Healthcare's Big Moment

As most of you are probably aware, President Obama will be addressing both houses of Congress tomorrow evening about health care reform. 56% of Americans, and 52% of Independents, say that they plan on watching the President’s speech, so when we look back on this debate, regardless of the outcome, this will, in all probability, be a big night. So, here are some thoughts on where the debate stands, what President Obama might say (based on public polling data,) and, most importantly, what to look for (in terms of polling data) after Wednesday.

The Current Environment: In the latest CBS poll on healthcare, 67% of respondents say that they are confused by the healthcare debate and plan, and a full 60% claim that President Obama has not explained his healthcare plan well enough (65% among independent voters.) Though confused, the public finds healthcare ‘important’ by a margin of 93-6% and 73% believe that healthcare reform will affect them personally, according a Pew Report. And, Americans recognize that a minor change will not create the change they think is necessary in healthcare, with 60% stating that a ‘complete overhaul’ or ‘major reform’ is needed, according to an NBC poll.

While the majority of Americans may not understand the healthcare plan and view major reform as important in general and to their families, they are split on whether they would advise their Congressperson to vote for or against the bill, with 37% voting for and 39% voting against, leaving a full 24% unsure of, at this point, what to do with healthcare reform, according to a Gallup poll. However, of those people who are unsure about healthcare reform, only 36% say it will be a ‘major factor’ in how they vote for Congress come 2010. Though Gallup does not release their crosstabs, I would wager that the ‘unsure’ group is disproportionately made up of moderates, independents, and ‘leaners,’ which means while healthcare might be an important partisan issue in 2010, it might not influence those in the middle as much as we think (in fact, if the economy rebounds or falls further, that will be a bigger issue, as it is, right now, to most Americans.)

As it stands right now, Americans are unsure about healthcare, though they are interested and will tune into the President’s speech. 28% of Independents (19% of Republicans and 23% of Democrats) are unsure of how their Congressperson should vote – though partisan, this issue needs clarification before the public really makes a decision on the issue. With President Obama’s approval hovering around 50%, his ability to take these unsure voters and create supporters will help him pass healthcare, which, in turn, would help his stalled approval numbers.

What we might hear from The President: On September 3^rd, Joel Benenson (President Obama’s pollster) sent a memo to Congress with the basic premise that, when people hear about the President’s plan for healthcare, support increases. Specifically, he points to an NBC poll that, initially, puts public support for the President’s plan at 36%, with opposition at 42% (17% have no opinion initially.) However, after hearing that his plan

1. Will require insurance companies to cover people with pre-existing conditions
2. Mandate that most employers provide healthcare to their employees
3. Provide tax-credits for lower- and middle- income families to pay for healthcare, which is offset by increased taxes on the wealthiest

Support jumps to 53% (with 43% in opposition and 4% still undecided.) If this proves nothing else, it shows that when confused Americans are told about the President’s plan, they become substantially more supportive of his program.

During the President’s address tomorrow evening, he is sure to bring up all three points, especially mandating insurance companies cover people with pre-existing conditions. Another point he will, probably, stress is an increased focus on prevention programs to catch disease early. In the most recent Kaiser poll, 63% of Americans said that such a piece of the plan was ‘very important;’ however, 32% said that the most important part is helping Americans afford healthcare insurance – stressing both should increase support for his plan.

The public option (which polls at 59% support in the Kaiser poll) will come up – it has been at the center of the recent debate and President Obama must address this point. He can do one of two things – write it off as just a piece of his plan to placate Blue Dog Democrats and moderate Republicans into passing a healthcare bill or come out fighting for it in order to build up more public approval for the plan, forcing Blue Dog’s to realize that their constituents, once they understand the offering, want a public option. There is no doubt that President Obama will address the public option, the question, which even polling data can’t address, is whether he will come out fighting for it (attempting to turn public opinion in his favor) or drop it as just a piece in order to accomplish the other parts of his healthcare agenda. Right now, it is anyone’s guess.

Lastly, he must address the fact that 48% of Americans are worried that the government might play ‘too big’ a role in deciding their care, under the President’s reform efforts. Americans’ want a system where everyone is covered and insurers cannot drop them, but they are terrified of the consequences of such a plan. In his address, Obama must say that he understands the public’s fear, but reassure them (and explain to them) that his plan will increase their choice, NOT decrease it.

