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Thus far, there are 12 announced Democratic candidates for the White and rumors of more. At least one GOP candidate, Bill Weld, has thrown his hat into a bid to unseat President Trump and others are “exploring” their options. Their views about healthcare policies will likely determine who will win.

“Medicare for All’ aka M4A is the rallying cry for 9 of the 12 Dem’s: though no two M4A proposals are the same in terms of what’s covered, how they’re funded and the price tag, all promise something better than the status quo. In the GOP, the chorus in unison sings opposition to M4A pitting it as socialism and promises market forces are better suited to address access and affordability.

Barring a fiscal meltdown or global conflict, rhetoric about the health system’s flaws will dominate the 2020 campaign. The New Hampshire primary and Iowa caucuses are 11 months from now but the spin game about U.S. healthcare is already underway.

Collectively, the entire health system will be under increased scrutiny. Independently, each of the nine major sectors will also advance messaging to draw attention to their role, remind voters about their innovations and deflect against antagonist efforts to exploit their vulnerabilities. It’s prime time for healthcare spin.

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Healthcare in the U.S. is a big business. It’s $3.7 trillion—that’s almost $11,000 per capita. It employs 16 million—more than any other industry including 20,800 added last month.

Each sector above plays a unique role in our ecosystem. Each wishes to protect their piece of the healthcare pie. All are sensitive to unflattering spin that diminishes their role or exploits their vulnerabilities.

The public is easily swayed by misinformation. A fact-based understanding of how the health system operates and the roles played by key sectors is low. That breeds susceptibility to negative spin. That means every sector and each organization must double down on messaging to avoid losing the spin game.