Guest: Rhetoric and reality in the health-care debate


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“Rhetoric must lead us through the Scramble, the Wrangle of the Market Place, the flurries and flare-ups of the Human Barnyard …” When Kenneth Burke wrote those words after World War II, he undoubtedly was thinking about left-wing communism engaging right-wing fascism. But he’d likely have supported the assessment that the 2009 health-care debates be characterized with the same metaphors. We need some good rhetoric.

The citizen (or legislator) trying to arrive at a reasonable decision faces three almost insurmountable barriers to rational judgment thanks to scrambling rhetoric.

One barrier is arithmetic obfuscation. Who has the time and resources to estimate the number of citizens covered by various plans, the 10-year cost projections to taxpayers and insurees, and the ratio between governmental money spent and savings recouped? Any proposed new system of public/private resources for health care requires a calculus that hurts our heads. Our eyes glaze over, our minds are numbed — we believe no one.

A second set of barriers defuses central issues. One recent deflector is whether private insurers can pay for abortions under the Stupak Amendment. All year we’ve listened to comparative judgments about which countries with “socialized” medicine are floundering, as though we’re pursuing wholly centralized health care. And then there are statements such as “You can’t keep your own doctor,” “Conservatives want to destroy the Democratic majority,” and recitations of fraudulent claims from greedy doctors and uncontrolled costs for medical technology and drugs. Fine issues, yes, but much better handled in single-topic, not omnibus, bills. Here, they’re diversionary rhetoric.

And the third barrier, red-hot rhetorical language. Rep. Virginia Foxx, R-N.C., told us that “Obamacare” would kill seniors. Now, MSNBC and Fox News talk shows trumpet a “government takeover of health care” by “bureaucrats;” “denial of treatment” (by insurance companies for some, by governmental agencies for others); and “waste, fraud, and abuse.” Bleeding hearts and angry populists ramp up the debate daily from legislative chambers, cable news, blogs, and online/TV ads.
Big advertisers include the AFL-CIO and AFSCME, Moveon.org, the Campaign for Responsible Health Reform (run by the U.S. Chamber of Commerce), AARP, the 60 Plus Association (a group countering AARP), America’s Health Insurance Plans, the conservative Family Research Council, Americans for Stable Quality Care (a medical association coalition supporting reform), and Conservatives for Patients’ Rights. By mid-fall, such groups together were spending $1.1 million a day on turbocharged, scorched-earth appeals to pity, fear, anger, altruism, and self-centeredness.

What’s a citizen to do? Read the Senate and House bills? Good luck. Follow trusted advocacy groups? Maybe. Stomp your foot? Nope, it’s a dirty barnyard. To escape the bad rhetoric and encounter good, reasoned arguments, you’re just going to have to read — columnists you believe, neutral websites such as ProCon.org — and watch the best of the balanced TV coverage, such as NewsHour With Jim Lehrer. Then e-mail your senator and representative. It won’t get read, but it will be counted, a citizen vote. Cross your fingers in hope that today’s “Wrangle of the Marketplace” will actually improve your health.

It couldn’t be done during President Clinton’s first term. Maybe this time a collective commitment to the well-being of all citizens will generate a positive rhetoric of health-care reform.

Bruce Gronbeck is a UI professor emeritus of communication studies and an expert in political communication.

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