Overall, tomorrow President Obama will lay out the plan he has tried to disseminate from the start, to an audience that has heard mixed things about what he truly wants his healthcare reform to look like. He should talk about requiring insurance companies (who are never popular with the American public) to cover everyone, regardless of their conditions, mandating, through various mechanisms, coverage for everyone, the public option (though the jury is out on what he will say about that), and, finally, that his plan is about putting the decisions back in the public’s hands – that with more preventative care, American’s will be healthier, but, when they have to make a decision, it will be up to them and their doctor, not a bureaucrat in Washington or administrator in New York. If he can do that, as the NBC poll shows, he can convince the undecideds (and maybe some of the decideds) to give his reform a second thought, making reform and the 2010 election much easier for him and his Democrat’s in Congress.

What to look for: After his speech, pundits and prognosticators will convene on network and cable news to proclaim success or failure – half will be correct, the other half will look awfully foolish in retrospect. But, we won’t know until Americans’ tell us. After tomorrow, look for changes in the number of undecideds in the polls regarding healthcare, especially when asked if they support President Obama’s plan. Also, look for what happens to Obama’s approval on the healthcare issue – this will be important to see if people have come around to his plan, which will affect his overall approval ratings. Lastly, look at the number of people who say they are confused about the plan. If the number remains around 65%, the President didn’t do a good job selling his plan to the public – actually, he’ll have wasted a great opportunity.

This being said, there are three potential outcomes from this speech:

1. Support for Obama’s healthcare plan increases across the board and the number of undecideds decreases as the move into the support column
2. Obama’s speech decreases support as more people become aware of what healthcare reform will actually mean, which will cause Obama’s approval rate to drop below 50% and, probably, stay there for some time
3. The worst case scenario is that there is little or no movement on the debate, and a sizeable portion of Americans remain confused about the plan. Here, Obama will have wasted crucial resources getting little from the public (at least if they hate it after Obama talks to them, we will know that they know about it and have an opinion on it.)

The outcome of the President’s speech tomorrow will be seen by the public’s support for his plan, his approval on the healthcare issue, and how many Americans remain confused and undecided on the issue of healthcare in America. A successful speech could dramatically change public opinion; pushing Obama’s plan through Congress with the support of Americans and lead the charge to the 2010 elections. A bad speech could doom the initiative and slow Obama’s progress as a President for a while. There could be a lot hanging on tomorrow night – for now, we’ll just have to wait and see.

Text Message Marketing: Why teens are changing the mobile marketing game

According to a recently released study from Pew (click here for link), cell phones are increasingly becoming the communication device of choice, especially among teens. 71% of all American teenagers have a cell phone, and among high school aged teens, that number is 83%. This is up from only a 45% penetration rate in 2004 – more than a 50% increase in usage over the past 5 years, and at what seems like an exponential pace. It seems that cell phone ownership sharply increases between the ages of 13 and 14 (when most teens enter high school) from 53% ownership to 72% ownership until ownership levels off in pre-college years at around 85%, which puts it at a higher rate than the average adult ownership rate (77%.) As more of these young cell phone users enter their adult years, the adult ownership rate can only increase to the 85% level seen in the pre-college teens.

What is more important than ownership, especially to the budding marketer or campaign strategist, is usage. Teens, while they do not disown the landline phone, are predominately on their cell phones. 38% of teens send text messages daily (up from 27% in 2006) while 36% make a phone call on their cell phone daily. To contrast that, only 29% spend time with friends in person daily outside of school and 24% IM daily – the people they won’t see daily after school are the ones they are texting and calling. Moreover, as teens migrated to a world of social networking, they become increasing reliant on their cell phones, with 54% of teen social network users sending text messages or IMs to friends through those sites. It seems that, when it comes to communicating, teens are becoming increasing dependent on this mobile technology to connect to and communicate with their peers.

