"Daily Dose": Progressives and Healthcare - finding a winning message

July 18, 2017


The news that Republicans' are failing to repeal the Affordable Care Act without a replacement has been received by Democrats and many progressives as a win. After all, the mission is to prevent Republicans from doing anything, right? This is one case where winning a battle could mean losing the war. Why? Because Democrats are failing to communicate a vision and message for healthcare in the United States that provides a progressive moral vision to counter conservatives. 


There is an insightful article in The Guardian today, "Trump pivots from Obamacare repeal to ordering Republicans to 'Let it Fail'.


The article provides great quotes that give us insights into the moral worldview, or frame, in which lawmakers are functioning in regard to healthcare. In terms of driving public discourse, framing is everything. If we believe that universal healthcare is a moral imperative and the best thing for everyone in this nation, then we must have an effective way to communicate our vision to people from both parties (and no party). As it stands now, we're not there. Both Republican and Democratic lawmakers evoke the same moral worldview on healthcare. And guess what? It's conservative.


Here are the primary ideas in the conservative moral worldview as it relates to healthcare:

1. The Public (government) is evil and immoral because it takes away our personal liberty ("freedom") through taxes and regulations.

2. The more self-reliant and disciplined you are, the more moral and successful you will be/are. Being dependent on others is immoral and makes you weak and a failure.

3. People who are poor deserve their poverty because they are undisciplined and immoral. Their poverty is deserved, painful punishment they must experience to make them disciplined and successful (pull themselves up by their bootstraps).

4. The Market itself is moral. Those who are successful are so because of #2. Those who fail do so because of #3. It is morally wrong for The Public (government) to interfere in the Market - it is the "decider" of who wins and loses (sound familiar?).


It is no accident that in the United States at the moment, healthcare is understood largely in the conservative "market" frame. Conservatives have been working through think tanks and media for decades so their frames and worldview dominate our political discourse and understanding of the world. What's most important is that even if you disagree with them as a progressive, you will find yourself understanding and repeating their metaphors and ideas over and over again - which makes them even more powerful! Even the name "Affordable Care Act" (chosen by Democrats), and the US Supreme Court decision upholding the ACA places healthcare squarely in the conservative "market" frame. Here are quotes from the article showing this in practice (conservative framing in parentheses):


Trump said: “Let Obamacare fail and it will be a lot easier. And I think we’re probably in that position where we’ll let Obamacare fail." (It will fail because of #'s 1 and 2 above. Also, since it imposes government on the market, failure is morally right)


Tom Cotton told the conservative radio host Hugh Hewitt: “I don’t see how any Republican senator who voted just 18 months ago for this very piece of legislation could now flip-flop 18 months on with Obamacare still inflicting so much harm on Americans." (It harms Americans by making them "dependent" on the immoral, overreaching government; intruding on their personal freedom with taxes and regulations, and not letting the market function as the moral decider of who succeeds)


Now, for a Democrat - guess which frame Chuck Schumer from New York evokes:


“The core of this bill is unworkable,” Schumer said, adding that Republicans “should start from scratch and work with Democrats on a bill that lowers premiums, provides long-term stability to the markets and improves our healthcare system”.


Schumer repeats and reinforces the conservative, market frame of healthcare - even evoking the metaphorical idea of providing "long-term stability to the markets." He's cognitively strengthening the idea that healthcare ought to be a market function - a bad idea if you want people to vote for universal healthcare!


Democrats must pursue a strategy that includes a complete re-framing of healthcare (and every other issue but we'll get to those in future blogs). Progressives need to get people out of the conservative moral (and make no mistake, it is moral) worldview of self-interest, moral markets, and overreaching government/tax burdens. 


The path to people perceiving universal healthcare as a moral imperative is empathy - the deeply held belief that we have a responsibility for others' well being just as our own. It's so deeply held that virtually every religion in the world has a version of empathy at its core. For many, we know it as "The Golden Rule" - do unto others as you would want done for you. 


Franklin Delano Roosevelt, in framing his "New Deal" used the story of The Good Samaritan, saying that "your government walks on the same side of the street as The Good Samaritan, while those who oppose our efforts pass by on the other side."


For progressives, the challenge is to stop responding to conservatives in their market frame, and responding with empathy. George Lakoff has repeatedly stated that "you can't be free if you don't have healthcare". And many people understand the basic moral concept that our freedom comes with a responsibility for others' freedom. 


Acting and talking about healthcare needs to begin with acting and talking local - because that's where you have (and can develop) connections with people through empathy. 


For example - start at the family level. Almost everyone has a family member who has faced medical challenges, which presented real threats to their overall well-being and affected their entire family. Relate the idea that people feel a deep sense of moral responsibility to help in those situations. Those are REAL family values - acting with empathy toward others.


Then extend that to friends and neighbors - doesn't that same feeling of empathy and moral responsibility relate to them as well? And most importantly, doesn't that make the community a better place to live? Those are REAL Wisconsin (or wherever you live) values.


You can see where this is going...it extends outwards. Once you have people in their progressive, empathetic frame - unless something triggers a change, they will stay in the progressive frame. You can't think of your own self-interest, or selfishly, if you are thinking through empathy. We can get people to perceive people in general through empathy - and that we are better as a people and nation if we care for each other. After all, those are real American values!


Viewing healthcare through the progressive frame of caring for each other as an American value provides us with a moral foundation for universal healthcare. Just as FDR evoked four progressive freedoms (freedom of speech, of religion, freedom from fear, and from want) that we all have responsibility to provide others; caring for each other's freedom to pursue a prosperous life means that healthcare is necessary for that freedom.


Who can argue against caring for others?


Tomorrow - to impeach or not to impeach? A big question for progressives going into 2018.