Draft Updated: 22 June 2012

1. Draft Updated: 22 June 2012

2. Overview • Methodology • Attainable Strategic Goals • Situational Analysis • Points of Engagement • Positioning • Current Communications • Outcome map

3. 1. Our Methodology • This strategic assessment: • is the product of a strategy sessions involving the Nanos Rutherford McKay & Co. partners; • is based on an analysis of our research for CHC; • was developed independently of CHC and represents our best advice from an independent perspective (draft 1); • was adjusted following presentation to CHC in early June 2012; • identifies and personifies a primary target for the campaign; and • is intended as a starting point for discussions (with CHC) to further develop the approach for reaching CHC’s objectives.

4. Meet Nicole - our target audience We need to reach her and, over the next few years, engage with her (on a shared journey). This profile applies to all regions and cultural backgrounds. • A mother with ageing parents/in-laws • Moderate news consumer • Non-partisan, a- political • Tends to make healthcare decisions for her family • Busy, impatient, focused on things immediately relevant to her day-to-day life

5. 2. Attainable Strategic Goals • 1.1 Goals • Pivot the narrative from money to a stronger public system - Healthcare is about more than just funding – it is about building a stronger public healthcare system • Fight the myths - Myths advanced by the privatization forces to be aggressively countered with strong evidence, personally-relevant narratives • Advance the cause and engage Canadians - Demonstrate that public healthcare is better through strong evidence, personally-relevant narratives

6. 2. Attainable Strategic Goals • 1.2 Organizational Goals • Further establish the CHC as the mainstream movement for Canadians and public healthcare organizations • Position the CHC as the “go-to” media resource for verifiable evidence about the value of the public healthcare • Facilitate the creation of an expanded coalition whose members see the CHC as the valued leader and public face of the pro-public healthcare forces in Canada

7. 2. Attainable Strategic Goals • 1.3 Supporting Objectives • The following “wins” over the next 3 years will tell us that we are reaching our desired goals: • Supporters of privatization are on the defensive • The media narrative is changing • The federal government is more engaged (talking about the issue even if they don’t want to) • Thousands of people like Nicole are engaged and taking action • Healthcare is an election issue

8. 3. Situational Analysis • This section sets out the main forces at play in the public domain and identifies and analyzes the four major groups of players (political, media, public and stakeholders)

9. 3. Situational Analysis • 3.1 Dominant Narratives • Common ideas (not necessarily true) to be managed: • Demographics – An ageing population is ramping up demand • Costs – As demands on the system increase, so do the costs • Hot-buttons – Long wait times and staff shortages are routinely cited as leading issues of concern • Private vs. Public – Debate on how to meet these challenges centres on how to balance roles of public and private sectors

10. 3. Situational Analysis 3.2 The Players

11. 3. Situational Analysis • Political • December 2011 federal announcement on the Accord, combined with the Conservative government’s “minority shareholder” approach, sets the context for 2014 • Healthcare is consistently the #1 or #2 issue for Canadians • The provinces and territories want to engage on healthcare and a new health accord • Healthcare is not one of the federal government’s five priorities, it is simply an issue to manage

12. 3. Situational Analysis • Media (Dominant Narratives) • System is Broken – Negative aspects of public healthcare – wait times, staff shortages, unequal access – are more newsworthy than successes • Demographic Time-bomb – The healthcare needs of Boomers are putting increasing pressure on an already overstretched system • Private is Cheaper – Private systems are cheaper, public systems are, or can be bloated, wasteful and less responsive • Inevitable Privatization – The system is already privatized to an extent and more privatization will likely be necessary or desirable • Comparison with U.S. – Election year could mean a spillover of the American healthcare debate; collateral impact on Canadian audiences

13. 3. Situational Analysis • Public Opinion (Summary) • Support for public solutions to strengthening public healthcare is high • Support is the same regardless of political affiliation • Almost half of Canadians see the expansion of private healthcare as weakening public health care (a third see it as strengthening) • Source: Nanos Research poll conducted for the Canadian Health Coalition in October 2011.

14. 3. Situational Analysis • Public Opinion

15. 3. Situational Analysis Public Opinion

16. 3. Situational Analysis Public Opinion

17. 3. Situational Analysis • Stakeholders • Most agree change is needed, but there is division on the nature of that change • Opinion usually divided according to ideology/vested interest • Increased privatization is supported by those who profit or could profit by it (Pharma, insurers, etc.) • Strengthening public healthcare tends to be supported by those currently working in the public system (unions, professional healthcare associations, etc.) • Think tanks are divided along ideological lines • Employers operating internationally generally recognize value and competitive advantage of public system

18. 4. Points of Engagement • Message Environment • We need to dominate at least 3 of the quadrant themes • Us = CHC • Them = Pro-private • For example, the CHC would describe the public system as universal and innovative.

