How did the healthcare reform debate -- arguably the country's most important policy discussion in decades -- turn into such a miserable cesspool of scheming and disinformation?
This past week we were treated to images of conservative protesters heckling Democratic lawmakers at town halls, demanding that they abandon plans for "socialized medicine" and "government-run healthcare."
We also saw polls showing that support is slipping for current reform plans. A Wall Street Journal/NBC News survey, for example, found that only about a third of respondents think what's on the table is a good idea. Forty-two percent say it's a bad idea.
Just a few months ago, healthcare reform looked like a slam-dunk. Now it seems like it's barely on life support.
"There's been a lot of noise and confusion," said James Harris, president of a Culver City PR firm that specializes in healthcare issues and a former PR executive at insurance heavyweight Cigna HealthCare.
"For the average person," he said, "this is all probably very hard to understand."
The spin industry has been working overtime to frame and sway the healthcare debate. My colleague Dan Neil concluded the other day that reform opponents were getting the upper hand "because the insurance industry's demagoguery is better and smarter than the reformists' demagoguery."
That's undoubtedly true. But a key problem here is that most of us aren't taking the time to understand the various parts of this admittedly complex equation.
Instead, we're leaving it to interest groups to call the shots, and the debate has devolved into a pathetic shouting match between partisan camps. It's hard to imagine genuine reform emerging from such an infantile environment.
"Does your company pay for your car insurance?" asked Peggy Frank, whose Westlake Village PR firm also specializes in healthcare. "No. Nobody's does. It's up to you to find out what's best for you.
"With health insurance, we've been raised to just say 'thank you' to whatever is provided by our employers. We don't know how to analyze the system or what's best for us."
As a result, people are easily swayed by whatever pitch plays to their ideological sympathies.
Take an ad produced by a group called Patients United Now. It features a Canadian woman, Shona Holmes, who says she got the runaround from her country's healthcare system after being diagnosed with a brain tumor.
"I'm here today because I was able to travel to the U.S., where I received world-class treatment," she says. "Government healthcare isn't the answer."
As if that didn't make the point with the subtlety of a ball-peen hammer, a gravel-voiced announcer then warns that "Washington wants to bring Canadian-style healthcare to the U.S."
There are a variety of problems with this spot, not least its repeated references to "government healthcare" when in fact Canada offers citizens a government-run insurance program, not medical treatment.
Moreover, no one's proposing "Canadian-style healthcare" for the United States. A single-payer insurance system isn't part of any of the leading reform proposals now making their way through Congress.
A limited public plan is on the table, but it would compete with private insurers to help keep costs down, not replace them.
Amy Menefee, a spokeswoman for Patients United Now, made no apologies for her group's ad potentially misleading people.
"The point of the ad is to show the extremes where things could go," she told me. "This would be a bigger role for government than we've ever seen. It's a power grab in this area of the economy."
Factor in Medicare, Medicaid, veterans assistance and assorted business subsidies, and the federal government already accounts for about 60% of all healthcare expenditures nationwide.
Streamlining the healthcare system isn't about a government power grab. It's about ensuring that the hundreds of billions of dollars of taxpayer money we now spend annually isn't being flushed down a rathole of private-sector waste and profiteering.
Moreover -- and I'm astonished reform proponents have failed so spectacularly at articulating this -- a restructuring of the U.S. insurance system isn't intended to place the government in total control of healthcare.
It's to try to extend coverage to most if not all of the roughly 47 million people in this country who now lack insurance, and to create more equitable conditions for those who do not receive group coverage from employers.
It's to address the extraordinary fact that the United States spends about twice as much per person on healthcare as other developed nations but nevertheless claims lower life expectancy and higher infant mortality rates.
In short, we're reforming our health insurance system because our current system is so obviously flawed.
But because most of us receive insurance from our employers, and in most cases it's been there for us when we needed it, it's difficult for many people to see the bigger picture.