At the first of two Democratic debates (6/26/19), MSNBC host and moderator Lester Holt asked the presidential hopefuls, “Who here would abolish their private health insurance in favor of a government-run plan?” He asked the same question the next night (6/27/19), and prefaced another question to Sen. Bernie Sanders: “You basically want to scrap the private health insurance system as we know it and replace it with a government-run plan.”–
At a glance, this seems entirely unremarkable. The terms “private health insurance” and “government-run plan” are everywhere in US media.
The question at the first debate, however, was asked just a day after a new report came out from the National Economic and Social Rights Initiative (NESRI). The report, “Parroting the Right: How the Media, Pollsters Adoption of Insurance Industry Spin Warps Democracy,” demonstrates how power brokers in the for-profit health industry have worked to make this exact language (“government-run healthcare”) the boilerplate description for a national health system in major media outlets.
“In framing a national health system as ‘government-run,’ the press is helping the insurance industry systematically frame the debate in their own interests,” lead author Ben Palmquist told FAIR.
As shown by this Google Books n-gram, the phrase “government-run healthcare” was virtually nonexistent until the insurance industry and its political allies launched a campaign to reframe the healthcare debate.
Though “socialized medicine” was used in attacks going back to Medicare’s founding in the 1960s, the report concludes that “before the 1990s, the term ‘government’ was rarely used to define publicly financed healthcare programs,” the report says.
NESRI tracks the origin of this effort to 1989, when the insurance industry began using the term. The largest insurance lobby’s report from 1988 has no mention of the term, instead using the more neutral “public” and “private” to describe insurance choices; one year later, they used the term “government-run” 35 times in one publication.
When the industry geared up to fight Bill Clinton’s health reform proposals—which actually preserved a large role for for-profit insurance–it ran the notorious “Harry and Louise” ads, warning that “the government may force us to pick from a few plans designed by government bureaucrats.”
In time, it became a doctrinal assumption in corporate media: Any kind of publicly financed medical insurance is government-run healthcare. The NESRI report found 13,300 Google News results with the phrase “government-run health care.” By contrast, there were just three with the phrase “corporate-run health care,” a ratio of 4,433 to 1.
Frank Luntz, the GOP polling consultant, explained the significance of the terminology on Fox News in 2009 (8/19/09): “If you call it a ‘public option,’” Luntz explained, “the American people are split. If you call it the ‘government option,’ the public is overwhelmingly against it.”
A few months later, Fox News producers were told by Fox managing editor Bill Sammon (Media Matters, 12/09/10) to “please use the term ‘government-run health insurance’…whenever possible.”
Anti–healthcare reform propaganda from Citizens for a Sound Economy.
The NESRI report’s credibility is boosted by industry and partisan documents showing the plotting of these actions in plain sight. It quotes then-Republican National Committee chair Hayley Barbour laying out GOP talking points (New York Times, 3/4/94):
We can’t afford a government-run healthcare system financed by a massive payroll tax…. We don’t have to have a government-run healthcare program to do healthcare reform.
The Koch Brothers-funded Citizens for a Sound Economy are quoted boasting in 1994 that it was
the first to label the Clinton approach “government-run healthcare”—a term that ultimately would help kill the myriad plans that subsequently were offered.
Why ‘government-run’ is inaccurate
From an AHIP (America’s Health Insurance Plans) memo on how to respond to the Michael Moore documentary Sicko.
NESRI argues that not only does this language amplify elite interests, but it’s simply inaccurate. The report notes:
Describing the entire healthcare system as “government” healthcare is simply wrong. Medicare, Medicaid, public options and Medicare for All are all publicly financed insurance programs that leave most of the healthcare system—including hospitals, physician practices, and drug and medical device manufacturers—in private hands.
The language is also “fundamentally biased” against public healthcare:
By drawing a contrast between “government” and “private” insurance, the media and polling organizations explicitly invoke government control of public insurance while rendering private insurance companies invisible.
A tool for journalists
While the report is an impressive piece of media criticism, Palmquist was adamant that the goal is to have constructive dialogue with editors and reporters to try and improve reporting on healthcare reform. With this goal in mind, the organization devoted a section in the appendix which uses examples to demonstrate how the media misused language and how they can fix it.
