Saturday, November 24, 2012

The Obama Administration, the ACA, and the Importance of Words

You would think that someone so adroit with words would have done a better job framing debate on the Affordable Care Act, but President Obama clearly dropped the ball. I would go so far as argue that their mistake singularly caused most of the backlash faced by the bill and gave conservatives the opening they needed to turn the public off and put the Administration on the defensive. At issue is the “Individual Mandate.”

Americans are predisposed to reject the idea of mandates. They don’t like being told that they are being forced to do anything. The word mandate raises negative images in people’s minds, and by choosing that term the Administration gave Republicans the ability to control the debate and frame the ACA as something being imposed on the American people. Poll after poll shows that when people are asked their opinion on particular aspects of the ACA that they are favorably received; only the individual mandate seems to meet with displeasure. This, in spite of the fact that only a very small segment of the population, most probably single males in their late 20’s to early 30’s, will be resistant to  a requirement that they purchase health care. The majority of people without health care will in all likelihood participate in the extended Medicare program.

The idea behind the mandate is reasonable enough; with more people receiving health care, insurance companies will be better able to spread the risk across a larger population as they receive more and more new clients. Moreover, the penalty for non-participation in the system is not particularly onerous, so those choosing not to participate are not really being compelled or forced to obtain health care.

But so it goes that a provision of the bill that really doesn’t impact that many people nonetheless has made people skeptical of it. As President Obama prepares for his 2nd term he should give strong consideration to introducing a new phrase to replace “individual mandate.” Maybe it can be called the “Personal Accountability” provision, or possibly the “Individual Responsibility” provision, or some derivation of those ideas. Accountability and responsibility are, by their nature, considered “conservative words.” Accountability and responsibility are terms typically associated with individual behavior; inherent in these words is the notion of choice. A mandate, on the other hand, is associated with government power and reach.

Since the ACA is filled with provisions where individuals and businesses will make choices, using either of these terms is also consistent with the philosophy behind the bill; it was not meant to be conceived of as a government directive in the way that a single payer plan is.

Hopefully the Obama Administration will see the light and aggressively reframe the arguments validating the ACA. A crucial component of that new “marketing” campaign is the language chosen by representatives of the President. Let’s hope they have learned their lesson and decided to scrap the term “mandate” in exchange for language more consistent with the belief system of our culture; the decision to use it was a huge blunder.

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