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Winning the Language of Health Care Reform

Life and Freedom are moral issues. It is time for Democrats to talk about health in those terms, beyond just policy terms like health insurance reform, bending the cost curve, types of exchanges, etc. 

Health means life. If you get a major illness or injury and cannot get it treated adequately, you could die. And tens of thousands do. 

Health means freedom. If you have a serious illness or injury and cannot get it treated, your freedom will be limited in many ways. Your physical freedom: you may no longer have the freedom to move around. Your economic freedom: you may not be able to work or your medical bills may impoverish you. Your emotional freedom: you will not be free to live a happy life. 

Health is therefore a moral issue of the highest order. And it is a patriotic issue. Health security is a problem for far more Americans than military security. Your security is far more likely to be threatened by the lack of treatment for illness and injury than by any likely terrorist attack.  

Real terror is seen in the thousands of letters sent to the White House and Congress by people whose lives have been shattered or threatened by the behavior of the health insurance corporations.  Wellpoint, which made $2.7 billion in fourth quarter profits in 2009, tried to raise its Anthem/Blue Cross premiums 39% in California. Wellpoint made its profits by NOT giving health care. It treated 2.2million fewer people. It found a way NOT to treat people who needed treatment, either by refusing to insure them, or dropping them as clients, or denying authorizations. If you are sick or injured and that happens to you, you face terror — very real terror.  

That’s when “health maintenance organizations” (HMOs) become health terror organizations.  

The Obama administration has been missing the moral arguments in the health care debate, while conservatives always hit their moral targets.  Where the conservatives argue loss of freedom (“government takeover”) and life (“death panels” and abortion), the administration has been giving policy wonk arguments about economic and pragmatic policy details that the public cannot understand: health exchanges, percentages of the poverty line (133% vs. 150%), and so on. They are real enough. But they do not communicate the moral issues. 

Morality and Policy

Why should Congress move to reconciliation? Because it is moral. It is the right thing to do, because it will enhance life and freedom. 

Why should the public option be in the reconciliation bill? Because it is right and practical: it allows the market to police the insurance companies — to keep their greed from overwhelming the life and freedom of tens of millions of Americans. And a public plan— an American Plan!—  gives you an your doctor much more freedom to determine your treatment, with no profit incentives for insurance companies to deny you care. 

Why should national exchanges, not state exchanges, be in the reconciliation bill? Because they provides greater economic freedom — through bigger pools, which means much more affordable insurance for all.  Affordability means economic freedom! 

Why cover folks up to 150%, not just 133%, of the poverty line. To offer life and freedom to many more of our fellow Americans. 

Why should anti-trust exemptions be ended for health insurance companies? Economic freedom! Anti-trust exemptions function like corporate bailouts. They transfer the money from ordinary people into corporate coffers. By reducing or eliminating competition, corporations can charge more for less treatment to fewer people. Those extra charges, plus out of pocket costs when we are denied care under the plans, come out of our pockets. Anti-trust exemptions take money out our pockets and put it into corporate profits. They threaten our economic freedom. 

And how should we be thinking about the passage of a health plan that makes progress but falls short of what is needed? We should be taking it as a national commitment — a moral commitment — to health for Americans. It is a commitment to doing what is right, to life, freedom, and health security, a first step of many steps to come. 

It is time to return to the moral fundamentals. Health security is deeply patriotic — perhaps our most important form of security. Health means life. Health means freedom. Everyone can understand that.  

George Lakoff is Goldman Distinguished Professor of Cognitive Science and Linguistics at the University of California at Berkeley. His latest book is “The Political Mind: A Cognitive Scientist’s Guide to Your Brain and Its Politics.”

This article was originally published on

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