19. 5. Positioning • 5.1 Message Scenario • Consists of: • Narrative – the story you want to tell, the themes that will run through all communication • Framing – the content you will engage in • Language – the dictionary/vocabulary you will use

20. 5. Positioning • 5.2 Narrative • Story • Our universal healthcare system provides the care we need without putting ourselves and our families at risk. We don’t need line-of-credit healthcare. • The public system is universal and finds innovative ways to reduce costs. Profit-driven systems are unequal and risky. They find ways to maximize their income by focusing on areas where there is enough demand and potential for profit. They drain resources from the public system and from the finances of Canadian families. • Canadians value the public healthcare system and they want it to be strengthened. The best way to strengthen healthcare is to improve the public system.

21. 5. Positioning • Themes • We are all covered by universal healthcare. Our public system should be improved. • Public healthcare is innovative. It maintains quality care while finding innovative ways to reduce costs. • Private healthcare is unequal and risky. Private systems maximize their income by focusing on areas where there is enough demand and potential for profit. They drain resources from the public system and from the finances of Canadian families. • We don’t need “line-of-credit healthcare.” You and your family should not have to go into debt for your healthcare.

22. 5. Positioning • 5.3 Framing • Engage in three of the four theme quadrants – use evidence and personal stories to promote public healthcare, debunk myths about public vs. private healthcare • Avoid the no-win technical engagements: • Accounting war – overly complex financial issues • Legal war - federal enforcement of the Canada Health Act (focus on CHA principles and values rather than law enforcement) • Political war - partisan politics

23. 5. Positioning • 5.4 Dictionary • Create, maintain and share lexicon of terms/vocabulary • Everyday language that avoids jargon and buzzwords (i.e. the complex and/or overused language of public administration, political activism, science & medical, etc.)

24. 5. Positioning • 5.4 Dictionary - Ours

25. 5. Positioning • 5.4 Dictionary - Theirs

26. 6. Current Communications • 6.1 Positive Foundation • Website with interactivity, social media & multi-media • Printed/downloadable communications products are well-designed • Detailed information and solid evidence available • Multiple opportunities to take action

27. 6. Current Communications • 6.2 Overall Recommendations • Need to bring clarity and focus to current communications • Align with positioning set out earlier in this deck and the multi-year campaign following

28. 6. Current Communications • Recommend messaging has a tighter focus (currently “watchdog” positioning along with a webcast promo, an ask for donations and a website welcome) • Integrate - separately branded campaigns appear somewhat disconnected from overall brand and with each other

29. 6. Current Communications • Communications vehicles offer solid evidence/info but often wrapped in political/ideological attacksthat may undermine credibility • Canadians support the public system regardless of political affiliation; ideological attacks only alienate

30. 7. Outcome Map • 7.1 Overall Approach to Reaching Issue & Organization Goals: • Focused and integrated – simple, focused messages, common look • Credible – CHC as a coalition of experts and healthcare providers that forcefully advocates by remaining focused on the issues, not the players - counters myths with facts and verifiable info • Evidence-based – collect and share credible evidence that debunks myths and shows that the public system is better • Story-based - collect and share stories from healthcare workers, researchers and patients about their personal experiences with an innovative, cost-effective and responsive system • Personalized – ensure communications speak to the experiences of individuals/families; avoid “healthcare administrator” language • Interactive – attempt to connect with individual Canadians and have viral sharing of our information

31. 7. Outcome Map • 7.2 Staged Approach for You and Nicole • Mobilize(Establish leadership, call for leadership, pull together plans, resources, evidence, personalized stories, reach out to Nicole) • Engage (Push out messages, counter myths, engage Nicole in reaching out) • Attack(Aggressive pressure, Nicole takes • direct action) • Win • (see slide 7) • Throughout: rapid response to misinformation and new developments (using evidence, personalized stories in social and traditional media) • 2012 2013 2014 2015

32. 7. Outcome Map • 7.3 Next Steps – Mobilize Stage • Discuss and agree internally to a version of this deck; obtain buy-in and commitment from all • Obtain buy-in and commitment for message discipline protocol that reinforces main themes but allows for regional flexibility • Adjust/approve positioning, begin harmonizing existing communications, esp. website • Prepare detailed work plans and budgets for stages 1 and 2 (Mobilize and Engage) • Begin organizing and/or collecting evidence and personal stories according to detailed criteria

33. 7. Outcome Map • 7.3 Next Steps – Mobilize Stage • Plan call for leadership campaign “Step Up” leading up to the National Medicare Week during last week in November 2012 • Develop statement based on positioning; approach premiers/provinces and territories as well as notable Canadians to sign on • Media plan as each responds (releases, advisories, backgrounders and trained spokespersons) • Launch a “Step Up” web page and supporting YouTube channel • Focused social media plan that a) encourages individuals to sign on to the call for leadership statement, 2) announces support/non-support of provinces and territories, and 3) highlights support of notable Canadians • Begin “Step Up” events across the country

34. Nicole • “Our universal public healthcare system gives me the care I need without putting my family at risk.” • “When I show up at the hospital, I should only need my health card, not my credit card.” • “I’m uncomfortable with anyone profiting from my family’s misfortunes.”