No matter how you come down on Medicare For All, it is certainly helpful for voters to think of health care as something they have a right to. If that sounds too strident, consider that this is exactly how all other citizens of modern democracies think about the universal systems they, as voters, have chosen. They’ve chosen them because wherever they’ve been tried it costs less and the outcomes are better. The savings puts money in their pockets.
Democrats have various proposals, from shoring up Obamacare to Medicare for all who want it to Medicare for All. No matter your chosen position, our framing on healthcare needs to change. Conservative strategists have established cost as the dominant frame. This is compounded by the frame they’ve nurtured for decades that taxes are de facto evil (as opposed to being an investment in our nation). The message that embodies the conservative frames; and that the CNN moderators questioning Bernie Sanders in the January debate seemed to have lifted straight from the conservative strategy handbook, is…
“Your campaign proposals would double federal spending over the next decade at an unprecedented level of spending not seen since World War II. How would you keep your plans from bankrupting the country?”
Note that the assumptions implicit in the CNN question are that this is additional spending, that taxes are bad, that our failing healthcare system is not already bankrupting the country and that private industry has had nothing to do with any of it.
Quite a suitcase full of conservative framing that dovetails perfectly with a core conservative strategy of projecting all the country’s ills on the government. In healthcare they also project the devastating failures and exorbitant cost of the current profit based system onto Bernie Sanders, Elizabeth Warren and Democrats in general. (It’s hard to speculate on why CNN repeated the propaganda here -are they simply a victim of expert conservative framing or were they teeing Sanders up for a comprehensive rebuttal to such absurd notions?)
So how do you respond to healthcare questions that, lock, stock and barrel, buy into conservative framing? The normal advice to is avoid your opponent’s frame. That’s hard to do when the conservative frame of cost has been so successful for so long that we don’t even know we’re being played; some of our own candidates have actually adopted the conservative frame of “It will cost too much” and help the conservative strategists out by publicly beating each other over the head with it.
The irony is that cost should have been our frame! Under any of our plans, costs are less and outcomes are better. Conservative strategists know this because cost is their greatest weakness; they never actually lower costs, but instead do everything they can to maintain the current failing system, because it serves their prime directive of concentrating and protecting wealth over the needs of citizens. (In fact you can almost always uncover what conservative strategists believe to be their greatest weakness by looking at what they project onto us.) A useful response could be…
“Thank you for your question about exorbitant health care costs. Our current system has indeed failed and if nothing changes it will bankrupt the nation. My plan covers everyone and the moment it is adopted it puts significant amounts of money back into all our pockets.”
You could be clever, stop talking, and let that just hang for a moment thereby forcing the next obvious question: “How so?”
The student of framing knows that when talking about any of our plans, repeating the conservative frame of “It costs too much” strengthens it, so people will unconsciously adopt the implicit conservative frame that anything other than the current system must cost more. This undercuts our ability to neutralize conservative cost messages or gain traction for any of our plans.
Let’s look deeper for better frames. From a Guardian article:
“Take … the case of a secretary earning $50,000 in wage and currently contributing $15,000 through her employer to an insurance company. With universal health insurance, her wage would rise to $65,000 – her full labor compensation. With an income tax of 6% – which, if applied to a base large enough, would be enough to fund universal health insurance – she would have to pay about $4,000 more in tax. But the net gain would be enormous: $11,000. Instead of taking home $50,000, the secretary would take home $61,000.”
How’d you like to have an extra 11,000 bonus in your pocket? What would that stimulus do for our economy!? The explanatory frame in the Guardian article is important; the money paid by your employer to the health insurance companies is in fact part of your earnings. After all, if your employer dropped your health care coverage (or your pension or 401K contribution, for that matter), would you stay there? Rather than talking about health care as a “benefit” which vaguely implies a gift, talk about exorbitant health care costs as lost earnings taken by insurance companies.
Another strong explanatory frame for us is failure. The current system is failing: it costs more and more as the outcomes slip further behind other countries. Pretty much everyone knows this at some level. Conservative strategists definitely know this and, of course, they project that failure onto existing universal systems, especially in Canada with fear about mythical long waits and doubt about the quality of pharmaceuticals. We need to use the word failure whenever we talk about the current system (indeed about virtually all Republican policies and certainly about the Republican President). Many of us have personal and emotional stories we can tell of the failures of our failing healthcare system.
And here’s a value frame: freedom. Are you free to live your life and be productive and fulfilled if you cannot get the health care you need? Many health care stories from our current failing system involve the loss of freedom in some way. Value frames of fairness, dignity, equity (and others) also apply. Put a spotlight on them in the health care stories you tell.
As you talk with voters, Reframing gives them another way to look at the issue and it lights up value frames around this issue that are powerful and strengthens those same frames on other issues.