The faithful stenographers at Politico share a leaked memo from GOP strategist Frank Luntz on the ideal language for conservatives to use in the upcoming health care fight. Luntz does not discuss a potential GOP plan - the memo only provides a guide for opposing a hypothetical universal health plan (a policy that Obama did not support during his campaign but is being pressured to support now). Luntz would like the GOP to acknowledge the health care crisis, urge reform, and then stand firmly in the way of any substantive changes to the status quo.

His talking points center on the following three themes: choice and freedom, bureaucracy, and timeliness of care. Let's take a look at how effective these themes might be in forging opposition to a public health care plan.

Choice: After graduating from college in 2006 I did not have health insurance for two years. I am now lucky enough to be employed by a worker-friendly company with a generous health insurance plan (did I mention I have dental? Dental!!). I am firmly in the middle class, but Luntz's talking points are entirely irrelevant to my concerns about health care. I don't care about choice and freedom because I already have no choice or freedom - I have an HMO that can arbitrarily deny coverage of any procedure at any time. If I get laid off, I will have no choice or freedom either. I'd have to buy some remarkably overpriced COBRA if I want health insurance. Good thing I'm young because if I were above 50 or had a chronic disease (like diabetes) I would have even less choice. It's well-documented that health insurance companies regularly deny coverage to the elderly and sick. I also don't have a choice if I want to change jobs to advance my career - would I be able to take a better position if it didn't offer health insurance? This is a vast panoply of concerns I have regarding health insurance. And none of them are addressed when I hear that a public health insurance plan might hinder my health care choices. And I'm not alone in these concerns. Fifty million Americans already don't have much choice in their health care because they can't afford any insurance at all. And surely as the recession progresses this number will grow. So please Mr. Luntz, let's not talk about "choice" because we're not buying it.

Bureaucracy: So if choice is a non-issue for many Americans, how about bureaucracy? Everyone hates bureaucracy. That's about as uncontroversial as hating to pay taxes. Again, this is a talking point explicitly targeted towards those who currently have insurance and who are not worried about the cost or quality of coverage. If you don't have health coverage or can barely afford your current plan, potential bureaucracy hassles are simply not on the list of things that concern you about insurance. But does this talking point even make sense for people who have insurance? Interacting with private health insurance providers isn't some beautiful streamlined process. In fact, it involves a metric boatload of bureaucracy - especially if there are any mistakes with your payments or if you need to dispute any decision that the people who are totally not bureaucrats make about your coverage. I understand that bureaucracy is inherently unappealing, but how is this an effective message against government when many peoples' own experiences with corporations belie it?

Timeliness of Care: The dreaded waitlists of Communist Canada and the Union of Soviet Socialist Republics of The Netherlands will manifest here if a public health care plan becomes enacted. Once again, this argument is only intelligible to those who actually receive timely care right now. Unfortunately a very large number of Americans currently do not receive timely care for their health problems. A recent poll showed that 20% of Americans are delaying necessary medical coverage, mostly due to the high cost. A similar percentage expect to have difficulty paying for their health coverage in the coming year. There is no evidence that a public healthcare option will necessarily create waitlists, but the reality is that timeliness of care is already a serious problem for millions of Americans (especially the 50 million who cannot afford health insurance). This problem will only become worse due to the changes in employment that millions are experiencing during the recession.

Ultimately it's not a surprise that every major theme that  Luntz encourages Republicans to use are simply not relevant to a huge swath of Americans. The GOP may have won the health care debate in the early nineties by appealing to a similar constituency (white, relatively wealthy, fully employed) with similar messaging, but they are vastly underestimating the changes that have happened since then - changes that make these arguments much less effective to growing numbers of Americans. These changes include the phenomenal growth in cost of care relative to increases in wages and the loss of millions of jobs and growth in job insecurity. While the GOP will use the images of totalitarian life that most terrify Americans (rationing, loss of liberty, centralized control, waiting in line) to oppose health care reform, they fail to realize that our current privatized health care system is already a nightmare of rationed and delayed care for millions who have no other choice. I will leave you with highlights from a recent poll on a variety of health-related issues:

• 29% have not filled necessary prescriptions in the last 12 months due to cost
• 27% have skipped tests or treatments in the last 12 months due to cost
• 33% have postponed necessary medical care in the last 12 months due to cost
• 26% have had trouble paying medical bills in the last 12 months
• 42% have relied on over the counter medicine or home remedies instead of going to a clinic due to high costs of doctor visits
• 66% are either somewhat or very worried about affording the health care they need
• 78% are either somewhat or very worried about their incomes not keeping up with increases in health care costs
• 57% are either somewhat or very worried about losing coverage
• 67% would approve of a public health insurance option
• 57% would like to see private insurance companies competing with a public plan
• 61% would still support a public health insurance option even if it were the first step toward single-player government-run healthcare