Health Care Reform and the Word Game

In politics as in Scrabble, whoever controls the language controls the game. The most powerful words and phrases in the health care reform debate right now are coming from those opposed to reform: “rationing,” “death panels,” “kill granny,” “big government,” “government takeover,” “socialism,” “socialized medicine.”

Fear words like these are related to a common human phenomenon psychologists call “loss aversion.” Human beings tend to worry about changes. No matter how bad things may be, no matter how inadequate our present condition, there's always a chance it could be worse. Change may mean loss.

People who have health insurance, even expensive, inadequate health insurance, are worried that they might lose it or the medical care itself. This fear is most visceral with the “death panels” and “kill granny” phrases. I hope the claims behind these phrases have been thoroughly debunked in recent weeks, and I hope that people are beginning to realize that we already have rationing by insurance companies. It’s the last four terms--“big government,” “government takeover,” “socialism,” and “socialized medicine”-- that seem to have the most staying power, turning up again and again over the decades.

All four phrases reflect a divide in political philosophy in the United States about the role government should play in our lives. However, powerful as they are, none of these phrases is being applied accurately to the health care reform debate.

 “Socialized medicine”  is a system where the hospitals, pharmaceutical manufacture, and equipment manufacture are owned and operated by the government and where providers such as doctors are employed by the government. The U.K. has some of these features. Veteran’s health care has some of these features.

“Socialism” is a system of governance in which everything is owned and operated by the government and everyone is an employee of the government—hardly descriptive of our capitalist system.

A “government takeover” of medicine would mean that “socialized medicine” would be put in place. That is absolutely not under discussion under any plan before Congress or the President. Nor is it being considered even by the most radical liberals in Congress.

“Big government” is perhaps the phrase with the most credibility in this discussion.  Yet all it means is that whoever is using the term thinks government should not be regulating or funding whatever area of our lives is under consideration. Do we ever hear the term "big government" in connection with huge farm subsidies to corporate farmers? In connection with defense spending? In connection with regulating people's private lives? Curious, isn't it? Is it only "big government" when social programs are involved?

Repeated often enough and with enough volume, these phrases can be highly effective in prompting the fear of change.

Is there anything in any of the bills that remotely resembles “socialized medicine”? The short answer is no.

Some members of Congress would like a “single payer system.” That is not socialized medicine. The government would not own the hospitals or the drug companies or employ the doctors. It would simply be the insurer, as it is now in Medicare.

“Single payer” is not on the table. A “public option” is. This would make the government one among many insurers. If you don’t like your current insurer’s offering, you could choose the government as your insurer. If you don’t have an insurer, you still have the government’s plan. That’s in no way “socialized medicine” or a “government takeover.”

Whether it’s “Big Government” to set things up so that health care costs are contained and people are able to afford the care they need is a matter of perspective.



 ============



Cartoon for the day