Medicare is a very popular program.
If you cook up a policy to enroll every American in a single-payer health care plan that guarantees free treatments at point of service while banning private insurance and call it “Medicare for All,” that slogan tests pretty well.
It’s true that Medicare does not make treatment free at point of service or ban private substitutes for the public program. But this vision of health care is inspired by the Canadian program called “Medicare,” so in a sense, “Medicare For All” is a good description of the proposal as long as you understand “Medicare” to mean “similar to the Canadian program called ‘Medicare’” rather than “similar to the American program called ‘Medicare.”
Even so, Medicare For All as proposed by Bernie Sanders is considerably broader and more generous than Canadian Medicare, covering things like dental, vision, and pharmaceuticals. So when Bernie states that his proposals are simply what “every other major country on Earth” has achieved, that is misleading. In fact, no country that I’m aware of has a health program as expansive as the one he proposes for the United States. His ideas are genuinely very left-wing even by the standards of Canadian or Swedish politics.
But Sanders’ messaging choices reflect his sound political instincts. He takes ideas that are pretty far-reaching and frames them in the calmest, most reassuring way he can think of. And in the case of the “every other major country” tweet, he’s not lying — it’s a bit of a sleight of hand, but it genuinely is true that other rich countries have universal health care and we don’t.
I think that’s smart. Word choices by politicians and activists matter, swing voters tend to self-identify as moderate, and as a result, people who want to win should try to portray their ideas as moderate, common-sense reforms rather than sweeping vehicles for change.
At the same time, words are not magic. Invoking “Medicare” as a slogan is smart politics, but there’s no way you’d be able to actually pass Sanders’ legislation without people noticing its drastic and often unpopular implications. To ever get BernieCare done, you’d need to convince people that the actual ideas are good, not trick them into thinking the changes are more modest than they are.
Slogans don’t substitute for policy
I was thinking of this when I was reading Mary Harris’ interview with Anat Shenker-Osorio in Slate, headlined “Why Abortion Activists Need to Stop Using the Word Choice.”
I don’t have extremely strong convictions about what word you should use for the political faction that believes abortion should remain legal. But I always thought the basic logic of “pro-choice” was pretty clear: you want people who believe that abortion is wrong as a matter of religious conviction to still vote for candidates who believe that abortion should be legal. That’s important. A lot of people have views that incorporate both the metaphysics of fetal personhood and also support for a woman’s right to choose, and Democrats are counting on the votes of many religiously observant Black and Hispanic voters.
My big complaint with Shenker-Osorio’s take isn’t that her ideas about language and framing are necessarily wrong — I’m open to the idea that there’s a better option than “choice” — it’s the way she evades talking about policy.
As her big positive case study in favor of her ideas, she cites the successful campaign to legalize abortion in Ireland. That is absolutely something that we should study and learn lessons from. But the necessary starting point for learning lessons from Ireland’s success is understanding what they succeeded in achieving.
Under the terms of the Regulation of Termination of Pregnancy Act of 2018, abortion is legal in the Republic of Ireland under the following conditions:
When the pregnancy is less than 12-weeks old.
When two doctors certify in good faith that the fetus is likely to die either before or within 28 days of birth.
When two doctors certify that continuing the pregnancy poses a serious risk to the life or health of the mother.
When one doctor certifies that there is an emergency threat to the life or health of the mother requiring immediate action.
That is a big change from the historical abortion policy situation in Ireland, and it is very much at odds with the policy goals of the pro-life movement in the United States of America. But it is also a much more moderate policy than the one advocated for by the pro-choice movement in the United States of America.
In “Winning After Roe,” I argued that progressives should push for essentially the Irish policy solution — legal abortion in the first trimester, an exemption for the health of the mother, and some effort to assure the public that the health exemption is not just a gigantic loophole. These are broadly popular, politically defensible positions that would preserve the legality of abortion in the vast majority of cases.
Democrats thus far have not taken up my advice, largely I think because pro-choice groups have made it clear they are not yet prepared to certify this stance as supportive of abortion rights.
Instead, the party and the movement are having this conversation about framing, language, and slogans. On one level it’s fine to talk about framing, language, and slogans because those things matter. But the semantic content of what you are saying matters more. I think it is fine and appropriate to say that political slogans developed in Ireland over the past five to 15 years may be more relevant than slogans developed in the United States 50-60 years ago. But you can’t just sweep under the rug the fact that Irish choice activists won their battle by advocating for a more popular, more moderate policy.
Dog-whistling can be smart
I’m not a hard-core “language doesn’t matter” person; I do think the salience of policy issues is an important aspect of politics.
When Milan and I compared the Democratic Party platforms in 2012 and 2020 and documented a leftward shift on many issues, I didn’t count immigration as a topic they moved left on. That’s because the policies advocated for in 2012 and in 2020 are actually very similar. But if you want to see an example of how language can matter in politics, check out what 2012 says (emphasis mine):
Democrats are strongly committed to enacting comprehensive immigration reform that supports our economic goals and reflects our values as both a nation of laws and a nation of immigrants. The story of the United States would not be possible without the generations of immigrants who have strengthened our country and contributed to our economy. Our prosperity depends on an immigration system that reflects our values and meets America's needs. But Americans know that today, our immigration system is badly broken -—separating families, undermining honest employers and workers, burdening law enforcement, and leaving millions of people working and living in the shadows.
Democrats know there is broad consensus to repair that system and strengthen our economy, and that the country urgently needs comprehensive immigration reform that brings undocumented immigrants out of the shadows and requires them to get right with the law, learn English, and pay taxes in order to get on a path to earn citizenship. We need an immigration reform that creates a system for allocating visas that meets our economic needs, keeps families together, and enforces the law. But instead of promoting the national interest, Republicans have blocked immigration reform in Congress and used the issue as a political wedge.
