The Collapse of ObamaCare is Rooted in Unclear Communication

Maui Time | September 8, 2009
A poll says that 67 percent of Americans don't understand Obama's healthcare plan. I'm one of them.

It's not because I don't pay attention. I'm a news junkie. Could it be that I'm an idiot? If my insurer offered psychiatric coverage I could afford to find out.

I'm pretty sure, though, that my friends are smart. I asked my publisher, who runs the oldest publisher of graphic novels in the U.S., whether he understood what Obama's "public option" was. He didn't. I asked a teacher, who earned a masters from an Ivy League school. She didn't either. I asked a bunch of political cartoonists. Neither did they.

Obama's attempt to reform healthcare is all but dead; his polls are dropping. How did Obama turn lemonade into battery acid? Obama PR flack David Alexrod tries to explain that "to make choices is to make some unhappy." GOP strategist Charles Black counters that the president's popularity and "good will" doesn't equate to support for "liberal policies."

I think they're both wrong. The collapse of ObamaCare is rooted in the problem described by the cognitive linguist George Lakoff: liberals do a crappy job of communicating to the public.

Speaking of which: what is/was this mysterious "public option"?

On the left, The Nation magazine says it's "designed around not making people change their healthcare if they like what they have." OK, so that's what it's not. What is it? "Instead, there will be rules that insurance companies have to follow to provide better care, and a health insurance exchange, including a public option, for people who don't have employer-provided care."

A public option is a public option is a public option. How helpful.

I rely on words to make a living. I've published 14 books. Some have even sold well. "Health insurance exchange"? WTF?

You know what I think? I think this is like that fairy tale about the emperor's new clothes. I think The Nation doesn't know what the "public option" is any more than the rest of us. They're just afraid to admit it.

On the right, The National Review says it's "a government-run insurance plan that will compete with private insurers." Compete how?

For a guy reputed to have a way with words, Obama isn't adding any clarity.

Since the left is talking gibberish, let's go with the conservative definition of Obama's "public option." According to the right, Obama wants to create a U.S. government-run insurance company -- call it GuvCare -- that competes against private insurers in the open marketplace. Again, I may be a moron. But common sense tells me that this GuvCare only makes sense, and will only ease the crisis of out-of-control healthcare costs, if it offers cheaper coverage than private companies. If that's the case, everyone will switch to GuvCare. Goodbye, Aetna. Ciao, HIP. Right?

Wrong, says the president. "Why would it drive insurance out of business?" Obama asked in May. "If private insurers say the marketplace provides the best quality health care, why is it the government, which they say can't run anything, suddenly is going to run them out of business? That's not logical."

Because, um, GuvCare would be cheaper? And if it's not cheaper, what's the point?

I don't think Obama knows what the "public option" is either. Either that, or he's lying. And he wants us to know he's lying.

Pretty dumb.

Lakoff believes the difference between the way liberals and conservatives communicate goes back to how they equate government to the family. Conservatives see the state as a "strict father" -- tough love, bear the consequences of your decisions -- whereas liberals prefer the "nurturant parent model" -- non-judgmental parents who help their kids out of a jam.

I think that's half the picture.

The GOP is effective despite its inherent demographic disadvantages, such as the fact that there are more Democrats than Republicans. This is because conservatives know how to use complicated terms in order to obfuscate and simplistic ones to promote memes.

Consider the words and phrases used by the right to attack healthcare reform. "Death panels." "Rationing care." "Nazi." "Communist." "Socialist." Sure, they're false and nonsensical. (Nazism and Communism are diametrically opposed ideologies.) But those tag lines simple. There's no confusion. Everyone knows what they mean -- or thinks they do.

Republicans deploy stripped-down phraseology to make unpopular concepts seem palatable: "Peacekeeper missile." "Shock and awe." "USA-Patriot Act." Go ahead, read my mail. Just don't call me unpatriotic!

Right-wingers use complicated terms in order to confuse. Torture becomes "enhanced interrogation techniques." Killing civilians is "collateral damage."

Democrats, on the other hand, use Republican rhetorical techniques against themselves.

It's truly baffling. Consider American liberals' preferred solution for healthcare: "single payer." It's been around for years. But what the hell is it?

"Single payer" sounds to me like "I have to pay." Which sucks. I already do that! But "single payer" actually refers to funding source -- the government. But "single payer" is not socialized medicine, in which doctors become federal employees. Get it? Me neither.

Why not call it something simple, like "free healthcare"? Yeah, yeah, we'd pay through our taxes -- but people understand "free." Free is easy. Free makes sense.

Alas, Democrats seem to be running a contest to be as confusing as possible. Now that the "public option" is dead (which is probably OK, given that it was non-existent), Democrats are pushing for something called a "healthcare trigger."


Dems say the "trigger" isn't a death panel. Instead, private insurance companies would have to make their services cheaper within a certain number of years (say, five). If costs stayed high, the U.S. government would then create a...public option. (Unless Congress, feeding at the trough of insurance company lobbyist money, was persuaded to amend the law between now and then.)

"This is the best shot we've got for getting a public option," a House Democratic adviser told UPI. "It's better than nothing."

Actually, it's exactly the same as nothing. Except that nothing sounds better.

I understand "nothing."

Ted Rall, President of the Association of American Editorial Cartoonists, is author of the books "To Afghanistan and Back" and "Silk Road to Ruin."

Maui Time

Maui Time Weekly provides insightful analysis and in depth reporting. We believe some issues are so important they require thoughtful consideration. We are not a “paper of record”—a daily journal of government meetings, ribbon-cuttings and corporate announcements. We decide what’s...
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