It’s been a hot summer, no doubt about it. But as the sun sets on August, will the cooling breezes of September calm the debate, or will it be another month of death panels and protests? As one who was around in 1993 when health care reform had a withering autumn, I believe supporters of reform are in far, far better shape. After struggling with a message and frame, President Obama's new message about health insurance reform has staying power. In fact there is only way to respond to the emotionally charged fears about the alleged sacrifices that await the American people according to opponents of reform. That response is an emotionally compelling but also reassuring message that reform will give Americans “stability and security” in their health care for the first time in the nation’s history.

Under health insurance reform, losing a job will no longer mean losing coverage. Getting a disease will no longer mean that an insurance company will deny you coverage. Working for a small employer will no longer mean having inferior benefits or no coverage at all.

Americans still support the moral argument for reform, but that argument is not enough when the opposition is telling them, however inaccurately, that they will lose the quality of health care that they have.

By focusing on the central question of "What is in it for me?" leaders of reform can dislodge abstract and distant arguments such as the 46 million uninsured or the impact of health care costs on the economy. They can also appeal to gut level concerns that health care coverage may not be there through life’s ups and downs.

Despite the media attention on the most controversial aspects of reform such as the public plan, the opportunity remains to show the public that regardless of how the remaining questions are resolved, there’s a quite a bit that has been agreed upon.

This fall, reform leaders should emphasize the historic opportunity to provide stable health care to the middle class. Its enactment will be as important as Social Security and Medicare have been in providing a stable retirement. They shouldn’t let inevitable compromises turn reform into a half of loaf. Health insurance reform, as the President now emphasizes will be a victory worthy of improvement for years to come.

What usually is a relatively quiet summer recess period instead has been marked by some of the most rancorous discussions we have ever seen.

In this type of environment, there can be no “winners.” In fact, what gets lost is an important opportunity for citizens to dialogue with policymakers, and to understand better the complexity of the challenges we face in health care reform.

Whether or not the media have exaggerated the extent of these heated forums—and despite the fact that much of the inflammatory rhetoric appears to have been incited by some who hold more extreme views—we cannot afford simply to dismiss the intense interest these discussions have generated.

At the end of the day, what really worries most Americans about health care is this: “will there be a doctor in the house when I need one?” and as a corollary, “will the system, and the people in it, truly care for me?”

In other words, we cannot let the “sound and fury” of a few detract from the many whose concerns are legitimately based on their personal experience with today’s health care system. Our status quo is simply unsustainable, and the need for reasoned discussion and finding common ground has never been more acute.

I believe and our Coalition agrees that an honest, open, and intense national debate about health system reform is essential. Unfortunately much of the August P.R. “offensive” has been anything but and instead has been riddled with misinformation, fear tactics, demagoguery, and in some instances, outright distortion of facts (e.g., the charges of death panels and euthanasia.)

Tactics such as these have been used many times before to fight necessary reform efforts proposed by both Republican and Democratic Presidents, most recently in the reform efforts advanced by President Clinton. In their study of that effort, and why it failed, David Broder and Haynes Johnson, in their book “The System” concluded that,

“Too much of the debate was dominated by negative sound bites, by the importuning of ‘spin doctors’ with their misleading arguments, false analogies, and statistics crafted for the convenience of the argument, not the truth of the case. As a result, the public, for excellent reasons, was confused and frightened throughout. In a classic sense, the people were woefully uninformed. The manufactured, and manipulated, ‘public opinion’ prevailed.”

I am pleased that President Obama and other proponents of health care reform have not allowed such tactics, which constitute a disservice to American people, go unchallenged. In the end, the American people, when confronted with all the facts, will understand and will choose reform over the status quo.

No one wins a distorted debate.

The town meetings and the media coverage of the town meetings has diverted attention from the core issues in the health reform legislation still in question in the Congress and of concern to the American people. Even when the media is trying to act responsibly by fact checking and myth busting, its focus on controversial and often symbolic issues of concern primarily to activists on the right and the left creates unease and doubt about health reform among the greater American public and paints a picture of where the public stands that is at odds with what more scientific public opinion polls show (they show slippage and growing anxiety but still overall support for moving ahead).

Obviously the town meetings and the issues raised at them deserve some coverage. The problem is balance and context. The crucial decision for journalists is not how to cover the town meetings but how much to cover them and how much to elevate narrow issues of importance mainly to activists on the right and the left over the central issues standing in the way of a deal on Capitol Hill and of greatest concern to the American people, such as how to pay for health reform and how well the legislation will or will not help average people with their health insurance costs. The media likes to think it merely follows events. But what the media covers and how it covers it will have a substantial impact on public opinion and on the public verdict on health reform in the coming months.

Most people are not in a position to know the answer to that question. For the past two months, trench warfare has been underway completely below the radar for the Washington press corps -- who tend to think everything important begins and ends in Washington, DC.

At least once a week President Obama (or someone else from the White House or the DNC) has been sending talking and attack points by email to 13 million faithful recipients. In response, the NCPA has been sending counter messages over talk radio and by email to 1.1 million petition signers at freeourhealthcarenow.com

I would say the opposition has been winning. But not because of lies and distortions. Rather, because the opposition has been better informed and more accurate. Many of the people at town hall meetings have actually read HR3200. Some show up with Zeke Emanuel's articles on rationing or copies of Tom Daschle's writings on the purpose of comparative effectiveness research and the role of the health board. The typical representative, of course, hasn't read any of this.

In my part of the world people have ODed on healthcare reform. They are still on vacation or getting their kids ready for school. They are not watching much TV other than checking the weather or the beginning of the football season. I rarely run into anyone who wants to discuss healthcare reform these days. Today's story on the administration perhaps moderating its govt plan broke through the distraction and I sense from my contacts this morning may restart the momentum to get this done.