Obviously part of the problem is that they are being deliberately lied to. But there are probably relatively few people out there swallowing and regurgitating all the lies.

Why? Simple: relatively few people pay much attention to politics, and most people have a very low level of familiarity with the specifics of any particular issue. According to a recent Kaiser poll, only 27% of Americans are following the health care reform debate closely. There are strong believers on both sides of the issue, but the key, as it always is in American politics, is the mushy, ill-informed middle. Those are the people who are reparably confused. But it’s important to understand that Americans are confused about the very basics, about even the terminology that they are supposed to use when chatting at the water cooler. Most importantly, they don’t know what the public plan is, and the phrase itself is open to Rorschach-style projections. The famously salesman-like Obama failed to frame his product in the most basic way: giving it a good name.

In 2005, you could be for or against “the privatization of Social Security.” In 1995, you could be for or against “welfare reform.” In 1965, you could be for or against “guaranteed health insurance for the elderly” and the “Voting Rights Act.”

What are you supposed to be for in 2009′s health care debate? What simple, easy-to-understand, attractive phrase did Democrats pick to encapsulate their plan? The “public plan” was it, but “public plan” is a terrible political phrase. “Public” conveys the idea of something that everyone uses, provided by the government: public transportation, public parks, public roads and bridges and beaches. How easy to believe that the public plan entails “government-run health care,” or a “government takeover”! Only recently have the Democrats started saying “public option,” but “public plan” has already stuck.

But wait, you say, the public plan is actually popular! A recent NY Times poll found 66% favoring “a government administered health insurance plan.” First of all, I’d love to see what the same sample of people thought about the “public plan.” I’m confident we would have seen a different, and lower, level of support, which reflects the fact that Republicans and Republican-leaners know they’re supposed to hate the public plan, and also the fact that it’s such an easy thing to believe the worst about.

Second, support for the public plan is extremely shallow. The same poll found 69% of Americans feeling concerned that the quality of their health care would drop. That’s a powerful concern. The same Kaiser poll from before showed that support for the public plan plummeted when it was suggested that it would give government an unfair advantage over insurance companies and be the first step towards single-payer. Granted, support rose when people were told it would provide choice and bring down costs by increasing competition. But Obama didn’t want (or shouldn’t have wanted) competing narratives about a public plan. You don’t want the mushy middle to be prepared to believe anything they’re told, not on an issue as sensitive as health care. You don’t want to count on their believing your side of the story.

Third, remember the 27% statistic from before. A successful political endeavor has a tagline that the other 73% can get behind, because the 73 percenters are the air that the 27 percenters breathe: they are friends, family members, colleagues, and interview subjects for journalists. What they think is at least as important as what the well-informed think.

Ironically, I believe that the way to solve this problem would have been to use an even vaguer phrase than “public plan,” which is now coming into vogue, from the start. It always should have been “health insurance reform.” Get “health care” out of it. Nobody feels any love for Aetna and Blue Cross, but people like their “health care”: they like their doctor, they like their local hospital, they like their kids’ pediatrician, and they like their pills. Threaten those things with reform (read: change) and you’re bound to scare people. Throw in language about a “public plan” and you’re bound to confuse people. But “health insurance reform” isn’t the type of thing you can easily believe bad things about. It suggests change, which people overwhelmingly desire, and probably to a much firmer degree than they support any particular kind of change. And it focuses the attention on the insurance companies and on the consumer-friendly regulations Obama is pushing. Obama and his PR team have realized their mistake, and their new eight-point list of reforms is supposed to rectify it. It might work, but it would have saved us a lot of pain if he had thought through the sales job in the beginnning.

I have to agree with Maureen Dowd, who writes today that “the president’s overconfident Harvard Law Review side, expecting a high-minded debate, prevailed.” (An even more cynical observer might say that the President’s accommodationist, business-friendly side prevailed.) But the root problem isn’t that Obama’s failing to “squash” his nutty opponents, as Dowd says. He is trying and trying and trying to do that, but he will keep failing because the terms of the debate have been set, perhaps irreparably, in his opponents’ favor.

This morning I haphazardly discovered one such measure, thanks mostly to Matt Lauer. This morning, as I ate my fiber-rich cereal topped with banana, blueberries, and skim milk (my personal preventive measure), I watched Matt do a feature on making smart choices in chain restaurants. He lined up five or six ungodly sandwiches from places like Chili’s and Ruby Tuesday, next to each of which was a slightly-less-ungodly alternative, invariably a pallid-looking grilled-chicken concoction. The placards displaying nutritional information (e.g., 1,900 calories for a burger topped with onion rings from Outback) were not even the most powerful reminder of the unhealthiness of much restaurant fare. That would be the mammoth bowls of French fries or plates of glazed donuts that were said to have equivalent amounts of sodium, or saturated fat, or cholesterol as their respective ungodly counterparts.

