Presidential Healthcare Reform Rhetoric: Continuity, Change & Contested Values from Truman to Obama

This Book Analyzes The Rhetorical Strategies Employed By The Four Democratic Presidents, Truman, Johnson, Clinton And Obama, Who Tried To Expand Access To And Affordability Of Healthcare In The United States. It Considers How They Made Such Arguments, The Ethics They Advanced, And The Vision Of America They Espoused. The Author Combines Rhetoric Analysis, Policy Analysis, And Policy History To Illuminate The Dynamic Nature Of The Way American Presidents Have Imagined The Moral And Social Bonds Of The American People And Their Exhortations For Governance And Policy To Reflect And Honor These Bonds And Obligations. Schimmel Illustrates How Democratic Presidents Invoke Positive Liberty And Communitarian Values In Direct Challenge To Opposing Conservative Ideologies Of Limited Government And Prioritization Of Negative Liberty And Their Increasing Prominence In The Post-reagan Era. He Also Draws Attention To The Ethical And Policy Compromises Entailed By The Usage Of Specific Rhetorical Strategies And Their Resulting Discursive Effects. Machine Generated Contents Note: 1. Introduction -- 2. History Of American Liberal And Conservative Healthcare Rhetoric And Public Policy -- 3. Methodology And Theory: The Social Imaginary And Its Moral Order -- 4. Harry Truman's November 19, 1945 Address To Congress On Healthcare Reform -- 5. Lyndon Baines Johnson's Remarks At The Signing Of The Medicare Bill, July 30, 1965 And Related Speeches -- 6. Bill Clinton's September 22, 1993 Address On Healthcare Reform To Congress -- 7. Barack Obama's September 9, 2009 Healthcare Speech To Congress -- 8. Conclusion. Noam Schimmel. Includes Bibliographical References And Index. Praise for this Book 6 Dedication 8 Acknowledgments 10 Contents 18 Chapter 1: Introduction 20 1.1 The Significance of Healthcare in Contestation of the American Moral Order and Social Imaginary 20 1.2 Democratic and Republican Conceptualizations of the American Social Imaginary 23 1.3 Core Concepts 28 1.4 Book Structure 29 1.5 Empirical Focus and Corpus Construction 30 1.6 Rights, Liberty, and Individualism in US Law and Politics 31 1.7 The US in Comparative Perspective: Healthcare as a Legally Guaranteed Right in European and Other Nations 35 1.8 Healthcare Reform Today: Obama’s Affordable Care Act 38 1.9 The Evolution of Democratic Healthcare Reform Rhetoric 40 Notes 41 Chapter 2: History of American Liberal and Conservative Healthcare Rhetoric and Public Policy 54 2.1 Historical Efforts to Expand Access to Health Insurance 54 2.2 Policy and Discourse of Proponents of Health Insurance Coverage Expansion 56 2.2.1 Richard Nixon’s Healthcare Reform Proposal 58 2.3 Discourse of Opponents of Health Insurance Coverage Expansion 61 2.3.1 The False Specter of Socialism 62 2.3.2 Unions and Corporations 66 2.4 Republicans Reject Social and Economic Rights: The Reagan Era and Beyond 67 2.5 Major Healthcare Reform Policy Milestones 70 2.6 American Exceptionalism: Why the US Did Not Guarantee Near-Universal Health Insurance Until the Patient Protection and Affordable Care Act 72 2.7 Conclusion 77 Notes 78 Chapter 3: Methodology and Theory: The Social Imaginary and its Moral Order 89 3.1 Aristotle’s Theory of Rhetoric: Appeals to Ethos, Pathos and Logos 89 3.2 Rhetoric Analysis in Practice: Mapping Rhetorical Strategies and Their Rhetorical Effects 91 3.3 Rhetorical Strategies 92 3.4 The Social Imaginary 94 3.5 Discourse and Hegemonic Constructions of the Social Imaginary 99 3.6 The Middle Class in the American Social Imaginary 106 3.7 Discourse: An Evolving Theory from Foucault to Fairclough 108 3.8 The Public Realm 112 3.9 Conclusion 116 Notes 117 Chapter 4: Harry Truman’s November 19, 1945 Address to Congress on Healthcare Reform 129 4.1 A First Attempt at Comprehensive National Health Insurance 129 4.2 Dimensions of Rhetoric 130 4.3 Post-Second World War Political and Historical Context 132 4.3.1 Truman’s Ethos in Context: An Era of Faith in Government Action 132 4.4 Speech Structure of the Special Message to Congress on Healthcare Reform 136 4.5 Rhetoric Analysis of Truman’s Special Message to Congress Concerning Healthcare Reform 137 4.5.1 The Ethos of Healthcare Reform: Strategies of Moralization and Historical Temporality to Defend Healthcare as a Right 137 4.6 Logos: Illustrating Deprivation with Data and Presenting Truman’s Healthcare Reforms 140 4.6.1 The Logos of Policy Expertise and Technical Excellence: Applying Rhetorical Strategies of Anticipatory and Defensive Rhetoric 143 4.6.2 Military Preparedness in Truman’s Logos: The Rhetorical Strategy of Linkage to Advance