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Frank Luntz reappeared last week when a tipster slipped Politico a twenty-eight-page document called âThe Language of Healthcare 2009â that Luntz had given to Congressional Republicans. It quickly traveled through the blogosphere, and health reform proponents thought they had caught Luntz red-handed in oiling up the Republican message machine.
Over at The New Republicâs health blog, Jonathan Cohn wrote that the appearance of the latest Luntz communiquĂ© made him âslightlyâ more optimistic about chances for reform. Cohn argued that Luntz had toned down the Republican message; his memo was more benign than a similar one written by William Kristol in 1994, advising Republicans to tell people âthere is no health crisis.â This time Luntz advises them to acknowledge the crisis but define it in terms of the audienceââif youâre one of the millions who canât afford health care, itâs a crisis,â or if a bureaucrat gets between you and your doctor, itâs a crisis.
Before going further, itâs good to remember who Frank Luntz is: a GOP pollster and consultant par excellence, known for testing language on focus group participants to find which words resonate best with ordinary folks. Republican pols can then use those words to sway public opinion in their favor. In the mid-1990s, Luntz helped shape the messages that led to the FDA Modernization Act of 1997, a conservative triumph that, among other things, let drug companies expand their markets for âoff-labelâ uses (uses other than those for which the FDA had approved the drug). Stressing a âcorporate partnership for safetyâ and talking about âbetter scienceâbureaucracies are stuck in the past,â the new law reduced the number of clinical investigations needed to establish drug safety and effectiveness and eliminated certain consumer protections. During the first Congressional attempt to privatize Medicare in the mid-1990s, Luntz told Republicans to use the words âsaving,â âpreserving,â and âstrengtheningââbut not the word âimprovingââto describe Medicare, because it will make seniors think they will lose benefits they value.
âWords are especially important,â Luntz instructed at the time. âSetting the right tone at the outset is critical.â This go-around, Luntz and his Republican clients are hoping that the words they suggest will indeed set the right tone. Cohn has done a good job of showing where the pollsterâs message is substantively incorrect. But rhetoric can be substantial, too. With all stakeholders trying to push public opinion (and the outcome) in their direction, key words and phrases matter. Hereâs where journalists come in.
Luntz counsels Republicans to âhumanizeâ their approach and stop talking about the âhealth care system.â âIndividualize,â âpersonalize,â âhumanize,â Luntz advises. Journalists, take note! Campaign Desk has been urging the press to humanize and personalize its stories for over a year. During the campaign, very few stories told how the candidatesâ proposals affected real people. Once legislation emerges, stories that analyze and probe how people will be affected should become a staple.
âWaste, fraud, and abuse are your best targets for how to bring down costs,â Luntz tells Republicans. Democrats and their allies, too, have been using terms like âwasteâ and âinefficiencyâ for some time. By now, the public âknowsâ waste, fraud, and abuse are bad. When pols use those terms, itâs best to add a graph or two explaining that it is doctors, hospitals, and other providers who often engage in wasteful, fraudulent practices, and that much health care inflation stems from the overuse of new medical technology that has not yet been proven effective. Letting the phrase âwaste, fraud, and abuseâ stand without context is almost akin to misquoting someone.
Make the government the bogeyman, Luntz advises, suggesting that Republican arguments against the Democratsâ health care plan (whatever that is) must focus on âpoliticians,â âbureaucrats,â and âWashington.â Republicans should also use the term âgovernment takeoverâ rather than âgovernment runâ or âgovernment controlled;â they should also define the consequences of such a government intervention:
In countries with government run healthcare, politicians make YOUR healthcare decisions. THEY decide if youâll get the procedure you need, or if you are disqualified because the treatment is too expensive or because you are too old. We canât have that in America.
In the last few weeks, the press has started to use the term âgovernment runâ to describe a public insurance option that would compete with coverage sold by private insurance companies. âSchumer Points to a Middle Ground on Government-Run Health Insurance,â read a recent New York Times headline. The phrase has become pejorative short hand for describing what a public plan is, even if Luntz thinks âgovernment takeoverâ works better. In reality, no oneâleast of all the publicâknows exactly what a public plan will look like. Journalists should describe what a plan will and wonât do, and curb the tendency to use shorthand that unwittingly passes along the Luntz-tested terminology.
Use horror stories from Canada, Luntz says. They âdo resonate,â he explains. I say think twice about running them. Whenever some anecdote is trotted out about poor care in Canada, itâs wise to remember that the media ran with the horror stories during the last round of health reform, and misled the public. When The New York Times reported that women were waiting in line for pap smears, the Canadian ambassador sent a letter to the editor refuting the claim; but by then it was conventional wisdom that women could not get pap smears in Canada. The takeaway: When some pol makes a claim about rationing in Canada and waiting in line for health care, investigate it. Make a call or two to Canada and find out whatâs really going on.
When, in the early 1990s, the claim was made that people in British Columbia were denied heart surgery, I went to Canada to find out. A judge who headed a royal commission investigating the claims told me everyone one of the stories fell apart when Canadians scrutinized them. However, that didnât stop the American press from repeating them.
Frank Luntzâs message teaches and reinforces what good journalism is all about. Language matters. So use it well.
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