Five tips on how to change the language of the healthcare debate

by phil on Thursday Jun 25, 2009 8:16 PM
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I've been listening to conservative talk radio and FOX News for months now, cringing as they smear Obama's healthcare plans. Since then, I've been blogging over at Loaded Terms, coming up with various ways that we can win the war of rhetoric. I've now summarized these ideas into a short memo that will help us change the terms of the debate.

Five years ago, I was inspired by George Lakoff's Don't Think of an Elephant, which offers suggestions to progressives on how better to frame political debates. Immediately it is clear that he uses his own advice as he refers to his audience as progressive instead of the smear-word liberal. The book was a cult hit when it came out, but unfortunately the advice was too late for John Kerry's election.

Right now, the conservatives are winning the war of words on healthcare, but we can turn the tide. Here are five message control suggestions for healthcare reformers:

1. When they mention socialist medicine, you mention unregulated, profit-driven, fragmented, capitalist medicine

When the opposition mentions socialist medicine, almost every time it kills the conversation. But it doesn't have to play out that way. Just as socialism evokes Stalin, Mao, and Che, why can't you evoke the robber-barons of the early 20th and late 19th centuries? Just as Americans are suspicious of socialist icons overseas, they're also suspicious of capitalist pigs at home, from Enron-types to Big Oil and Big Pharma.

The opposition is getting away with being the underdog party that will say "No" to socialist medicine. So it's our duty to reveal what they're implicitly for, which is essentially profit-driven, capitalist medicine. Ask the rhetorical question, "Why should providing health insurance be a profit-driven enterprise?" "Would you want to face an insurance company that has all the money and incentives in the world to deny your claims?"

2. Stop using the word public

When the opposition talks about privatized healthcare, they're subtly playing on Americans' fears about privacy invasion. When they talk about public healthcare, they're invoking Americans' fears of public services, like the DMV or welfare. Instead, try to appeal to patriotism using terms like National health insurance.

3. Stop referring to Europe and Canada

70% of Americans do not have passports. So in the average American's mind, the grass isn't greener on the other side, precisely because they've never seen it. The European label was political death for John Kerry in his failed 2004 bid for president. Likewise, Michael Moore didn't endear anybody by showing how Cuba's healthcare is so much better.

If you have to mention a comparative system, maybe mention Australia, a country that the cowboy types of America can identify with. And say something along the lines of this:

Health care doesn't have to be exclusively socialist or "capitalist". The Australian system is a good example. Everyone is provided with free public health care and about 40-50% also have private health insurance. You have the benefit of efficient, effective "capitalist" healthcare, and the safety net of the public system if something like what you described were to happen.
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4. Instead of focusing on healthcare reform, start talk about insurance reform

The opposition has been playing on many Americans' fears that Obama is just causing too much change too much fast. The opposition talks about healthcare reform in terms that have nothing to do with Obama's proposal. It's almost a fact in conservative talk that Obama wants to put doctors on government payroll or that Obama wants to run the healthcare industry like he's "running" GM.

Also, the fact is most Americans are happy with their healthcare. That is probably the number one hurdle in changing the hearts and minds of Americans on this issue. It's the Lake Wobegon effect, where the average American believes their healthcare is above-average.

However, by referring to what Obama's reform plan is mostly about—insurance reform—you can localize the scope of the change. I think ordinary people have an intuitive sense that the insurance industry as a whole is corrupt and needs reform.

5. Instead of universal healthcare, talk about comprehensive healthcare

You have to tip-toe around people's fear of health welfare. Expanded coverage is something people agree with publicly, but in private, they would rather save their tax dollars.

By mentioning comprehensive healthcare, you invoke ideas of better health quality for individuals, which is actually very much a part of this. Small business owners, for example, who have been providing limited or no health insurance to their employees, have been clamoring for precisely this kind of reform.

Plus, you also remind people that perhaps their coverage may be limited. How many of you, when choosing your health insurance plan, had to make compromises and trade-offs? With national, comprehensive health insurance you won't have to do that. Rather you get more freedom and choices. What can be more American than that?

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