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Word Choice A Key Factor In Health Care Debate

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Word Choice A Key Factor In Health Care Debate

Word Choice A Key Factor In Health Care Debate

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STEVE INSKEEP, host:

It's MORNING EDITION from NPR News. Good morning, I'm Steve Inskeep.

LINDA WERTHEIMER, host:

And I'm Linda Wertheimer.

In a press conference tonight, President Obama will again make his case for changes to the nation's health care system. Yesterday, the president emphasized certain words while selling the plan. He said it would bring down long-term costs, expand the coverage and provide more choice.

INSKEEP: We mention that because part of the debate over health care is a debate over word choices. Every side uses words calculated to persuade you before you even think about it. Here's President Obama speaking last month at a town hall meeting in Wisconsin.

President BARACK OBAMA: If the private insurance companies have to compete with a public option, it'll keep them honest and it'll keep…

(Soundbite of applause)

President OBAMA: …help keep their prices down.

INSKEEP: That's President Obama describing a key part of his plan. A public option, as he calls it, keeping big insurance companies honest. Last week on MORNING EDITION, Republican Senator Orrin Hatch used different language for the same thing.

Senator ORRIN HATCH (Republican, Utah): The Democrats are insisting on having this government plan. Now…

(Soundbite of laughter)

INSKEEP: You're talking about what the administration calls a public option.

Sen. HATCH: Well, a public option or public plan or government plan. We call it the government plan because you think we're in debt today, wait till you see what happens when that happens.

INSKEEP: Everybody in this debate has a carefully nuanced position. So to get a sense of how different people are appealing to the public, including you, we've called in Frank Newport, editor-in-chief of the Gallup Poll. Welcome back to the program.

Mr. FRANK NEWPORT (Editor-in-Chief, Gallup Poll): Thank you. Good to be with you.

INSKEEP: How do voters respond to the words public option, as opposed to the words government plan?

Mr. NEWPORT: Well, I think the key there is a public option that would be in existence along with a private plan. And when you put it that way and when you stress that, every bit of polling outlook that shows the majority approve that idea. If you simply say do you want the government to run health care, the polling is much less positive. So it sounds like the Republican, of course, wants to emphasize this is a government plan and not talk about the fact that it would be in existence along with the private plan. Obama the Democrat's much more likely to want to continue to emphasize this would simply be there along with the current private plan.

INSKEEP: Let's listen to another way that the public plan is discussed. Republican Roy Blunt of Missouri did not talk about this plan itself - or government plan, if you wish. He talked about what he says it will lead to.

Representative ROY BLUNT (Republican, Missouri): We believe, and everybody analyzing that future marketplace seems to believe that if there's a government competitor, you will not be able to keep what you have. Because if there's a government competitor, the government will never compete fairly, and before you know it, there are no competitors.

INSKEEP: Now why would Roy Blunt not precisely talk about this public plan -public option, whatever - in the way the administration describes it, but to talk about what he thinks it will lead to in the future?

Mr. NEWPORT: Well, the data clearly show that Americans value having their current plan - in fact, in a recent USA Today Gallup Poll, that rose to the top of the list. So it sounds like he was pushing right at that very sensitive nerve on the part of the American public, which is trying to stress that you would no longer have a choice, couldn't keep your current plan, and so on and so forth.

INSKEEP: Oh, because people were telling pollsters they don't like the number of uninsured, they don't like the rising cost of health care. But most people do happen to like the insurance they have right now.

Mr. NEWPORT: That's right. In particular, they like to have the choice of being able to choose insurance and choose doctors and hospitals. The significant majority of Americans - our data show 84 percent of American adults have insurance. And if you ask them are you satisfied with your insurance coverage -in fact, are you satisfied with your health care in general, the majority of the Americans say yes.

INSKEEP: We're talking with Frank Newport of the Gallup Organization about some of the polling that is out there on health care and trying to connect it up with the political rhetoric. Let me ask you about something that is not in any health care bill yet, although a lot of people have been talking about it: the need to save a lot of money in the way that America delivers health care to people. Henry Waxman, author of one major bill, wants doctors to be more cost effective in the tests and procedures that they give people. Here's how he describes it.

Representative HENRY WAXMAN (Democrat, California): I see that in a hospital setting, there are a lot of tests involved in order to find out what has happened and why it happened and how to stop it from occurring again. Those tests are essential. But sometimes, when you look at the broad population, they're excessive.

INSKEEP: So he says too many tests, but Waxman's bill does not mandate that doctors behave differently. It tries to encourage them to behave differently. Why would Democrats or the administration shy away from trying to tell doctors exactly what to prescribe?

Mr. NEWPORT: Notice he was saying broad population, general costs. So Americans would sign on to that in general, we should lower costs. (unintelligible) Americans aren't as concerned about health care cost in their own plan as one might imagine. Why he would shy away in reaction to your question, specifically from mandating that doctors and hospitals have to change, I have not seen in polling data. However, since the American public likes free choice for themselves, maybe they would say to themselves, I'm not sure I want the government telling my doctor that he or she can't order this or that test.

INSKEEP: What would prompt Republicans on the flip side to talk about rationing health care and suggest that might be a danger here?

Mr. NEWPORT: I think that word tested well. That came out in some memos by some well-known consultants, use that word, use that word. And I think you see it or have seen it in the past. We at Gallup have not tested rationing versus restrictions or other kind of things. So I cannot personally verify that that tests well with the public, but I'm assuming it did in somebody's research.

INSKEEP: Let me ask about another word that has entered in the debate in recent days. Michael Steele, the chairman of the Republican Party, has repeatedly described President Obama's health care plan as a, quote, "experiment," unquote.

Mr. NEWPORT: Yes. When that occurs so frequently, as it did in his discussion and in some of the other talking points from Republicans, we have to assume that somebody must have decided that that would play well with the public if you argued that this is being done too hastily and is a risk, and they're just kind of gambling with your health care future.

INSKEEP: It's a little Orwellian to ask this question, but do you think that it is possible for one side or the other to win the debate simply by winning the argument over whose words are chosen to describe the debate?

Mr. NEWPORT: These are complex policy matters which the average American could not be expected to understand, particularly the nuances. I'm not sure everybody on Capitol Hill understands all that's involved in all of these complex health care reform suggestions or legislative possibilities.

So in that situation, the public certainly listens for cues as you explain something to them, and listens for key words. And yes, indeed, in public policy debate, if you can grab the public's imagination by continually stressing something negative about something complex, that's what they will tend to agree to in the short term. So that, in fact, does work.

I have confidence, however, in the long term that the American public will sniff out whether something, in reality, is working well or not. So the fundamentals of this plan are what are going to determine whether or not it's judged a success if we're talking here, I think, five or 10 years from now.

INSKEEP: Frank Newport of the Gallup poll. Thanks very much.

Mr. NEWPORT: My pleasure.

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