Whether their heart has really been in the fight for a public option all along is debatable, but it’s evident now that despite their intentions, the Obama administration has handled the fight for real health care reform—and specifically the public option—poorly. The problem, says George Lakoff, is obvious, and even more deflating because we’ve seen it play out with the Democratic Party over and over again: they got wonky. In other words, they went for the brain when they should have been aiming for the heart.
The values Progressives uphold are all there in the public option: empathy, responsibility, fairness. The problem has been in the messaging. In the framing.
What has been going wrong?
It’s not too late to turn things around, but we must first understand why the administration is getting beat at the moment.
The answer is simple and unfortunate: The president put both the conceptual framing and the messaging for his health care plan in the hands of policy wonks. This led to twin disasters.
The Policy-List Disaster
The whole is greater than the sum of its parts.
Howard Dean was right when he said that you can’t get health care reform without a public alternative to the insurance companies. Institutions matter. The list of what needs reform makes sense under one conceptual umbrella. It is a public alternative that unifies the long list of needed reforms: coverage for the uninsured, cost control, no preconditions, no denial of care, keeping care when you change jobs or get sick, equal treatment for women, exorbitant deductibles, no lifetime caps, and on and on. It’s a long list. But one idea, properly articulated, takes care of the list: An American Plan guarantees affordable care for all Americans. Simple. But not for policy wonks.
The policymakers focus on the list, not the unifying idea. So, Obama’s and Axelrod’s statements last Sunday were just the lists without the unifying institution. And without a powerful institution, the insurance companies will just whittle away at enforcement of any such list, and a future Republican administration will just get rid of the regulators, reassigning them or eliminating their jobs.
Why Do Policymakers Think This Way?
One: The reality of how Congress is lobbied. Legislators are lobbied to be against particular features, depending on their constituencies. Blue Dogs are pressured by the right’s communication system operating in their districts. Congressional leaders have a challenge: Keep the eye of centrists and Blue Dogs on the central idea, despite the pressures of right-wing communications and lobbyists’ contributions.
Two: In classical logic, Leibniz’s Law takes an entity as being just a collection of properties. As if you were no more than eyes, legs, arms, and so on, taken separately. Without a public institution turning a unifying idea into a powerful reality, health care becomes just a collection of reforms to be attacked, undermined and gotten around year after year.
Three: Current budget-making assumptions. Health is actually systematic in character. Health is implicated in just about all aspects of our culture: agriculture, the food industry, advertising, education, business, the distribution of wealth, sports, and so on. Keeping it as a line item - what figure you put down on the following lines - misses the systemic nature of health. The image of Budget Director Peter Orszag running constantly in and out of Sen. Max Baucus’s office shows how the systemic nature of health has been turned into a list of items and costs. Without a sense of the whole, and an institution responsible for it, health will be line-itemed to death.
Obama had the right idea with the “recovery” package. The economy is not just about banking. It is about public works, education, health, energy, and a lot more. It is systemic. The whole is more than the sum of its parts.