Cries of Crisis

Rethinking the Health Care Debate

Robert B. Hackey

• Publisher: University of Nevada Press
• Year: 2012
• ISBN:
  9780874178906
• Topic: Politics & International Relations
• Subtopic: Politics
• Index: Politics & International Relations

Since the late 1960s, health care in the United States has been described as a system in crisis. No matter their position, those seeking to improve the system have relied on the rhetoric of crisis to build support for their preferred remedies, to the point where the language and imagery of a health care crisis are now deeply embedded in contemporary politics and popular culture.In Cries of Crisis, Robert B. Hackey analyzes media coverage, political speeches, films, and television shows to demonstrate the role that language and symbolism have played in framing the health care debate, shaping policy making, and influencing public perceptions of problems in the health care system. He demonstrates that the idea of crisis now means so many different things to so many different groups that it has ceased to have any shared meaning at all. He argues that the ceaseless talk of "crisis, " without a commonly accepted definition of that term, has actually impeded efforts to diagnose and treat the chronic problems plaguing the American health care system. Instead, he contends, reformers must embrace a new rhetorical strategy that links proposals to improve the system with deeply held American values like equality and fairness.

NOTES

INTRODUCTION Constructing the Health Care Crisis

1. Robin Toner, “Poll Says Public Favors Changes in Health Policy,” New York Times, April 6, 1993, A1; Timothy Johnson, “Town with a Heart: Small Town Fights Health Care Crisis,” 20/20, December 26, 2003.

2. See Bruce Kuklick, The Good Ruler: From Herbert Hoover to Richard Nixon; Thomas Langston, With Reverence and Contempt; Daniel T. Rodgers, Contested Truths: Keywords in American Politics Since Independence; and Rita Charon, “Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust,” 1898.

3. Robert Alford, “The Political Economy of Health Care: Dynamics Without Change”; Godfrey Hodgson, “The Politics of America Health Care: What Is It Costing You?”; Stephen Shortell and Walter McNerney, “Criteria and Guidelines for Reforming the U.S. Health Care System.”

4. Cindy Jajich-Toth and Burns W. Roper, “Americans' Views on Health Care: A Study in Contradictions”; Robert J. Blendon et al., “Americans' Health Priorities: Curing Cancer and Controlling Costs”; Jon Gabel, Howard Cohen, and Steven Fink, “Americans' Views on Health Care: Foolish Inconsistencies?”; ABC News/Kaiser Family Foundation/USA Today, Health Care in America 2006 Survey Chartpack; Robert J. Blendon and John Benson, “Understanding How Americans View Health Care Reform”; Everett Carl Ladd, “The Congress Problem”; Lawrence Brown, “Comparing Health Systems in Four Countries: Lessons for the United States,” 55.

5. Joel Best, Random Violence: How We Talk About New Crimes and New Victims.

6. James A. Morone, “Nativism, Hollow Corporations, and Managed Competition: Why the Clinton Health Care Reform Failed,” 391.

7. P. M. S. Hacker, Wittgenstein, 9.

8. “The Real Health Issue,” New York Times, June 25, 1974, 36; Linda Disch, “Publicity-Stunt Participation and Sound Bite Polemics: The Health Care Debate, 1993–94,” 7; Daniel Yankelovich, “The Debate That Wasn't: The Public and the Clinton Health Care Plan”; William Glaberson, “Struggling to Bring the Health-Care Debate Home to Readers,” New York Times, May 25, 1993, A2; Theodore R. Marmor, “A Summer of Discontent: Press Coverage of Murder and Medical Care Reform,” 499.

9. Kathy Kiely and John Fritze, “Passions Flare Up at Health Care Forums,” USA Today, August 10, 2009, A4; Bob Beckel and Cal Thomas, “How to Break Up Town Brawls,” USA Today, August 20, 2009, A11; Bill Lambrecht, “Tempers Run High at Forums on Reform of Health Care,” Providence Sunday Journal, August 9, 2009, C12; Nancy Pelosi and Steny Hoyer, “‘Un-American’ Attacks Can't Derail Health Care Debate,” USA Today, August 10, 2009, A7; “Dishonest Debate Mars Bid to Overhaul Health Care,” USA Today, July 31, 2009, A10.

10. Murray Edelman, The Symbolic Uses of Politics.

11. Charon, “Narrative Medicine,” 1897.

12. Beatrix Hoffman, The Wages of Sickness; Robert B. Hackey, “Symbolic Politics and Health Care Reform in the 1940s and 1990s”; “Text of President's Message to Congress Advocating Passage of Medical Care Bill,” New York Times, February 28, 1962, 16.

13. Richard M. Nixon, “Remarks at a Briefing on the Nation's Health System.”

14. Hodgson, “Politics of America Health Care”; William L. Kissick, “Health Policy Directions for the 1970s,” 1343; David Kotelchuck, “The Health Status of Americans,” 5.

15. Kuklick, Good Ruler, 30.

16. John Edwards, “Press Release: Edwards Announces Plan for Universal Health Care”; John McCain, “Text of McCain Speech on Health Care,” Wall Street Journal, October 11, 2007.

