As the 2016 election campaign ground into its final days, Prime Minister Malcolm Turnbull appeared on the evening news bulletins. “Medicare will never, ever, ever be privatised,” he declared. At Labor campaign headquarters a cheer went up among staff and volunteers who were gathered around a bank of TVs to watch the primetime bulletin.

After the longest election campaign in Australian history, this is where it had landed: Turnbull debating on Labor’s turf, denying claims about cuts and plans to privatise Medicare.

How it came to this for Turnbull says a lot about the shortcomings of the Liberal Party’s campaign. It also says a lot about Labor’s strategic success in making Medicare a key election issue. But, more than anything, it is a reminder of just how potent a well-developed-and-executed scare campaign can be in an electoral contest.

Unpopular but effective

Voters regularly report they hate election-time scare campaigns, but campaign professionals keep running them. There is a simple reason for this: scare campaigns work.

When pollsters probe voters on what drives their voting behaviour they find time and again that fear and negative messages are more persuasive than hope and positive messages. Fear trumps hope, so sadly this means that, in most national electoral contests, we see parties playing small-target politics while focusing most of their energy on negative attacks on their opponents.

In most Australian elections negative ads account for the majority of the parties' advertising spend. In 2016, just on 75% of Labor’s total estimated advertising spend was on negative ads.

But this does not mean every scare campaign will be effective. There is an anatomy to a successful scare campaign that is often not understood.

Labor’s “Mediscare” campaign in the 2016 federal election is an example of one such campaign that did bite. An Essential Media poll taken late in the campaign showed 50% of voters thought it likely the Liberal Party would attempt to privatise Medicare if it won the election, 34% said it was unlikely and 17% did not know.

Of those polled, 81% said the privatisation of Medicare, as well as changes to its current form, were cause for concern.

Four reasons ‘Mediscare’ worked

So, why was the Mediscare campaign so effective?

First, it played to an existing belief. Advertising works best when it plays to people’s existing biases or beliefs. Opinion polls regularly report that voters believe Coalition governments are more likely to cut health services or privatise an area of government activity.

Voters, at least, were predisposed to believe such a claim. Labor was pushing against an already opened door.

Turnbull conceded this point in his post-election analysis when he talked about Labor having “fertile ground in which that grotesque lie could be sown”. He was referring specifically to the Abbott government’s cuts to health in the 2014 budget, which undoubtedly helped the Mediscare campaign. But the real point is that the Coalition is always going to be vulnerable to attack on this issue.

The second key ingredient of Mediscare’s success was that Labor had enough evidence to make the claim credible.

Labor advertising pointed to Health Department plans to privatise the Medicare payments system, the Turnbull government’s cuts to Medicare rebates for pathology tests and scans, its increase in the cost of medicine prescriptions, and the A$57 billion in cuts to health in the 2014 budget – complete with quotes from Turnbull supporting the 2014 cuts.

The Canberra press gallery was certainly not convinced about the Mediscare claim and dismissed it almost summarily. But in the court of public opinion this evidence made the claim very believable – as Labor knew it would from the focus group testing it had run.

Third, Labor’s campaign was backed in by a credible third party, the Royal Australian College of General Practitioners, which ran the best TV ads of the campaign on cuts to Medicare rebates.

Health unions also ran a grassroots campaign in marginal seats and among users of the health system.

Fourth, Labor executed the campaign very well. Importantly, the delivery of the Mediscare message was done through multiple channels – not just through traditional broadcast advertising. The Bob Hawke ad on Medicare had close to 400,000 views on Facebook alone.

The Australian Council of Trade Unions (ACTU) handed out a million replica Medicare cards to voters in major metropolitan areas and marginal electorates across the country – particularly in the last three days, after the election advertising blackout.

Labor targeted 1.6 million voters in marginal seats with phone calls and social media engagements about saving Medicare. And activist organisation GetUp! ran a campaign about saving hospitals, which complemented Labor’s campaign, with its volunteers having more than 40,000 phone conversations with voters in marginal seats.

None of these examples relied on mass media, yet they reached a huge audience that would be the envy of most traditional media outlets. What’s more, the interaction with the audience – often a one-to-one conversation – is arguably more powerful than a traditional advertisement, particularly in a media-saturated world.

The Liberal Party’s complicity

The Liberal Party was also complicit in the Mediscare campaign’s success. It let the campaign run for far too long before responding to it.

The claim that the campaign was cooked up in the last two weeks of the election race is a furphy. Anybody who was close to the campaign – Labor, Coalition and Green – knew it was coming. The ACTU launched its campaign in February. Labor’s election-day bunting, warning about the privatisation of Medicare, was printed back in May.

When Labor unleashed the full attack in the second half of the campaign the Liberal Party let it run for well over a week before starting to respond properly.

In previous elections we have seen some outstanding examples of how to rebut a scare campaign. In 2007, the Rudd campaign shut down a Coalition attack on “union control of Australia under Labor” with a pre-prepared ad in which Kevin Rudd lampooned the Liberals’ ad.

In 2010, Tony Abbott killed Labor’s scare campaign about a “WorkChoices comeback” by pre-empting it with the mantra that “WorkChoices is dead, buried and cremated”.

During the Howard era the Liberals would regularly run ads about Medicare being secure under the Coalition so as to inoculate themselves against this well-worn Labor attack. But in this campaign, despite all the warnings, the Coalition was left completely flat-footed.

Internal Liberal Party critics have also demanded to know where the Coalition’s own scare campaign was. According to Abbott’s former chief-of-staff, Peta Credlin, the best antidote to a scare campaign based on a lie is a scare campaign based on a fact. So where, she asked, was the scare campaign about “Electricity Bill” and the impact of his climate-change policies on power bills? Or where was the Coalition’s border protection offensive to hit hard at Labor’s greatest vulnerability in marginal electorates?

The Liberal Party has run some of the most effective political scare campaigns of the modern era. These include:

• Labor will allow communists to take over Australia (1950 – 1972);

• Labor will give unions too much power (1950-ongoing);

• Labor will allow refugees to overrun Australia’s borders (2001-2014);

• Labor plans to introduce a wealth tax (2001); and

• Labor will introduce a great big tax on everything (2010 and 2013).

One thing is certain following the 2016 campaign: the Coalition will not hold back on the scare campaign in the next election. And Labor is likely to be buoyed by the success of Mediscare.

Nicholas will be online for an Author Q&A between 12:15 and 12:45 on Thursday, July 14, 2016. Post any questions you have in the comments below.

Nicholas Reece is a former secretary of the ALP in Victoria and was a senior adviser to Prime Minister Julia Gillard and Victorian premiers Steve Bracks and John Brumby.