O, brother? Where art thou (and your social media chops)?

It is times like these I bet the White House wishes it had a public relations agency at its disposal, and not just an office of the press secretary.

It is times like these I bet the White House wishes it had a public relations agency at its disposal, and not just an office of the press secretary.

The rollout of the Affordable Care Act has been, while not an unmitigated disaster, certainly a massive stumble of enormous magnitude. It is a cautionary tale that strikes fear in the hearts of those of us who have handled PR debacles, fended off the jackals, kept the client happy, and unearthed just enough voices of reason to get our story told in an effort to ultimately win the war.

Now, I don't mean to take anything away from President Barack Obama's top communicator, Jay Carney, and Carney has a staff that is probably pretty competent – I'm just wondering: where's the hammer? Where's the PR offensive? What became of the well-oiled machine that David Plouffe built and others, including my friend Jonathan Kopp, helped turn into an example of how to engage audiences in the dawn of the social media era?

For an administration that was birthed in 2009 on the strength of an awesome social media and PR campaign that utilized every new tool and technology to get out the vote — and galvanized a generation of disaffected teen, 20-, and 30-somethings in the process — this is a pretty grim affair. It's as if the Luddites somehow snuck back into the West Wing over the last few years, closed the Twitter accounts, turned the fax machines back on, and reverted to rotary phones for media pitching.

In order for the ACA to be successful, besides having a working web portal, of course, millions of healthy young Americans must sign up. It's a simple economics issue: you need a lot of people paying monthly premiums and not spending too much time with doctors or in the hospital, to offset the dramatic costs associated with insuring the elderly, sick, and lower-income Americans who were without healthcare.

And therein lies the issue. Where is the tenacious, focused, (seemingly) clever organic engagement of these Americans in the places where they are congregating, communicating, and sharing online?

Where's the influencer campaign, engaging voices with expansive online networks that reach, capture, and energize young Americans? This may be a stretch, but I'll throw it out there anyway. What fun – and exponential impact – could Jenna Marbles have with a trademark video on the ups, downs, ins, and outs of shopping as a newly minted college graduate for the right healthcare package?

Where are viral videos showcasing early successes? There are 100,000 enrollees already, some of whom, I have to imagine, are under the age of 30. Where are the Vines, YouTube videos, and other clever visual story lines that capture, in the right vernacular and with the right imagery, the angst of young Americans struggling to figure this out not just as a new healthcare option but as a critical component of their life planning?

Where is the owned content strategy – the narratives that speak from the outside in focusing on how we as a nation lag behind most other developed nations including Canada, Sweden, and Great Britain in cost, expansiveness, and effectiveness of healthcare? Why is this not being told through the voices and experiences of the elderly, sick, and lower-income Americans, but also through the lives of young, healthy Americans who are taking their future into their own hands, making smart decisions early in their careers, and challenging the status quo? Why are these stories not populating across key channels of access, insight, and influence speaking to young Americans?

And finally, where is the competitive de-positioning? Where is the FUD – the “fear, uncertainty, and doubt” being sown amongst the fertile fields across the Facebook, Twitter, LinkedIn, and Instagram landscapes? The voices of disunity are loud, strident, and persistent, from many quarters but emanating loudest out of the echo chambers populated predominantly by Republicans and their sub-species, the Tea Party.

First, we need to remember that great social change can be a brutal contest of wills: many Americans – led by Republicans – were ready to run FDR out of Washington in the early days of The New Deal. He had William Randolph Hearst to contend with in the Fourth Estate. We've now got the equivalent of a nation of citizen journalists in this cacophonous media maelstrom – and you need a PR agency with the savvy and skills to engage and evangelize them, particularly when the stakes are as high as they are with universal healthcare.

Fear, uncertainty, and doubt? You bet! Give me the admin password to the @healthcaregov handle!

Brian Regan is SVP and GM for New York at Access Communications.

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