For instance, the report argues journalists should “not equate insurance with the entire healthcare system”:
There is much more to the healthcare system than insurance. The healthcare system includes hospitals, clinics, dentists, pharmacies, drug and medical device companies… All of these sectors span the public and private sectors.
The report provides examples of biased language vs. balanced language. The report also analyzes the industry impact on individual media outlets, Congress, pollsters and more. The amount of data available will also aid media critics and journalists to follow up on any number of related topics–or study media coverage of other industries and look for similar patterns.
“This is just a snapshot in time,” Palmquist said. “The primary goal is to try and encourage people to think about these things from 10,000 feet. To think about how these industries exert influence.”
Unsurprisingly, media coverage about the debates has continued to frame healthcare in the insurance industry’s preferred terms–focusing on protecting “private insurance” over issues like inequality, health outcomes or healthcare costs. In fact, CBS News, Politico, The Hill, Yahoo! News, the New York Times, the Daily Caller, Vox, Newsweek and many others all used the term “government-run” healthcare in their June 28 coverage of the debates.
Feautured image: NBC‘s Lester Holt moderating the first Democratic presidential debate of the 2020 campaign.
What’s in a name?
Control of the narrative
And yet, greedy corporate ones, isn’t Social Security a government run program? And it works well——- until the politicians try to “make their changes.” Actually corporate ones, if you truly cared about ,We the People, you would realize that when people don’t have to worry about their health cost, all kinds of things improve for the entire nation. But I truly understand some of those government run programs, you know , like the MILITARY that not only can’t seem to find the money they’ve lost, but they do not seem to even understand basic accounting. FOCUS there and uncover untold riches!.
I share your take in its entirety.
“There is much more to the healthcare system than insurance. The healthcare system includes hospitals, clinics, dentists, pharmacies, drug and medical device companies… All of these sectors span the public and private sectors.”
Indeed. As is the case in almost every other country that by defining Health Care as a Human Right and seriously controlling the profit-motive have better, universal, more comprehensive CARE at half the cost of USAmerica’s corporate, for-profit, remedial sick care as a commodity system.
HR1384 – Expanded and Improved Medicare for All would allow us to cut current costs and apply the still substantially larger per person per year available in what’s still the “richest” country on the planet for even better, more comprehensive universal care than those civilized countries now enjoy.
“There is much more to the healthcare system than insurance. The healthcare system includes hospitals, clinics, dentists, pharmacies, drug and medical device companies… All of these sectors span the public and private sectors.”
And the profit-motive baked into USAmerica’s corporate dominance of remedial sick care perverts the entire system.
The collusion between insurance corporations, AMA, Big PhRMA, the corporate “medical centers” and corporations manufacturing supplies and equipment with the goal of ever increasing corporate overhead and profits also perverts the quality of care.
From medical schools through the chain to the mechanistic and the hasty provision of “remedial sick care” (my last stay in a hospital was a 6 day nightmare of physical torture and sleep deprivation), the system is biased toward highly profitable and invasive surgery and drugs while even limiting people’s access to THAT due to centralized “medical centers” and the doctor’s “offices” clustered around them (economies of scale). The profit motive also means that the industry tends to reject most preventive care and alternative modalities that could actually improve health or, heaven forbid provide profit killing CURES.
HR1384 – would also allow us to improve and expand the spectrum of actual CARE provided to people.
I don’t want what the government is selling. Whether its called Obama care, Health Care for all, Universal Health Care, its based on Western medicine’s model of disease care which works to keep doctors doing their thing and pharma doing what they do best, make money selling drugs which has very little to do with what constitutes health.
Some years ago to deal with a serious illness at time when I had phenomenally good health insurance. Everything which made me worse was covered by insurance; everything which made me better I paid for out-of-pocket. Obama Care or Universal care is based on the wrong model and I want nothing to do with it.
Good article, once again pointing out the subtle(?) use of biased language to influence a debate.
I highly recommend Dr. Elizabeth Rosenthal’s book An American Sickness.
Bruce, Troy, NY
RN; EMT