As Washington debates what to do about health care, each side has put forth its favorite terms like ration, public-option, and government takeover to frame the discussion. Frank Luntz, author and Republican wordsmith, put out a memo called "The Language of Healthcare 2009." He says his ten rules will help Republicans stop the "Washington takeover" of health care.
MIKE PESCA: From WNYC in New York, this is NPR's On the Media. Bob Garfield and Brooke Gladstone are both away this week. I'm Mike Pesca. When it comes to the words deployed in the health care debate, it seems like the wordsmiths live by the oath, first do some harm. Every phrase must be tinged with subtext. There were the obvious ones. The Republicans tell us Democrats want to “ration” your health care. You'll experience “long lines.” The Democrats never speak of “universal” health care any more, too otherworldly, perhaps. Then there’s the phrase “public option” as a way of saying “government-funded health care.” It seems to me that the phrase “public option” can be applied to any government program that might run into opposition. “Public option” is a term of art, and it’s a little subtle. This ad put forth by the RNC, less so. Over images of babies and children, we hear these words. [MUSIC UP AND UNDER]
ANNOUNCER: The next big ticket item, a risky experiment with our health care.
MIKE PESCA: Those words were actually a little off script. Yes, there is a script. It was authored by Frank Luntz, who recently put out a ten-point memo telling Republicans how to talk about health care. He writes, quote, “You'll notice we recommend the phrase ‘government takeover’ rather than ‘government-run’ or ‘government-controlled’.” Yes, we have noticed that, in TV ads.
ANNOUNCER: With our health care system in crisis, some want a government takeover.
MIKE PESCA: And on cable TV.
MALE CORRESPONDENT: His goal seems to be a government takeover, not making insurance more available.
MIKE PESCA: And, on the floor of Congress.
CONGRESSMAN: The administration and a small group of very liberal Democrats are intent on pushing through a government takeover of health care.
MIKE PESCA: So Frank Luntz, what’s so potent about the phrase “government takeover?”
FRANK LUNTZ: The phrase “government takeover” is much more powerful than “government control.” Government control is something that we've dealt with, with Medicare, Social Security. Government takeover is a much more frightening word to describe what some in Washington want to do.
MIKE PESCA: Is it accurate?
FRANK LUNTZ: Well, it depends on what happens with this government option or public option. There’s a great example. It is a government option. It will be funded by the government. But those who want significant health care reform realize that a government option isn't popular, so they call it a public option.
MIKE PESCA: Well, let's talk about – maybe the big question is are we in a crisis. How do you advise the opponents of the health care proposals to talk about the state of things as or as not being a crisis?
FRANK LUNTZ: Very simple. It is far better for you to focus on the changes that you propose to make, than it is to argue over whether or not we're in a health care crisis. And I've said this to those who don't support the administration’s position. If you refuse to acknowledge the legitimate fear and concern, if you ignore the millions of people who are uninsured, you'll get voted out of office because the American people have decided that some sort of health care reform needs to pass.
MIKE PESCA: This brings to mind when President Bush won reelection and he wanted to reform Social Security, and there was a debate then if Social Security was a crisis. And it turns out the Democrats won that debate. President Bush wasn't able to push through his reforms. Why are you not taking that lesson, that you could dispute if this is even a crisis?
FRANK LUNTZ: Because I've spent a lot of time with the American people over the last six months and I've listened to them, and they really do believe that the health care system, while effective for most Americans, are still leaving some behind, and they want it addressed.
MIKE PESCA: And so, people’s opinions on the ground are dictating which phrases to use. You can deny that Social Security is a crisis ‘cause people didn’t feel like it was a crisis. A different set of facts with health care.
FRANK LUNTZ: It is a different set of perceptions with health care. One of the problems that I have is that those who get their information from sources like FOX News have a completely different perception and have a different set of facts than those who get their information from MSNBC. And what we have now that we did not have back when health care was debated in the early 1990s is a shared set of facts, and so that listeners can quite possibly reject everything that I say because their sources are completely different. It’s a real problem, and it actually encourages much more extreme language as people try to play to their base.
MIKE PESCA: There’s one phrase that your side of the debate uses. It’s when you talk about government bureaucrats standing between you and your doctor. Anytime I talk to a regular person or a family member and I ask them about what about government bureaucrats standing between you and your doctor, they always laugh and they say, well, the current situation right now is the HMO bureaucrat [LAUGHING] standing in the way between me and my doctor. I mean, you leave yourself that opening so blatantly, I wonder if harping on the government bureaucrat works in your advantage. Why do you think it does?
FRANK LUNTZ: Oh, it’s, it’s a simple answer. You ask the questions you just did: Do you resent the fact that HMO bureaucrats get between you and your doctor? The answer for you and millions of Americans, is yes. Then the follow-up is, well, then do you want to add yet another layer of bureaucracy, this one not from your HMO, this one right from Washington, D.C.? So now you have two people that can tell you no. That’s where it becomes effective.
MIKE PESCA: In your ten rules for stopping the Washington takeover of health care, there’s a lot of discussion about avoiding using economic terms, like “free markets,” “tax incentives,” terms that are near and dear to the hearts of many Republicans, but you say they don't work that well in this debate. Why not?
FRANK LUNTZ: They don't work well at all because the American people don't trust corporations. And one of the things that they dislike the most about the current system is that they see it as being too profit driven. So if you employ the economic argument, it just reminds people that there is profit in this system, and there are a lot of people who resent that.
MIKE PESCA: I would imagine that many people who are in Congress right now, many Republicans ran, and if you ask them what are their core values, things like free markets and competition would rank right up there. So when you tell them, stop mentioning free markets and competition, is that really hard for some of them to do?
FRANK LUNTZ: Well, it’s not a matter of changing their principles, because what they support still maintains an individual-focused system rather than a collective system. But it is a different tone and a different way to communicate it. Just as the Democrats now, who are so used to talking about socialized medicine, you've noticed that you never hear that terminology, that you don't hear “universal care” any more, either. Those two terms the Democrats have dropped because they realized how unpopular it was.
MIKE PESCA: Frank, I want to thank you for joining me today.
FRANK LUNTZ: It’s always a pleasure. I'm glad to do this.
MIKE PESCA: Frank Luntz is a Republican consultant and author of Words that Work: It’s Not What You Say, It’s What People Hear.