Watching this, I thought to myself, surely there are millions of people who would eat a huge gooey burger topped with blue cheese, knowing obliquely that it is “bad for you,” but who wouldn’t eat 17 orders of fast-food French fries if they knew that’s what they were effectively doing. And surely, if we got people to stop doing the former, we could cut down on obesity, diabetes, heart disease… and huge medical bills to treat those conditions.

But how to make people face these alimentary choices directly, with full (or, in econo-speak, “perfect”) information? Obviously one way is simply to require that restaurants disclose nutritional information in easy-to-read places, preferably right on their menus or big menu boards. “Texas Ranch Bacon Cheeseburger” (or whatever)  doesn’t sound quite so appetizing when you see “1,440 calories” and “1,800 mg sodium” next to it. New York City has the most famous such law, requiring eateries with more than 15 locations nationwide to post calorie counts on their menus. Philadelphia recently passed a stronger law, requiring disclosure of not just calorie counts but saturated fat, trans fat, sodium, and carbohydrates on printed menus (just calories on the big boards in fast-food restaurants). California is the only state with a nutrition-disclosure law.

Though perhaps not as controversial as a ban on trans fats like NYC’s, which impinges more obviously on Americans’ beloved freedom to make terrible, costly choices, a nationwide nutrition-disclosure requirement seems to me like one of those good ideas that might die a quick, quiet death in that graveyard of good ideas, the United States Senate. Various food-industry groups and fast-food company spokespeople will adopt the comfortable rhetoric of choice in order to defend denying people the information necessary to make choices. They may even evoke the “free market” in defense of information asymmetry, which, as economists know, always leads to a distortion of what consumers’ choices would look like in a real, pure market. These objections, of course, are and will be ridiculous. Nobody thinks the “free market” is harmed by my knowing that a serving of cereal contains 13 grams of sugar, or that a can of Dr. Pepper contains 40. Why it should be any different for food served in restaurants is beyond me.

In any case, the Senate HELP Committee health care reform proposal includes a calorie-disclosure requirement. It’s not perfect: I would like to see a national regulation modeled off Philadelphia’s, because calorie counts are only part of the nutritional picture. And I think that, in an ideal world, the regulation would apply to all restaurants, not just chain ones. I can see why the issue is tackled that way: for one thing, fast food and chain restaurants attract poorer clientele, who are more likely to be insufficiently educated about proper nutrition; for another, they are easier to demonize because everybody, even those who frequent such places, knows that they’re bad for you. But there’s no reason other than political calculation to exempt a 16-ounce Wagyu steak from a law covering a Texas Ranch Bacon Cheeseburger.

So, let’s hope that the HELP Committee’s proposal, which is a good start, does not die in the markup process, and that it is incorporated, if it’s not already, into other health care reform proposals. I’ll eat to that.

Another, related issue that doesn’t get enough attention is that the GOP’s antipathy towards rationing  would seem to protect inefficient, unhelpful health care. You would think “rationing” could only be bad if the item being rationed were, you know, good, but the Republicans don’t even like the idea of assembling data and best-practices information and making them available to doctors. If a certain procedure or treatment works well, it won’t be “rationed” by such harmless regulations. So the Republicans are essentially defending the sacred right of doctors to be wrong.

Another interesting , oft-overlooked irony is the fact that the last time the Republican Party had a health care plan of its own, “rationing” was a quite explicit goal of theirs. What do you think Sen. McCain meant when he talked about consumers taking “individual responsibility,” and becoming “much more responsible in health care costs”? The goal of his health care plan was to force consumers to put more skin in the game by exposing them directly to the costs of health insurance, giving them insufficient funds with which to purchase it, and forcing down insurance costs using the bluntest instrument possible, the consumers’ inability to purchase adequate coverage. You might say the consumer would be doing the rationing rather than the government, but that is not the reality of it: the quality of health insurance would be determined by the seemingly arbitrary amount of the government’s tax credit.

It would be useful to remember such things when dealing with demagogues like Mark Steyn who suggest that President Obama is going to lower costs by euthanizing old people. The claim is not just crass, offensive, and blind to the unavoidable hard choices of policy making, but shockingly lacking in self-awareness to boot.