Tuesday, April 22, 2008

Post Mortem on the Late-Term Elderly Medical Care Insurance Rollout

I’ll have to alter my assessment of the political impact slightly, now that we’re seeing some serious coverage. I don’t see the deduction issue having a serious impact, but more broadly, the rollout reports feed into the now-familiar incompetence issue adding to the image of a bumbling, indecisive administration. However, that’s an already well-established trope, and these latest troubles are a temporary blip compared to the other far more serious problems of the coalition and more specifically the Fukuda administration.

MK kindly reminds me that even after I altered my assessment of the impact of the Late-Term Elderly Medical Care Insurance System, I still didn’t see the deduction issue having a serious impact. So true. I guess that’s why I’m not a political strategist. And speaking of political strategist, where was the LDP strategist who failed to make the following points and push them relentlessly through the media before the rollout?

1) The new insurance system is designed to ensure the viability of the national healthcare system.
2) On average, low income households will pay a little less, while high income households will pay a little more.
3) We’re leveling costs across municipalities, so some households will see their bills go up, while others go down. We’re taking measures to alleviate the hit.
4) We’re deducting the monthly payments from pension payments for your convenience and to cut costs.
5) Our local and national offices will be on call to answer any questions and solve any problems that you may encounter.
6) For details of the makeover, here’s the url, or call or visit our representatives at…

The message should have preceded the rollout, initiated by a series of informal talkfests-by-invitation (complete with box lunches/cake-and-coffee and dog-and-pony shows) between matched members of the administration (Prime Minister; the Minister of Health, Welfare and Labor; and top MHWL bureaucrats) and the media (editorial writers and reporters on the MHWL beat, i.e. MHWL kisha club members), accompanied by a print-and-broadcast PR blitz that emphasized these points. That way, they could have formed the basic contours of the narrative, which would have put the grumbling and bumbling in context. In the event, the grumbling and bumbling became the context.

A well-designed and well-executed might not have stopped losses altogether, but it certainly would have stemmed the tide. Most importantly, it would have given the Fukuda administration a boost in the competence department, where its biggest deficits lie. The DPJ is not making much headway here either, indicating that the political battle here is not so much over substance as over form.

I am not making it up. This is how it’s done. The government typically has six months to one year to design and implement the public relations campaign between the Diet vote and the actual rollout. The Koizumi-Abe-Fukuda administrations had two years to prepare after the Diet voted to do the makeover. So what happened?

I really don’t know. I’ve written before about problems in the kantei, and it certainly was the job of people in the Prime Minister’s Office to keep tabs on this issue (among many others) and coordinate public communication efforts. But the MHWL should have been doing it on their own initiative in the first place. Incompetence? Loss of will? Both? Your guess is as good as mine.

So much for Monday morning quarterbacking. Now, back to work.

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