Five ways to talk more accurately (and persuasively) about health care reform

Health care reform is going to happen in the coming months – in one form or another. It will be a messy process and an imperfect final product, but it's going to happen. There's simply too much riding on the issue and too many good and smart people working too hard for it not to happen. Notwithstanding the rants of big insurance companies and their unwitting (or maybe "half-witting") allies in the world of right-wing ideologues and conspiracy kooks, the stars are simply too well aligned.

Still, there remains a lot that committed people of good will can and must do to help the process along and to improve the final result. Much of it, of course, has to do with calling and writing our elected officials, showing up at events, emailing friends, writing letters to the editor and all of the other activities normally associated with basic political activism. These are important things that people should certainly continue to do.

Another major contribution that reform supporters can and ought to offer, however, has less to do with what they do and more with how they communicate about the issue.

The "PolicySpeak" problem

One of the main reasons that the process has been so difficult thus far has to do with the fact that reform supporters have done a generally lousy job of explaining the need for (and the contents of) the reform package. Too often, we've lapsed into a kind of defensive "wonk talk" in which we spend our time attempting to explain and debate intricate issues and/or rebutting the lies of the opponents – many of whom will do and say anything. Though logical and persuasive to policy wonks, these kinds of explanations come off as gibberish to a large segment of the population.

Linguist and political analyst George Lakoff made much the same point yesterday in an online essay attacking what he calls "PolicySpeak" and Policy Watch contributor Andrea Verykoukis expanded on Lakoff's comments as well. Though Lakoff overstates the case – things are not as bad as he portrays them – he makes some very valuable points. Here's a central one:

"PolicySpeak is the principle that: If you just tell people the policy facts, they will reason to the right conclusion and support the policy wholeheartedly.

To many liberals, PolicySpeak sounds like the high road: a rational, public discussion in the best tradition of liberal democracy. Convince the populace rationally on the objective policy merits. Give the facts and figures. Assume self-interest as the motivator of rational choice. Convince people by the logic of the policymakers that the policy is in their interest.

But to a cognitive scientist or neuroscientist, this sounds nuts. The view of human reason and language behind PolicySpeak is just false. Certainly reason should be used. It's just that you should use real reason, the way people really think. Certainly the truth should be told. It's just that it should be told so it makes sense to people, resonates with them, and inspires them to act."

And here's part of Verykoukis' insightful following up:

"Everyone knows the wheels are off the health care-mobile, we've all fought with insurers, or worried about family members who need expensive drugs, or thought twice about using insurance while getting our kids/selves/cats some therapy. Everybody knows. But the reform effort was easily hijacked by the anti-government right who demonized a public option with their shopworn stock phrases. The administration wasn't ready, though it should have been, and let the whole debate run away without us. It's time to take back the night, people, and Lakoff's the one to show us how.

The biggest thing he points out is that the president came out with a list, rather than a unifying idea. Never underestimate the power of the unifying idea."

Five unifying ideas

So, in the spirit advanced by Lakoff and Verykoukis, here are five simple ideas that supporters of reform may wish to use in the weeks ahead as they think about, discuss and work to influence the health care debate:

#1 – The objective of reform is simple: It's to provide every American with a guaranteed, affordable choice in health care. Lakoff suggests it should be dubbed "The American Plan" and it's a good idea because it's actually an extremely patriotic concept. If Americans can band together to win a war, to put a human on the moon, or to combat and overcome international terrorism, they can certainly come together to construct a health care system that guarantees every American access to an affordable doctor of their choice.

#2 – The current, private insurance-based system is a disaster. Every day, millions of people are being harmed and getting ripped off by a system that rations care, denies care and puts profits ahead of people's lives. This is true for the one-in-six Americans without health coverage, for those who are denied coverage because of so-called "pre-existing conditions" and for just about everyone else who, at one time or another, finds themselves battling with an insurance company bureaucracy over a bill. To top things off, our country spends far more per person on the whole mess than any other country in the world. Clearly, we can and must do better. 

#3 – We are in the midst of a national emergency. Think about it: millions of Americans are living shorter, less healthy lives because they cannot afford to see a doctor. Millions more live in fear that they could join those ranks at any time. To make matters worse, the current system is so wildly inefficient and illogical that it is bankrupting the country. Americans literally cannot afford to keep paying the kinds "private taxes" that they currently pay to the insurance, drug and health care conglomerates.

#4 – Giant insurance and pharmaceutical companies should work for us. We should not work for them. In the current system, the real power to decide what kind of health care Americans receive resides with giant insurance and pharmaceutical company bureaucrats. That's why even those Americans who have health care coverage must constantly worry about their policies being "cancelled" and absurd, industry-created concepts like so-called "pre-existing conditions." We need a system of doctor-patient care that puts that power back in the hands of consumers and their physicians. There's nothing magical or written in stone about the current system. The size and power of the insurance and pharmaceutical companies is a recent aberration. They should be tools that we use to help make quality health care readily available – not the focal point around which everything in the system revolves.

#5 – America is falling behind. Most of the rest of the nations of the industrialized world are way ahead of the U.S. in assuring that their citizens are guaranteed access to affordable, quality doctor-patient care and that insurance and drug companies know their proper roles. Their people are generally healthier, happier with their care and pay less than Americans. America's economy will continue to fall further and further behind much of the rest of the world until we grab this bull by the horns. We cannot simply allow the current crisis to continue to fester unattended.

Setting the record straight

As the push for health care reform begins to head into the home stretch in the coming weeks, vested interests and their allies on the fringe will continue to lob stink bombs at the reform movement in an effort to hijack the debate. They will manufacture all kinds of wild accusations and red herrings in an effort to redirect the discussion.

This is a trap that reform supporters should avoid. At this crucial moment in American history, America needs less "PolicySpeak" that attempts to address the tortured and manufactured arguments of opponents and more simple, straightforward reminders of the need for a "can do," all-American solution to the crisis we confront.