Just Frame It: Health care debate as much about words as it is how to pay for full coverage

Written by: Michael Hays on Aug 22, 2007 10:32 AM EDT

Most Americans know our health care system is broken.

The looming fight in the presidential races – and eventually within Congress – is destined to come down to two things: how to pay for a universal, single-payer system, AND, how to defend the merits of such a policy against right wing smear jobs/fear campaigns.

Remember “Hillary Care?” Does the term “socialized medicine” make your ears red and blood pressure rise?

In “Don’t Think of an Elephant!” George Lakoff spells out the conservative mind-set on health care. “It is the responsibility of parents to take care of their children. To the extent that they cannot, they are not living up to their individual responsibility. No one has the responsibility of doing other people’s jobs for them. Thus prenatal care, post-natal care, health care for children, and care for the aged and infirm are matters of individual responsibility. They (health care matters) are not the responsibility of taxpayers.”

Could this be what President Bush really wanted to say to reporters when he recently threatened to veto the expansion of state-funded health insurance for children(S-CHIP)?

The real key to the universal health care debate is convincing undecided Americans that coverage is a right, not a privilege. Aetna thinks it is a privilege. Your insurance underwriter thinks it is a privilege. The conservative Cato Institute, funded by wealthy interests, thinks it is a privilege. Working class Americans do not, especially the 45 million people who don’t have insurance.

Put simply, some services should not be for profit. Public works, the U.S. Post Office, air and

water regulation, disaster relief and mine safety are just a few of the responsibilities assumed by the public sector.

Lakoff lists progressive or liberal principles as including: equality, freedom, opportunity, fairness, two-way communication, community building and trust. Democrats need to use these same values to make the case for universal coverage for all.

The United States spent $1.9 trillion on health care in 2004, according to the federal Agency for Healthcare Research and Quality. But what are we getting in return?

Dennis Kucinich, Democratic candidate in 2004 and 2008, showed his dissatisfaction with the status quo in March 2004 press release. “We’re already paying for universal coverage. We’re just not getting it. We’re pouring a large portion of every health care dollar into the waste of the private insurance companies, their executive salaries and stock options, their lobbying and advertising,” Kucinich stated.

Candidates for president (Democratic-only) have often spoken on the campaign trail about this topic. However, specifics on paying for expanded coverage are often glossed over, or worse, not detailed at all. This is sure to derail even the best rhetoric should it continue.

Sen. Hillary Clinton supports universal coverage on her campaign site but fails to elaborate on either how it would work or how such a system would be funded.

Sen. Barack Obama wants to make quality health care available to every American, along with “affordable premiums, co-pays and deductibles.” Obama’s plan to pony up the cash is slim, other than this tidbit, “Governments at all levels should develop a national and regional strategy for public health that includes funding mechanisms for implementation.”

Sen. John Edwards proposes to make insurance affordable to every American by penalizing businesses that don’t offer coverage, giving Americans greater bargaining leverage with health care companies and offering new tax credits. Again, it lacks a plan to pay for it.

Kucinich is the only candidate proposing a single-payer, universal system aimed at cutting waste and improving care. Those savings are enough to fund coverage for all Americans, he states. The Kucinich plan would establish “Medicare for All - a universal, single-payer, not-for-profit health care system that leaves no American behind,” according to his site.

Leading Democrats are sure to use phrases like “market-based,” “efficient” and “user-friendly” in their stumps about health care. In doing so they play right into the hands of conservatives, using their language to describe something progressives want.

As Lakoff would tell you, words are a tricky thing.

The author is a freelance journalist residing in Lansdale.

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