Word came Thursday that, last year, Fox News Washington managing editor Bill Sammon had directed his staff to avoid using the phrase “public option” to describe a proposal hotly debated during the health reform debate. That option, proposed by Yale political science professor Jacob Hacker and embraced by some—but not all—of the progressive advocates, would have injected a real element of competition into the insurance industry. It would have, according to political scientist Jonathan Oberlander from the University of North Carolina, actually been a strong force for controlling health care costs. As it turned out, cost control lite won out.
The public option was not to be. After months of equivocation, the president threw it under the bus in his efforts to placate the insurance industry, the hospitals, and the doctors, who were hardly fans of something that could lower their profits and incomes.
Now we learn that Frank Luntz, the Republican wordsmith extraordinaire, was at work behind the scenes to craft the language that public plan opponents could exploit. They could use it to turn the public against the proposal that might have given them a cheaper, more comprehensive alternative to the policies sold by Aetna and Blue Cross. In a post yesterday, the liberal watchdog group Media Matters for America reported that Luntz had advised Fox personalities to use the term “government option.” Luntz said that when the term “public option” was used, the public was split, but when “government option” was used, the public was overwhelmingly against it—a nod to the anti-government sentiment among many Americans.
In e-mails to the staffs of several Fox shows, including Fox News Sunday, Sammon reminded them to use the correct language. He also suggested that when it was necessary to use the term “public option” it was best to use the qualifier “so-called,” as in “so-called public option.” That modifier, which brushes the term with a negative coating, reminds me of the terms that opponents of the consumer movement used years ago when they referred to “so-called” or “self-styled” consumer advocates as a way to denigrate their activities.
Last year, Campaign Desk pointed out that Luntz was busy selecting the “right” language months before it looked like the public option had legs. In a twenty-eight page document called “The Language of Healthcare 2009” that became public in the spring of that year, Luntz advised making government the bogeyman. He told Republicans to use words like “politicians,” bureaucrats,” and “Washington” to fight health reform. He suggested that they use the phrase “government takeover” rather than “government run” or “government controlled.” That’s when his clients were interested in derailing any thought of a national health system, like Britain’s. We also noted that in May 2009 the media had begun to use the term “government run” to characterize the public option. We advised journalists to describe what the public option would do, rather than just pass along Luntz-tested terminology.
Luntz has had a long career fashioning language that helps his Republican clients. In the mid-1990s, during the first attempt to privatize Medicare, he told them to use the words “saving,” “preserving,” and “strengthening” Medicare—words we hear today when the subject comes up. How many times did we hear the president and his aides say that health reform will “strengthen Medicare”? “Words are especially important,” Luntz advised.
For the record, the Dems did the same thing during the reform debate, and reporters repeatedly quoted people who stayed on the messages fashioned by Democratic pollster Celinda Lake. Lake counseled them to avoid saying “Medicare for all” and “universal coverage.” Those terms, she said, didn’t play well with the public. Instead, they were to use the word “choice,” as in giving people a “choice of public and private plans.” The Democratic take on the public option.
It’s hard to say whether Luntz’s focus group-tested language succeeded in fomenting the dislike for health reform now registered by the pollsters. For months, polls showed that large segments of the public liked the idea of a public option, and still do. When I conducted a CJR Town Hall in Missouri earlier this year, several of the people I chatted with were upset that the reform law didn’t go far enough. One woman told me that the reform law “is pretty short from what I would have liked.”
And a few weeks ago I interviewed a Brooklyn businessman running a messenger and shipping service. We talked about how the reform law tax credit might help him. After expressing skepticism that it would help much, he blurted out: “I am disappointed that the administration has not taken the original package which included the public option. It most certainly would have kept prices down so we would not have had the price increases now running amok.” What a surprising comment from a business guy, I thought.
Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.