Thursday, August 20, 2009

The PolicySpeak Disaster for Health Care

George Lakoff, Professor of Cognitive Science and Linguistics at UC Berkeley, Author, and blogger for The Huffington Post has an interesting post entitled The PolicySpeak Disaster for Health Care on what he believes are communications mistakes that have been committed by the Obama administration when selling people on health care reform. It is a very long and detailed post, so I am not going to try to summarize it with accuracy here in any detail. He starts out:

Barack Obama ran the best-organized and best-framed presidential campaign in history. How is it possible that the same people who did so well in the campaign have done so badly on health care?


What has been going wrong?


The answer is simple and unfortunate: The president put both the conceptual framing and the messaging for his health care plan in the hands of policy wonks. This led to twin disasters.

The PolicyList Disaster

The whole is greater than the sum of its parts.

Howard Dean was right when he said that you can't get health care reform without a public alternative to the insurance companies. Institutions matter. The list of what needs reform makes sense under one conceptual umbrella. It is a public alternative that unifies the long list of needed reforms... one idea, properly articulated, takes care of the list: An American Plan guarantees affordable care for all Americans. Simple. But not for policy wonks.

The policymakers focus on the list, not the unifying idea...

The PolicySpeak Disaster

PolicySpeak is the principle that: If you just tell people the policy facts, they will reason to the right conclusion and support the policy wholeheartedly.


To many liberals, PolicySpeak sounds like the high road: a rational, public discussion in the best tradition of liberal democracy. Convince the populace rationally on the objective policy merits. Give the facts and figures. Assume self-interest as the motivator of rational choice. Convince people by the logic of the policymakers that the policy is in their interest.

But to a cognitive scientist or neuroscientist, this sounds nuts. The view of human reason and language behind PolicySpeak is just false. Certainly reason should be used. It's just that you should use real reason, the way people really think. Certainly the truth should be told. It's just that it should be told so it makes sense to people, resonates with them, and inspires them to act. Certainly new media should be used. It's just that a system of communications should be constructed and used effectively.

The good professor details what he believes is a flawed model of how people reason:

What Is Reason Really Like?

PolicySpeak is supposed to be reasoned, objective discourse. It thus assumes a theory of what reason itself is -- a philosophical theory that dates back to the 17th Century and is still taught.

Over the past four decades, cognitive science and neuroscience have provided a scientific view of how the brain and mind really work. A handful of these results have come into behavioral economics. But most social scientists and policymakers are not trained in these fields. They still have the old view of mind and language.

The old philosophical theory says that reason is conscious, can fit the world directly, is universal (we all think the same way), is dispassionate (emotions get in the way of reason), is literal (no metaphor or framing in reason), works by logic, is abstract (not physical) and functions to serve our interests. Language on this view is neutral and can directly fit, or not fit, reality.

The scientific research in neuroscience and cognitive science has shown that most reason is unconscious. Since we think with our brains, reason cannot directly fit the world. Emotion is necessary for rational thought; if you cannot feel emotion, you will not know what to want or how anyone else would react to your actions. Rational decisions depend on emotion. Empathy with others has a physical basis, and as much as self-interest, empathy lies behind reason.

Ideas are physical, part of brain circuitry. Ideas are constituted by brain structures called 'frames' and 'metaphors,' and reason uses them. Frames form systems, called worldviews.

All language is defined relative to such frames and metaphors. There are very different conservative and progressive worldviews, and different words can activate different worldviews. Important words, like freedom, can have entirely different meanings depending on your worldview. In short, not everybody thinks the same way.

As a result, what is taken as "objective" discourse is often worldview dependent. This is especially true of health care. All progressive writing supporting some version of health care assumes a progressive moral worldview, in which no one should be forced to go without heath care, the government should play a role, market regulation is necessary, and so on.

Those with radical conservative worldviews may well think otherwise: that everyone should be responsible for their own and their family's health care, that the government is oppressive and should stay out of it, that the market should always dominate, and so on.

Overall, the foundational assumptions underlying PolicySpeak are false. It should be no wonder that PolicySpeak isn't working.

Ultimately, he claims to know what to do to fix the problem, but then suggests why progressives are not receptive to such a fix:

They may find it hard to comprehend framing, metaphor, and narrative as the way reason really works -- as what you need to do to communicate truth. Instead, they may well think of framing as merely manipulation and spin, as the mechanism that the right wing uses to communicate lies.

I'll try to summarize:

  • Lists of features don't "sell" people on anything of importance.
  • Traditional, classical, 17th century "reasoning" doesn't sell people.
  • Ignore recent advances in neuroscience and cognitive science at your peril.
  • Framing is essential.
  • Metaphor is essential.
  • Narrative is essential.
  • Empathy and emotion are essential.
  • Tools do not lose their validity just because "the other side" uses them against you.

I actually do not agree with everything he says and I believe that the Obama administration really is following the optimum path given the realities called Washington and America, but many of his ideas do have merit, at least in an abstract sense on paper. In truth, I believe that the Obama administration is in fact already following the essence of a lot of his advice even if not to the degree and specificity that he would prefer.

-- Jack Krupansky


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