For much of the health care debate,
opponents of the legislation did a better job
than supporters of winning the message war

Politics is often a war over vocabulary, and the media represent the playing field on which that war is at least partially, and perhaps still primarily, played.

In the crucial battle over the words and themes that can help define a policy debate, opponents of the health care bill seemed to enjoy considerably more success than the supporters, according to a PEJ Nexis search of these terms.

A study of the concepts and rhetoric that found their way into the media narrative from June 2009 through March 2010 revealed that the opponents’ leading terms appeared almost twice as frequently (about 18,000 times) as the supporters’ top terms (about 11,000 times.) Boiled down to its essence, the opponents’ attack on big government resonated more in the media than the supporters’ attack on greedy insurance firms.

In an attempt to quantify these message wars, PEJ examined the web sites of three organizations opposed to Democrats’ reform plans and three that supported them. We identified the key concepts and themes espoused by these groups. We then searched for those terms in a Nexis database of about 60 news outlets across six different media sectors and analyzed the findings for the most popular ideas from each side. (See Methodology)

The three most resonant ideas opposing the Democrats’ legislation were that it was the first step in a government run takeover of the health system; that it would lead to increased taxes; and the likelihood of rationed health care.

Of these three, the terms “government run” health care or a “government takeover” of health care or health care and “government bureaucrats” appeared most often, about 8,800 times in the search results during the 10 months studied. Then came the phrases “tax increases” or “new taxes,” which showed up about 6,700 times. Finally, the idea that health care would need to “rationed” appeared approximately 2,600 times.

Supporters of the legislation tried to stress three other ideas. Most notably, they wanted to portray a powerful and ruthless insurance industry. They also pitched the concept of increased competition under new legislation as well as new coverage of pre-existing conditions.

But the supporters of the health reform plans had considerably less success in the media conveying those ideas. A series of terms—including “insurance company abuses,”  “insurance lobbyists” and “unfair insurance industry practices”—showed up only about 560 times in the Nexis search.

A few supporters’ phrases did register as a significant presence in the Nexis search. The word “competition” showed up almost 6,700 times and “pre-existing conditions” appeared about 3,700 times. But those phrases don’t have the clear political clout of attacks on government health care or insurance company greed. It is also harder to know the context in which they appeared in the media coverage.

The Nexis search seems to reveal that it proved easier to create short and punchy descriptions conjuring up concerns about big government than about big insurance. And even after the President regained the initiative in early 2010 and helped steer the bill toward eventual passage, it was the opponents’ rhetoric that was more prevalent in the coverage.

One example of this resonant rhetoric was the emergence of the term “death panels” in August 2009. That was the month when anger boiled over in the health care debate. The fiery town hall protests, featuring citizens yelling at politicians, proved irresistible to the press, and accounted for nearly one-quarter of all the health care coverage that month. And while some opponents of legislation had been talking about “government encouraged euthanasia” for some time, the idea seemed to crystallize in the press after the term “death panels” appeared in an August 7 posting on Facebook by former GOP vice presidential nominee Sarah Palin. In the posting, Palin alleged that government bureaucrats would sit on a “death panel” and decide whether citizens were productive enough to be “worthy of health care.” 

The Nexis search conducted by PEJ found about 2,500 references to “death panels” in media coverage, making it one of the opponents’ more powerful semantic weapons. Virtually all of them appeared after Palin used the term in her posting.