Get real! (by proper framing)
The Way I see It: The author makes a case for a shift to a consumer-driven system.
By Jordan L. Geller, MD
Medical Economics
December 15, 2006
There’s another problem with calling healthcare a right. It imposes an obligation on the government to fulfill that right—something our government is neither economically nor functionally equipped to do. In contrast, the Bush administration reform plan would shift at least part of the healthcare burden from employers and government back to the consumer. By coupling a high-deductible policy with a tax-free health savings account, policy makers believe that Americans will become more efficient and discerning consumers of healthcare.
The devil is in the details, of course. Still, if the current plan accomplishes anything, it will almost certainly raise anew the question of health and individual responsibility. This is crucial for progress in the area of healthcare reform, since, to date, the bad effects on health of certain lifestyle choices—poor diet, overeating, smoking—have done little to alter peoples’ behavior. If, on the other hand, consumers were forced to shoulder more of the financial burden of their lifestyle choices, finally, perhaps, they’d be motivated to pursue healthier choices.
Comments from our readers:
dmccanne / San Juan Capistrano, CA
Posted Dec 15 2006
The wealthiest nation of all is not financially equipped to do what all other industrialized nations have - insuring everyone? And the fear of spending money from a health savings account is a greater incentive to quit smoking than the fear of cancer, heart disease or emphysema? Get real! We each have a personal responsibility to take care of ourselves, but we also have an egalitarian responsibility to our fellow Americans to see that financial hardship does not compound the misfortune of illness or injury.
http://www.memag.com/memag/article/articleDetail.jsp?id=390156
And…
Building on the Progressive Victory
By George Lakoff
Rockridge Institute
December 15, 2006
What is a progressive worldview? It’s simple: You have empathy for others, and you act responsibly on that empathy, being both responsible for yourself and socially responsible as well. Progressives say, “We’re all in this together” while conservatives say,” You’re on your own.” It was running on those progressive values that won the election for the Democrats.
Progressive values-based reframing has begun to work, because it has been paired with authenticity (saying what you believe) and with framing that highlights the very real traumas affecting the nation.
The role of the progressive activists, grassroots, and netroots is to promote progressive values to biconceptuals both within and outside the Democratic party — to activate the progressive beliefs they already have and to extend them further by speaking a progressive language and using progressive values, ideas, and arguments. The goal is not just to move the Democrats in a more progressive direction, but to move Republicans and independents in that direction as well. The idea is to benefit the nation, not just the party.
And conservative values and practices, when they lead to people getting hurt and our democracy undermined, have to be attacked overtly.
This election marked a progressive victory and a victory for progressive efforts at factually accurate, values-based framing.
http://www.rockridgeinstitute.org/research/lakoff/building-on-the-progressive-victory
Comment:
By Don McCanne, MD
Berkeley linguistics professor George Lakoff has taught us much about framing. In the example from Medical Economics, I have applied some of his concepts:
1) Do not let the opponents frame the debate.
2) Establish your own framing that accurately communicates the principles you wish to express.
3) Be meticulous in maintaining the credibility of your framing.
4) When the opponents’ framing is not credible, do not hesitate to briefly expose their lack of credibility for the purpose of destroying their frame.
In the example, Dr. Geller has linked together, in a single frame, dismissing the role of government in health financing and relying on individual responsibility. Without entering his framing of rights and responsibilities, we have destroyed his credibility by exposing his fallacies - that the United States is not “economically equipped” for the task, and that personally assuming the financial burden of health care incredibly improves health, when all of the data is to the contrary.
Our framing much more credibly establishes two separate frames - one for personal responsibility, and the other for egalitarian responsibility.
Although Professor Lakoff’s message has been a call for progressives to catch up with the conservatives on framing, it is also a nonpartisan message. Let’s establish a highly credible frame for the health care reform debate within which we can all communicate. And let’s overtly attack those who would undermine the process.
For more on George Lakoff and the Rockridge Institute:
http://www.rockridgeinstitute.org/people/lakoff