“We knew that their ideas were far out of the mainstream and things were totally out of whack. We found ourselves living in a country where what was considered extreme just a decade ago was now national policy. How could this have happened?” [1]
It may surprise you that the above was written not after Donald Trump was elected president, but after George W. Bush was elected (with help from a conservative Supreme Court) in 2000. And in retrospect, the Bush administration’s positions on many issues appear tame compared to Trump’s.
The quote comes from the introduction to the book Don’t Think of an Elephant, by linguist and cognitive scientist George Lakoff, Ph.D. Lakoff contends that Republicans are much better than Democrats at framing – creating the “mental structures that shape the way we see the world.”[2] As a result, Republicans have been much better at getting elected, even when their policies are antagonistic to their supporters’ best interests.
Framing also connotes the way we communicate these constructs. Lakoff uses the example of the term ‘tax relief,” which creates the image of something that is burdensome (an affliction) and in need of remediation. Taxes are bad and need to be reduced or done away with altogether. The concept and the words stick even though they are inaccurate at best. Taxes pay for public schools, safe roads, public safety, and clean drinking water to name just a few of the benefits. But people don’t think of those things when confronted with the term tax relief. Combined with the term “government waste” and you’ve created a strong case to vote for the Republican candidate who will cut taxes and reduce waste, even though in the long run it will have a detrimental effect on the quality of life for most Americans.[3]
And consider how Republicans use words and phrases to elicit an emotional reaction. The following are comments from press secretary Karoline Leavitt. Notice the use of pejorative adverbs and adjectives (underlined) as well as connecting problems with the resurfacing of the Reflecting Pool with Democrats all the while appealing to patriotism.
“There’s actually been six arrests at the reflecting pool where, again, these deranged individuals, many of them longtime donors to the Democrat Party, to Barack Obama, to Act Blue, that have been vandalizing and desecrating our federal monument, one of the most beautiful monuments in the world, the reflecting pool. And that’s why President Trump is not going to stop with this effort. We’re going to not only hold those people accountable, but we’re going to fix the pool, make it, continue to make it beautiful from this despicable vandalism—just in time to celebrate our nation’s 250th birthday next week.”[4]
Republicans use framing to deride universal health care when they use the terms “free health care” and “socialized medicine.” UHC is neither free nor socialized medicine, but the terms stick. I was talking to a friend about my book, and he told me Americans won’t support my proposal for universal health care because they believe people will take advantage of the system if it is free. I quickly explained that my proposal is based on a flat health care transaction tax, so it is not free, and everyone pays into the system, thus there are no freeloaders. He responded that in countries like Sweden and Denmark the taxes have to be very high in order to have universal health care. I responded that it’s true Sweden and Denmark have high taxes, but you also get what you pay for: in addition to universal health care, these countries have early child-care, pre-K education, low tuition for college, and excellent pensions and long-term care programs for the elderly, not to mention a strong (mixed) economy.[5]
However, this demonstrates the power the of the terms “free health care” and “socialized medicine” as my friend is a retired physician. He spent his entire life working in socialized medicine (as a psychiatrist in a state hospital, community mental health clinic, and for the Veterans Administration), and his family is from Denmark!
I observed the same behavior while watching a liberal talk show. One of the guests pointed out that the polls indicate most Americans don’t want to give up their private health insurance and that people are rejecting universal health care because it comes with a price tag of over $30 trillion. Keep in mind that the guest was a liberal, but the information comes from conservative sources. At the time the program aired, a WSJ/NBC poll actually found that two-thirds of Americans support universal health care when it is an option rather than mandate. And the authors of the study that the $30 trillion price tag came from acknowledged it is just an estimate, not a definitive calculation.
Many Americans are unsure about universal health care or are sure they don’t want it because they are uninformed and misinformed. In large part, this is because Republicans are better – much, much better, than Democrats in framing the issue. And Democrats are not good at framing because they lack the will, insight, and coordination to become good at it. For example, Lakoff founded the Rockridge Institute, a progressive thinktank, to articulate progressive values and the use of framing to promote those values. However, the Institute only lasted five years, in part due to a lack of funding and in part due to a lack of interest by the Democratic Party.[6]
“Progressives have been under the illusion that if only people understood the facts, we’d be fine. Wrong. The facts alone will not set us free.”[7] This quote also comes from the introduction to Lakoff’s book, and yet, more than twenty years later we still hear Democrats say the best way to counter Donald Trump’s incessive lying is with the facts. Wrong. As Republicans, more so than Democrats, understand, facts don’t always matter. That is why, when they do frame issues, they use language that appeals to people at an emotional level.
If Democrats want to convince those Americans who are unsure about universal health care, they’ll have to develop strategies that use framing to inform and persuade and reach people at an emotional level. For example, stories about people who have been taken advantage of by insurance companies, who’ve had to declare bankruptcy because they couldn’t afford their medical bills, whose medical condition worsened because they couldn’t afford treatment, or had their treatment denied should be part of our framing arsenal. Simple phrases and slogans can help frame and communicate the topic. (How about my blog’s logo: The health of a nation is dependent on the health of its people, for starters?)[8] And we must continually remind those who have employer-based health insurance that their premiums and deductibles will continually go up as insurance companies try to maximize profits. That’s why my book is entitled The Case for Universal Health Care, because when you understand how and why it works, it’s difficult to refute the benefits.
Foonotes
[1] Lakoff, George (2004). Don’t Think of an Elephant, Chelsea Green Publishing. White River Junction, VT. p. xii
[2] Lakoff (2004). p. xv
[3] Framing is also one of the reasons I refer to my proposal as universal health care and not Medicare-for-all. As I will explain in another article, Medicare is actually quite costly.
[4] Thompson, Harry (2026). Leavitt defends White House response to Reflecting Pool damage. The Daily Beast. June. 23
[5] Denmark offers free college tuition compared to the U.S. where median student debt is around $25,000 at graduation.
[6] About ten years ago I contacted Democratic Party officials in regard to what I observed was a lack of strategic thinking, including the use of framing. I didn’t even receive an acknowledgement. Instead, I continued to observe the problems I had identified in my correspondence.
[7] Lakoff (2004). p. xiii
[8] Progressives like to make fun of Trump’s simplistic language and awkward statements, but that is what actually makes him an effective communicator with his base.
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