, discovering the benefits you thought were promised and paid for just aren’t there?” Dana asked. “That’s what happened to my husband Doug and me.”

Human truth is very hard for a human being, even the most hard­ened Washington politician, to turn away from.

Rule 7: Make It Personal for Decision Makers

Confrontation creates change in human beings. It forces them to evaluate their positions because it warns of the consequences if they do not. If you want recalcitrant decision makers to change their ways, confront them personally and publicly about their actions. Don’t just tell them why they are wrong; show them how their position reflects on their personal character.

Publicly confront them in a way that forces them to examine their person, not merely their positions. Then they must take inventory of what you have described and stand by it or change it. Successful decision makers typically change to conform with deep-seated social mores and ethical customs. Sometimes they even become your allies. Less-successful opponents compound their mistakes and dig themselves in deeper, which can give us more leverage over them. Making it personal means not name-calling or making spuri­ous allegations, but forcing a confrontation with an opponent on the battlefield of values.

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