Despite the obstacles, President Obama has made important progress in implementing immigration policies that reward hard work and demand personal responsibility. Today, the Southwest border is more secure than at any time in the past 20 years. Unlawful crossings are at a 40-year low, and the Border Patrol is better staffed than at any time in its history. We are continuing to work to hold employers accountable for whom they hire. The Department of Homeland Security is prioritizing the deportation of criminals who endanger our communities over the deportation of immigrants who do not pose a threat, such as children who came here through no fault of their own and are pursuing an education. President Obama's administration has streamlined the process of legal immigration for immediate relatives of U.S. citizens, supporting family reunification as a priority, and has enhanced opportunities for English-language learning and immigrant integration. When states sought to interfere with federal immigration law by passing local measures targeting immigrants, this administration challenged them in court.
If you have your immigration policy decoder ring at hand, you know what the phrases in bold mean. But I think that they are pretty unclear compared to the language about demanding personal responsibility, deporting criminals, securing the border, and reducing unlawful crossings.
This seems wise to me. Barack Obama had a balanced approach to immigration, and in his public messaging he wanted swing voters to hear its right-leaning elements loud and clear, and he was fine with its left-leaning elements being a bit muddled. The progressive policy commitment is in there, though, and it’s conveyed in a way that’s clear to people who care about it. When you hear people you don’t like communicating this way in politics it’s often called a “dog whistle” — Obama was telling immigration activists that he favored an amnesty program while trying to say it in a way that a lot of people might not notice.
That’s broadly similar to how Sanders deploys his Medicare for All message, and in both cases they have a similar weakness: when you try to actually pass the law, the details end up getting more scrutiny. The reason Obama’s approach had some chance of success was that he was hoping to get a bipartisan bill done, and any time you get a nice bipartisan signing ceremony, that tends to help paper things over. And beyond that, the path to citizenship idea — though controversial — is definitely more popular than broad-based tax increases or banning private health insurance.
Obama’s approach failed, but it did come pretty close to working. A comprehensive immigration bill passed the Senate with a huge bipartisan majority and had majority support in the House, too. Speaker John Boehner refused to put it on the floor for a vote, and then the surge of unaccompanied minors making asylum claims in 2014 shifted the political dynamic. Passing legislation is just inherently very hard in America, but I do think that as a pure messaging strategy, being deliberately obfuscatory about your most controversial ideas can be pretty smart. Republicans these days talk a lot about how they want to “stop the spending” in order to curb inflation, but they don’t say what spending they want to stop, because any large cuts they might propose would be unpopular.
You probably won’t like effective framings
Marcela Mulholland and McKenzie Wilson of Data for Progress have a new podcast out where they reference specific messaging testing experiments on abortion to see which ones do best.
It’s a really good discussion because they hone in on a point that I think tends to be neglected in this discussion — the best-testing messages tended to be ones they did not personally like. After all, these are two young, secular, college-educated women living in a big city and working professionally in progressive politics. If the whole electorate was made up of young female college graduates, then you could win on abortion with any message. But the point of developing a message is to try to come up with language that seems persuasive to people who aren’t progressive political professionals. In the case of the tests they did, that was generally messages that activated libertarian and individualistic ideas. Young leftists are not big on individualism. But as they say, this works precisely because it’s a political idea that appeals to people who aren’t leftists.
In the Slate article, Shenker-Osorio complains about trying to appeal to right-of-center individualists:
Harris: In the U.S., we talk about abortion as an individual right.
Shenker-Osorio: That’s right.
Harris: It’s almost by definition separate from the community.
Shenker-Osorio: Separate from the community, separate from relationships. And it has historically been argued in a libertarian framework. U.S. out of my uterus. Get your laws off my body. My child, my choice. And what happens with that “individual choice” language is, in policy terms, we get the Hyde Amendment.
I think this is backward.
At a time when abortion rights are under very clear and direct assault, you can’t optimize your messaging choices to try to advance Hyde Amendment repeal — a cause that’s unpopular and nowhere close to winning the needed votes in the Senate.
If the Supreme Court tosses Roe v. Wade, which seems very likely, many Republicans are going to push to enact draconian anti-abortion laws. Those laws will in many cases be unpopular and risk backlash. But to generate effective backlash, abortion rights activists need to counter-mobilize with a more popular position — the way they did in Ireland — not try to come up with a message that is optimized to try to defend an unpopular position. Compared to other western countries, the United States is more religious, which makes abortion rights harder to defend. But the United States is also more individualistic, which gives abortion rights a fighting chance. The most effective messages key into that, but effective messengers will also acknowledge that words aren’t magic and can’t substitute for aligning your views with things the public agrees with.
The Democrats have a huge opportunity to capitalize on Republican overreach on abortion, but in order to do that, they cannot tie themselves to policies that are even less popular. And the position that a abortion should be legal at 39 weeks for non medical reasons is genuinely extreme. Just think through what that entails exactly. And the opposition of course does not need to argue that the extreme cases are typical or even common.
The idea that there should be no restrictions whatsoever needs to be dropped fast, before it solidifies as a "defund the police" style messaging nightmare.
I'm increasingly disgusted by The Groups peddling their purity tests while Republicans work towards an ever more impregnable hold on power.
In the UK, after the Conservative landslide of 2019, a working class politician gave this evisceration of the 'cultism', 'purity tests', 'student politics' and 'culture of betrayal' of activists, whose disastrous consequences end up falling on the working class. I fear a similar outcome in the US in 2024.