During my recent adventures in physical therapy, I overheard an elderly woman, also in physical therapy, talking about a relative who had received bad medical care while traveling in Italy. Then she shook her head and made a disparaging remark about “socialized medicine.” I wanted to ask her if Medicare paid for her physical therapy, although I didn’t. I suspect that if I had told her Medicare was “socialized medicine,” she wouldn’t have believed it.

I thought of this woman as I read Joe Conason’s article in Salon called “Stop ‘Hillary-care’ now!” He calls the Right’s attempts to scuttle health care reform pathetic, and on many levels they are. But that doesn’t mean they won’t work.

Conason writes that the Right’s strategy is to stoke fear of government bureaucrats.

But as his memo indicates, that task is becoming more difficult as the actual conditions that Americans confront grow worse. No longer is it sufficient to deny the reality of crisis in the healthcare system — and if Republicans continue to do so, the overwhelming majority of the American public that is demanding reform will dismiss them. What Luntz urges his party to do instead is to redefine the crisis not as an existing problem of millions of uninsured families and unaffordable care, but as a looming threat of government medicine run amok.

Maximizing fear is the true message of the Luntz memo: fear of government-run healthcare, fear that bureaucrats will intercede between doctors and patients, fear that those same faceless bureaucrats in Washington will deny lifesaving procedures to helpless people. He urges the Republicans to promote “horror stories” about care delayed and denied in countries with national health insurance. If they heed his advice, we can expect to see ads warning that “your child could die” because government bureaucrats held up a critical operation until it was just too late.

Of course, bureaucrats at private insurance companies have been doing these terrible things for years, but we’re not supposed to notice.

Conason reports something said by Republican Senator Jon Kyl: “Imagine needing a new hip that will make it easier to get around, but just because you’re over 75, the government denies you that surgery. We can’t allow that to happen in America.” But Medicare pays for hip replacements all the time. So won’t Americans notice how absurd the GOP’s arguments are? I say some will. But some won’t.

The Right has done an amazing job of turning Americans into people with bifurcated brains. There’s a clear cognitive disconnection between “big expensive government programs” and “programs I like (that are run by the government).”

Remember this Bushism from the 2000 presidential campaign?

We trust individual workers, and so our plan says we’re going to keep the promise to our seniors. But we’ll allow younger workers at their choice to invest some of their own money in the private markets to get a better rate of return so that the Social Security promise will be kept.

And this frightens some in Washington. Because they want the federal government controlling the Social Security like it’s some kind of federal program. We understand differently though. You see, it’s your money not the government’s money.

Of course, Al Gore pounced on that remark, and in a sane world candidate Bush would have been hooted out of the campaign. But Bush was not hooted out of the campaign, and I think that’s partly because many of the people who heard the “like its come kind of federal program” remark didn’t catch the problem with it.

And I know in my bones that you could find people who have been denied care by insurance companies, or who have no insurance at all, who are opposed to “socialized medicine” because they don’t want “government bureaucrats” making decisions about health care.

Conason writes,

In a typical Luntz language memo such as this one, he commands Republicans to repeat certain words and phrases over and over again, on the humiliating assumption that both they and their constituents will behave like mindless stooges. His underlying aim is to strip words of their meaning to evoke automatic responses — and to shut down rational thought.

Yes. And y’know what? They are really good at stripping words of their meaning to evoke an automatic response. Think of what the Right has done to “liberty” and “freedom” for example. They play “freedom” like a trump card. It doesn’t matter what they’re defending, including torture and warrantless wiretapping; once “freedom” is thrown on the table, the trump card is supposed to win the hand. But within the context of the ideas they are defending the word “freedom” has no meaning.

On the other hand, I can think of times in which a majority of the American people saw through the sham. I’m thinking of the privatized social security scheme Bush tried to sell, and the Terri Schiavo debacle. I’ve thought for years that eventually the percentage of Americans with really bad experiences with the health care system would grow into a critical mass. And when that happened, I thought, maybe we could get reform.

But then there are lobbyists. Someone should work out a citizen-to-lobbyist influence ratio, as in how many irate citizens does it take to cancel out the influence of one lobbyist? It would be a really big number.

Then again, citizen opinion must count for something, or the Right wouldn’t even bother to scam us, nor would the insurance industry have paid for those “Harry and Louise” ads of yore. Perhaps all is not lost.