Adults, on the other hand, have mixed feelings about the use of mobility. 39% are considered ‘motivated by mobility’ while 61% believe that ‘stationary media’ is fine for them. However, 18% of adults who are ‘motivated by mobility’ are, what Pew calls, ‘ambivalent networkers.’ (click here for link.) These networkers skew male, but are primarily in their early 20’s and have, ‘folded mobile devices into how they run their social lives, whether through texting or social networking tools online.’ As more of these teen texters grow up, they will, most probably, enter the world as ‘ambivalent networkers’ increasing their dependence on their mobile devices to run their social life and connect with friends and colleagues.

So, while it doesn’t seem like teens will abandon more traditional media and communication tools (still, 32% talk on a landline daily) they are adding the cell phone as into their repertoire and increasing their mobility and connectivity to friends and family. Meanwhile, their mobility will continue to increase as the use of smartphones replaces the old call-n-text cell phones of yesterday. According to the Wall Street Journal, the smartphone market grew by 78% between 2007 and 2008, and is expected to grow by over 350% by 2012 (click here for link.) As teens get their hands on this vital new piece of information technology, their communication habits and social networking abilities will just increase and more and more will enter adulthood as ‘ambivalent networkers.’

So, why is any of this important? As more teens rely on their cell phones to communicate, marketers and politicians will need to find new creative ways to use this medium to connect to their target audience. It gives companies and elected officials a chance to communicate to teens on their level – the challenge is getting the awareness and message in just about 160 characters. However, if done successfully, cell phones and smartphones, in the hands of teens, can become a powerful tool for marketers, campaign managers, and public health officials.

Take North Carolina, for example. The pregnancy prevention campaign of North Carolina set up a free text line where girls can text their question to an expert anonymously and, within 24 hours, have a professional non-judgmental text response to their question or concern (click here for link.) Or, Abilene Christian University that handed out iPhone’s to its freshman class to allow them to get digital handouts and class podcasts on their phone. Here, educators and public health officials are tapping into teen cell phone use (and, perhaps, abuse) to get them important information in a format they are comfortable with (click here for link.)

Of course, the most well-known, or at least well-documented, use of the cell phone to communicate a message has been President Barack Obama’s 2008 campaign for President, which enlisted the help of the mobile phone to reach out to young supporters. And, it works. According to a Gallup study conducted in October of 2008, 38% of registered voters had been contacted directly by the Obama campaign, as opposed to only 30% by the McCain campaign. Moreover, when it came to voter contact in the crucial ‘purple’ states, Obama’s people contacted 53% of registered voters, as opposed to McCain’s 44%. Surely, this made a difference, and cell phone communication had something to do with it – particularly with the 18 to 29 year old age group, of which 40% were contacted by Obama’s staff, double the amount that were contacted by McCain’s people (click here for link.)

This, of course, raises the question: what made President Obama’s outreach successful? The answer, according to Distributive Networks, consists of 5 crucial components:

1. Seize control of the mobile channel
2. Build the opt-in list aggressively
3. Develop robust participant profiles
4. Optimize message frequency
5. Leverage mobile’s unique strengths

(click here for link.)

What this means for mobile marketing is that, it must be both personal and ubiquitous, while adding value to the consumer. Just as knowing who President Obama selected as his Vice President added valued to the millions that registered their mobile number to find out, businesses must create systems that enhance value for the consumer, not just deliver a message. Allowing consumers to check their account balance through their mobile phone, as Bank of America allows, is just one way marketers can capitalize on this ongoing and ever growing trend among today and tomorrow’s consumers (click here for link.)

On such a personal device as someone’s cell phone, successful mobile marketing campaigns will be one’s that add value to the users experience. These types of campaigns will reap the rewards of an ever-growing trend among America’s teens. On the other hand, marketers who fail to increase utility and see the phone as another mechanism to bombard the consumer with messaging will not only fail but also invade personal space, which could have increased backlash. Just as AT&T dealt with tremendous backlash from consumers when they spammed former American Idol text message voters with a reminder about the upcoming season, so too will other brands be hurt if they only communicate and don’t interact – don’t create a value-added experience for the user.

As teens become adults and move into the ‘ambivalent networker’ category with their smartphones buzzing from text messages, phone calls, and Facebook alerts, marketers will have to work harder to promote their brands and interact with customers, but in an increasingly mobile society, those who invest into smart campaigns that enhance the users experience will be rewarded, others will find that they have lost their signal.