Barack Obama entered the national political scene with a dose of soaring oratory at the 2004 Democratic National Convention. In 2008, he made his way across the American heartland with a stump full of fierce rhetoric, culminating in an inaugural address that cemented his position as the most prominent and effective rhetorician of our time.
In his Inaugural, Obama also showed how he planned to cut across old political concepts to drive his policy agenda. There he declared:
“The question we ask today is not whether our government is too big or too small, but whether it works, whether it helps families find jobs at a decent wage, care they can afford, a retirement that is dignified. Where the answer is yes, we intend to move forward. Where the answer is no, programs will end.”
Now, during the first defining battle of his presidency, this political formula has been used to powerfully frame the debate on health care — perhaps making government-run health care inevitable.
His master stroke has been to position government health care as a part of the competitive marketplace, a service that the government can provide at a lower cost to improve the overall quality of available care. (His most recent weekly address sounds not unlike the car insurance ads that claim to give you competitors’ quotes as well as their own… “15 senators could save you 15 billion on health care costs…”)
Which, of course, is exactly the argument of free marketers: that the government can undercut private industry, because it’s well . . . the government. It prints money. But Obama has neatly usurped their arguments and left them playing defense for private insurers. The last bastion of defense for the free market folks has been a mostly ineffective complaint about ‘unfair’ competition for private insurers.
Most people, however, already feel like they’re treated a little unfairly by private health insurance, what with eyeball popping monthly payments and those bankruptcy-inducing deductibles (and that’s just the people able to get coverage).
By insisting that his health care reform will be about competition, rather than just a crusade to cover more people, Obama also undercuts the tedious arguments about government waste and socialized care. Americans were scared off of HillaryCare and other government health care proposals in the past because of threats about rationed care and long lines at the doctor’s office, a threat made with a hint of national chauvinism and not a little cynicism, considering the state of health care in America today.
But, by positioning reformers as on the side of competition, Obama positions reform as a harbinger of efficiency and speed, rather than just government care. His position also focuses the public debate on the growing problems with our current health care system, making its current inefficiencies and failures the core question, rather than the need for change at all.
All of this seems to suggest that Obama has paid heed to people like George Lakoff and other left-messaging strategists that struggled to bring progressive policies out of the political wilderness over the past few decades. Lakoff’s theories in particular have gained traction with the progressive left, and his fingerprints can be found on Obama’s rhetoric today. Lakoff envisions meaning as a process of word association, where the impact of a certain phrase is composed of the other images it invokes, rather than any specific denotative definition.
Obama’s rebranding of health care reform undermines Republicans’ arguments because it plays the word association game so well. He has knocked defenders of private health care off balance by making them defend what scares people most about government health care — inefficiency, a lack of options and waste.
And that’s the real upshot. Obama’s reframing of health care has set the snowball rolling for reform over the long term. He might not win this battle — but it will not be his Waterloo. The real meaning of this fight will be seen years down the road, as supporters of an exploitive, inefficient and dangerous health care system dwindle, and voices for reform take center stage.
Chris Duncan, a political organizer, analyst and communications specialist living in New York City, is a weekly contributor to the D.C. Writeup. He blogs at NY Bullshit.
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July 25th, 2009 at 1:26 pm
The House leaders reached a deal on Medicare payments: A “Pay for Value” reimbursement system that rewards doctors and hospitals that achieve the best outcomes at the lowest cost.
As a result, The House gained a lot of votes, a lot of people who were withholding support.
The federal Medicare program insures some 44 million elderly and disabled Americans at an annual cost of $450 billion, almost one-fifth of total U.S. health care spending.
Supporters of the agreement say it could save the Medicare System more than $100 billion a year and improve care, that means $1trillian over a decade. (Please visit http://www.kare11.com/news/news_article.aspx?storyid=820455&catid=391 for detailed infos)
The Times in a July 7 editorial argued “As much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients,” Thus the remaining $239 billion over a decade does not matter.
No one can disagree with this best outcome / evidence-based system, and private insurance, too, will be greatly influenced by this change with the focus on value over volume. !
THANK YOU !
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