Name Changer Is Rarely A Game Changer, Madam Speaker : Shots - Health News Recasting the public option as a consumer option is unlikely to garner a wave of political support for a government-sponsored plan as part of health overhaul.
NPR logo Name Changer Is Rarely A Game Changer, Madam Speaker

Name Changer Is Rarely A Game Changer, Madam Speaker

Down in Florida this week, visiting with seniors in a place called Sunrise, House Speaker Nancy Pelosi adopted a shiny new name for the "public option" -- the issue on which hangs the fate of the health care overhaul.

She called it "a consumer option," adding that her moniker was more accurate because "public" implied it would be taxpayer-paid. "Which it is not," she added. But the new lingo will get a lot of use now that the Democrats have unveiled the House's new health bill. (See all 1,990 pages of the bill here.)

But will the new name stick? Not if history has much to say about it.

To be fair, Pelosi may be on to something here, at least in part. Polls show people like the idea of having "options." But the term "public" is more of a problem. It implies government and public support.

Everyone's heard of "public subsidy" and "public housing," terms that suggest public cost. But the "public option" at issue today is actually intended to lower the cost of health insurance across the entire system.

Even without the tax issue, the word "public" implies "government," and "government" means bad in certain circles. So even if the public plan's an optional thing, like a back-up, it gets the federal foot in the door. And that raises suspicions about whether the current, private, profit-based system would soon be extinct.

Consumer, though, that's a word we all like. We all know consumer spending drives the economy, and that consumer-friendly is a good thing. Who do you know who's not a consumer?

But Pelosi will need some help turning around an entire country that has grown accustomed to the phrase "public option" in its current use.

You might as well try to get people to stop calling the cause of the influenza pandemic "swine flu." Ask the Pork Producers Council, they have tried all year. "H1N1" just does not carry the same instant recognition.

On Capitol Hill, the landscape is literally littered with failed attempts to change the labels on controversial ideas.

President George W. Bush found that out when he tried to change Social Security into "personal accounts" in 2005. The opposition called it "privatization," and the effort tanked.

So the president turned to updating the immigration system. But once that bill was branded "amnesty" by its opponents, this time mostly in the president's own party, it was doomed.

The same thing happened to Bush the First back in 1990 and 1991, when he wanted to sign the extension of the Civil Rights Act but met stiff resistance to its affirmative action provisions. Opponents called it "the quota bill," arguing that reverse discrimination would rule the work place. Sen. Jesse Helms based his 1990 re-election campaign on the issue, and it worked.

Labels need not be accurate to be lethal. Earlier this year we saw what happened to end-of-life counseling when a certain former Veep candidate said the idea amounted to setting up "death panels" for the elderly and ill.

And don't forget "death tax," a term for the estate tax that became commonplace in the late 1990s.
The estate tax is paid only by estates worth millions of dollars, but the term "death tax" convinced so many Americans they were or would one day become subject to it, Congress passed deep cuts in it and has tried many times to abolish it altogether.

In each of these cases, plenty of people raised their voices against the killer labels, pointing out their inaccuracy and unfairness. But once a label has stuck, it is almost impossible to remove.

That's just the nature of public opinion. And hey, that public opinion, does that come from the government?