Social Solidarity 147 4.6.3 Public Health and the Rhetorical Strategy of Linking Individual and Collective Welfare: Transcending Class Division 149 4.7 Truman in a Comparative Perspective: The Uniqueness of His Rhetoric and the Place of the Poor Within It 153 4.8 Conclusion 154 Notes 156 Chapter 5: Lyndon Baines Johnson’s Remarks at the Signing of the Medicare Bill, July 30, 1965 and Related Speeches 160 5.1 Introduction 160 5.2 Government Programs of the War on Poverty and Great Society 162 5.3 Patriotism and Possibility: Moral Idealism in Johnson’s Social Imaginary and the Ethos of the Great Society 163 5.4 Healthcare Reform in the Great Society 167 5.5 Defending Positive Liberty and Championing the Disadvantaged in the Great Society 170 5.6 The Voting Rights Act and the Civil Rights Act 174 5.7 The Logos of the Great Society and the War on Poverty: Prioritizing Social Needs While Reducing Overall Government Spending 176 5.8 Rhetoric Analysis of Johnson’s Remarks with President Truman at the Signing of the Medicare/Medicaid Bill, July 30, 1965 179 5.8.1 Ethos and Pathos 179 5.8.2 Logos 183 5.9 Conclusion 184 Notes 186 Chapter 6: Bill Clinton’s September 22, 1993 Address on Healthcare Reform to Congress 193 6.1 Introduction and Political Context: Healthcare Reform as Limited Government Conservatism Is Hegemonic 193 6.2 The Working Class and Economically Disadvantaged: Increasing Invisibility 196 6.3 Clinton’s “Third Way” 198 6.4 Clinton’s Healthcare Reforms: Policy History and Causes of Reform Failure 199 6.5 Dimensions of Rhetoric 202 6.6 The Structure of the Speech 204 6.7 The Cardinal Principle of Clinton’s Speech that Incorporates Ethos, Pathos, and Logos: Security 205 6.8 Ethos and the Rhetorical Strategies of Historical Temporality and Moralization to Convey the Urgency of Change 207 6.9 A Counterpoint to Values of Equality of Opportunity and Solidarity: Rhetoric of Neutral Change and Economic Efficiency 210 6.10 Pathos in Support of Ethos: The Strategy of Personalization 212 6.10.1 Pathos and Bipartisanship 215 6.11 Logos: Problems and Principles 216 6.11.1 Logos and the Rhetorical Strategy of Personalization 217 6.11.2 Logos and the Rhetorical Strategy of Appropriating Conservative Values and Anticipatory and Defensive Rhetoric to Convey Moderation: Clinton’s “Third Way” 220 6.11.3 How High Healthcare Costs Harm Other Government Expenditure 223 6.12 Conclusion 225 Notes 227 chapter 7: Barack Obama’s September 9, 2009 Healthcare Speech to Congress 232 7.1 Introduction 232 7.2 Dimensions of Rhetoric 234 7.3 Political Context 236 7.4 Speech Structure: Overview 237 7.5 The Logos of Healthcare Reform: Protecting the “Middle Class” and Promoting the Principle of Universality 240 7.5.1 Logos: Conveying Concern for the Middle Class with Strategies of Moralizing/Moral Muting and Historical Temporality 244 7.5.2 Logos: Conveying Moderation through Strategies of Anticipatory and Defensive Rhetoric and Appropriation of Conservatism 248 7.6 Ethos: Communicating Conciliation through Moral Muting and Conveying Leadership and Integrity by Moralizing 250 7.6.1 Ethos: Constructing Social Solidarity Through Rhetorical Strategies of Appropriation, Anticipatory and Defensive Rhetoric, and Historical Temporality 252 7.6.2 Affirming Ethos Through Pathos with Rhetorical Strategies of Personalization with Moralization/Moral Muting 255 7.6.3 An Implied Rather than Explicit Ethos 259 7.7 Conclusion 260 Notes 263 Chapter 8: Conclusion 269 8.1 How Liberal Arguments for Healthcare Expansion Have Evolved from Truman to Obama and the Patient Protection and Affordable Care Act: Rhetorical and Policy Battles Now and in the Future 269 8.2 How Contemporary Healthcare Reform Rhetoric Reflects Historical Healthcare Reform Rhetoric 273 8.3 Ethos/Pathos/Logos in the Presidential Rhetorics 275 8.4 Healthcare Reform in the Future 277 8.5 Current Challenges to the Affordable Care Act 279 8.6 Healthcare Reform Successes and Significance 283 Notes 285 Bibliography 292 Index 318 Front Matter....Pages i-xviii Introduction....Pages 1-34 History of American Liberal and Conservative Healthcare Rhetoric and Public Policy....Pages 35-69 Methodology and Theory: The Social Imaginary and its Moral Order....Pages 71-110 Harry Truman’s November 19, 1945 Address to Congress on Healthcare Reform....Pages 111-141 Lyndon Baines Johnson’s Remarks at the Signing of the Medicare Bill, July 30, 1965 and Related Speeches....Pages 143-175 Bill Clinton’s September 22, 1993 Address on Healthcare Reform to Congress....Pages 177-215 Barack Obama’s September 9, 2009 Healthcare Speech to Congress....Pages 217-253 Conclusion....Pages 255-277 Back Matter....Pages 279-313