Health and the Rule of Three

When policy debates heat up, it’s not enough for policy analysts to run the numbers and for political analysts to count votes and gauge the influence of affected interests. You also need communicators to craft a crisp, clean message. One that resonates with listeners consciously and, if possible, subconsciously.

Every word counts. As a result, one of the key communication battlegrounds is very basic: What do you call the policy?  If you can win the naming battle, you are a long way toward winning the policy war.

Having participated in a number of these debates, I would like to offer the following conjecture, which I will boldly characterize as a rule:

The Rule of Three:  If debate about an economic policy is sufficiently important, that policy will have three different names: one used by proponents, one used by opponents, and one used by non-partisan agencies that don’t want to take sides.

That rule is asserting itself today in the debate over reforming the health care system, much as it did in the debate over Social Security a few years ago.

In 2005, President Bush proposed that workers have the opportunity to direct some of their Social Security taxes into an account, owned by the worker, that could invest in certain stock and bond index funds (in return, participating workers would forego some of their traditional Social Security benefits).  The three sides of the debate rapidly diverged in their characterization of the accounts:

  • Proponents christened them as personal accounts, a phrase that relied on the positive associations of the word “personal” (e.g., personal attention and personal responsibility).
  • Opponents referred to them as private accounts, a phrase that formed the basis for their larger charge that the proposal would privatize Social Security.
  • To maintain their non-partisan positions, the Congressional Budget Office (CBO) and Social Security’s Office of the Actuary (OACT) couldn’t use either name for the accounts, lest they appear to be taking sides.  So CBO and OACT referred to them as individual accounts.

You could often tell where someone stood on the issue just by the name they gave to the policy.

Today Washington is in the midst of an even larger debate – how to fix our struggling health care system.  And the rule of three is again asserting itself.

This time the issue is how to refer to President Obama’s proposal that Americans have the opportunity to purchase health insurance from a Federal insurance provider.

  • Proponents refer to this as a public option, a framing that draws on positive associations in both words.  ”Public” suggests the idea of open to all, for example, while “option” suggests that the policy would expand your choices, not mandate that you buy a particular health plan.
  • Opponents refers to this as a government plan (sometimes government-run plan), a framing that draws on the negative connotation of “government” (e.g., I’m from the government, and I am here to help you”).  The use of “plan” also leaves open the possibility — which some opponents believe is a probability — that Federal insurance might become less of an option and more of an inevitability.
  • The Congressional Budget Office, finally, has split the difference and referred to this approach as a public plan in their most recent analysis, thus using one word from each side.

I welcome other examples of the (conjectured) rule of three.

About Donald Marron 294 Articles

Donald Marron is an economist in the Washington, DC area. He currently speaks, writes, and consults about economic, budget, and financial issues.

From 2002 to early 2009, he served in various senior positions in the White House and Congress including: * Member of the President’s Council of Economic Advisers (CEA) * Acting Director of the Congressional Budget Office (CBO) * Executive Director of Congress’s Joint Economic Committee (JEC)

Before his government service, Donald had a varied career as a professor, consultant, and entrepreneur. In the mid-1990s, he taught economics and finance at the University of Chicago Graduate School of Business. He then spent about a year-and-a-half managing large antitrust cases (e.g., Pepsi vs. Coke) at Charles River Associates in Washington, DC. After that, he took the plunge into the world of new ventures, serving as Chief Financial Officer of a health care software start-up in Austin, TX. After that fascinating experience, he started his career in public service.

Donald received his Ph.D. in Economics from the Massachusetts Institute of Technology and his B.A. in Mathematics a couple miles down the road at Harvard.

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