17. Harold M. Schmeck, “A Plan to Insure Health Care for All,” New York Times, July 12, 1970, E5; Harry Smith and Lester Holt, “The Health Care Crisis in Chicago,” CBS This Morning, July 10, 1990. See also David C. Colby and Timothy Cook, “Epidemics and Agendas: The Politics of Nightly News Coverage of AIDS.”

18. John M. Broder, Robert Pear, and Milt Freudenheim, “Problem of Lost Health Benefits Is Reaching into the Middle Class,” New York Times, November 25, 2002, A1; “The No. 1 Worry,” Des Moines Register, October 12, 2004; “Health Care Reform: A Pill Too Bitter for U.S. to Swallow,” USA Today, October 17, 2006, 17.

19. Joseph Turow and Rachel Gans, As Seen on TV: Health Policy Issues in TV's Medical Dramas; Allison Waldman, “Dramas Deliver Medical Messages: Fiction Programming Can Create Awareness of Health Care, Diseases”; Victoria Rideout, Television as a Health Educator: A Case Study of “Grey's Anatomy”; Candace Cummins Gauthier, “Television Drama and Popular Film as Medical Narrative”; Mollyann Brodie et al., “Communicating Health Information Through the Entertainment Media.”

20. David Denby, “Calculating Rhythm,” 90.

21. This episode first aired during season 2 of Extreme Makeover: Home Edition (episode 20, “The Harvey Family”) on April 24, 2005. For an episode summary, see http://abc.go.com/shows/extreme-makeover-home-edition/episode-detail/harvey-family/68111 (accessed December 23, 2011).

22. Deborah Stone and Theodore Marmor, “Introduction,” 255; Shortell and McNerney, “Criteria and Guidelines,” 463.

23. Patricia Roberts-Miller, “Democracy, Demagoguery, and Critical Rhetoric,” 459; Lawrence R. Jacobs, “Health Reform Impasse: The Politics of American Ambivalence Toward Government,” 643.

ONE The Rhetoric of Health Care Reform

1. Virginia Woolf, “Mr. Bennett and Mrs. Brown.”

2. “50% More Doctors Urged by Parran,” New York Times, October 10, 1947, 29.

3. “Text of President's Message to Congress Advocating Passage of Medical Care Bill,” New York Times, February 28, 1962, 16.

4. Godfrey Hodgson, America in Our Time, 6, 464.

5. “60,995,000 Listed in Hospital Plans,” New York Times, August 18, 1949, 23; “50% More Doctors Urged by Parran”; “121,000,000 in U.S. Now Carry Insurance Against Cost of Hospital and Doctor Bills,” New York Times, January 12, 1959, 93.

6. “Johnson's Special Message to Congress Outlining Broad National Health Program,” New York Times, January 8, 1965, 16.

7. Quoted in Kuklick, Good Ruler, 139.

8. Donald Light, “Sociological Perspectives on Competition in Health Care,” 969.

9. Hodgson, America in Our Time, 3; Rick Perlstein, Nixonland; Hodgson, America in Our Time, 15 (emphasis in the original).

10. Albert O. Hirschman, Shifting Involvements, 40.

11. Burton Klein, “The Limits to Growth: A Report for the Club of Rome.”

12. Robert P. Hart et al., Political Keywords: Using Language That Uses Us, 5; Murray Edelman, Constructing the Political Spectacle, 31; Ronald Rotunda, The Politics of Language, 9. In Nixonland, Perlstein uses Nixon's ascendance to the presidency and his troubled terms in office as a lens to understand the social, economic, and cultural changes in America during the 1960s and 1970s.

13. Hart et al., Political Keywords, 1; Leslie Stahl, “Nursing Shortage,” 60 Minutes, June 9, 2002.

14. Roderick P. Hart and Susan Daughton, Modern Rhetorical Criticism, 155–57.

15. Rebecca Klatch, “Of Meanings and Masters: Political Symbolism and Symbolic Action,” 138, 145.

16. Harold M. Schmeck, “What the Government Can and Cannot Do,” New York Times, July 13, 1969, E6; “Clinton's Health Plan: Taking His Message to Congress,” New York Times, September 23, 1993, A25; John Kerry, “Health Care for All Americans.”

17. Dan Rather, “Part 1: Your Money or Your Life,” 48 Hours, May 26, 1993.

18. Hart et al., Political Keywords; Robin Toner and Sheryl Gay Stolberg, “Decade After Health Care Crisis, Soaring Costs Bring New Strains,” New York Times, August 11, 2002; Mike Allen and Amy Goldstein, “Bush Urges Malpractice Damage Limits; Plan Includes Goals Sought by Business,” Washington Post, July 26, 2002, A4; Kelly O'Donnell, “California May Have Found the Solution to Stabilizing Medical Malpractice Insurance Premiums,” NBC Nightly News, January 3, 2003.

19. Matt Lauer, Today, August 7, 2003; Katherine S. Mangan, “The Malpractice Menace.”

20. Langston, With Reverence and Contempt, 4; Edelman, Constructing the Political Spectacle, 31.

21. This de...