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Obama and the Dems Just Sound Too Wonky on Health Care

Barack Obama ran the best-framed presidential campaign in history. How is it possible that he and his team are communicating so poorly on health care?

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The source of these political disasters lies in an unlikely place: our most common understanding of reason itself.

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 17 th 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.

The Bi-conceptual Audience

A property of brains called “mutual inhibition” permits people to have contradictory worldviews and go back and forth between them.  Many people have both progressive and conservative worldviews, but on different issues — perhaps conservative on financial issues and progressive on social issues. Such people are called bi-conceptuals. President Obama understands this. He has said that his “bipartisanship” means finding Republicans who happen to share his progressive views on particular issues, and working with them on those issues—and not accepting an ideology (radical conservatism) rejected by the American people.

The people the President has to convince are the millions of bi-conceptuals. That means he has to have them thinking of health care in progressive moral terms, not conservative moral terms.  How can this be accomplished?

Why Do the Nature of Reason and Language Matter?

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