Wednesday, February 9, 2011

In Loving Memory of a Name

Jonathan Cohn has a nice short item today about the name of the health care reform signed into law last March: is "Obamacare" a good word for it? Jonathan Chait chimes in and points out that since Barack Obama is actually fairly popular that it's not exactly the slur some conservatives believe it is. I use "ACA" because I think it's the most neutral version, although I suppose "PPACA" is technically more accurate (Chait advocates it for that reason), but I find it uglier. Kevin Drum complains about Democratic ineptness:
The real problem here is that Democrats, once again, failed Legislation 101. This was their bill. They could name it anything they wanted. So what did they choose? PPACA. That's very memorable, isn't it? What's wrong with these guys?
I suppose, although "Affordable Care Act" isn't bad, is it?

Personally, I think it's very unlikely that the names of these things matter at all to their long-term popularity, not even a tiny bit: Pell Grants and IRAs and Medicare and the Interstate Highway System wind up succeeding if people wind up using them and liking them. So, if that's the case, you might as well go for the extraordinarily small portion of the electorate that has an aversion to blatant, obvious, ugly propaganda. My guess is that they're more likely to be Dems anyway, and those who love good branding and slick advertising for their own sake are more likely to be Republican-leaning.

More to the point, the bill itself is going to be forgotten; assuming it takes effect as planned, what's really going to matter are names of the various elements of it that individuals interact with. That is -- remember, ACA (or Obamacare or PPACA or Affordable Care Act of Patient Protection and Affordable Care Ac) isn't actually a single program; it's an omnibus bill containing various different elements that really are not directly related. For example, the CLASS act already has a name, but it's part of ACA.

Does the law actually give a name to the exchanges? That's where (I think) the real naming action will be. Perhaps the states can just sell naming rights to the exchanges. I suppose you couldn't let insurance plans buy it, but what about medical devices, or local hospitals?


  1. Many official terms come from coinages that were once pejorative.

    The classic example is the Big Bang Theory. This one was coined by the astronomer Fred Hoyle, the theory's leading opponent. Hoyle denied he ever intended the term to be pejorative, but most scientists consider it inaccurate: the "Big Bang" was neither big, nor a bang. In 1993, Sky and Telescope magazine sponsored a contest to rename the theory, but none of the entries caught on. "Big Bang" is just too catchy, too memorable, and, above all, too entrenched by now. The same is probably true of "Obamacare."

    I agree with Drum that the Democrats could have preempted this problem by coming up with a memorable title of their own. Among other possibilities they could have created a meaningful acronym along the lines of PATRIOT or DREAM, and that may have eclipsed any attempt to tag it as "Obamacare." Conservatives can talk about the NIGHTMARE act all they want, but the Dems clearly got the upper hand in that naming battle.

    I agree with all those who have suggested the name doesn't matter a whole lot in the long run. Conservatives began this "so-and-so-care" business in the 1990s with "Hillarycare," and it was a part of an attempt--a successful one, as it turned out--to stop the bill before it came to the table. But now that one of these "cares" has actually passed, what do they do now? Correct me if I'm wrong, but I don't think I've ever heard of a major historical bill being named for the president who passed it. And now it will happen courtesy of the bill's opponents. Even if the bill itself fades for the reasons you mentioned--it isn't a single program but a collection of different policies--the name "Obamacare" all by itself probably ensures that Obama's name hangs around for a while longer in the history textbooks than, say, Chester Arthur's. You really think that's what Republicans intended?

  2. Kylopod nails it. 'Obamacare' stands a decent chance of becoming the established generic name for the whole bundle, and remaining common usage for decades.

  3. Interesting piece and thorough comments. It may be that in the long run the naming doesn't matter, but can't you say that about anything (along with the Keynes, how in the long run we're all dead). Now it may be that the naming is somewhat on the margins but so is the battle over it. Put it another way, does the name "Patriot Act" matter much? If it had been called the "Internal Surveillance to make sure we're safe," might that have made it even more of an anathema to a libertarian, some of whom are speaking up now. However one of the keys here is the difference between Democratic constituencies and Republican ones. For whatever reason, appearing to be robust and on the side of the US in your naming just makes it harder to criticize (except by those, a small minority who dislike the patriotic, America is great rhetoric). Repubs won't like it anyway but making it harder to demagogue coukd make a significant difference. And given the extent to which the legislation was demagogued, if the Dems had been able to both name it robust and patriotic (The Save our great country from the upcoming Health Care Disaster bankrupcy and make sure that all god-fearing and non-god fearing, American Patriots health care availability Act."). I know its way too long but I don't believe that if every Democrat running in 2010 had a name that self-identified the parts of the legislation that are hard to criticize that some would have been so uncomfortable talking about it, public discussions would in many cases have a different tone, and at a minimum a criticism of it would have some negative consequences right off the bat like criticising the Patriot Act can feel unpatriotic.

    Finally, as I mentioned earlier, given that the public seems fairly evenly split on the new law (up and down and up...), the margins matter alot. That's to say a few extra positive points might have made it harder for Repubs to insist that a majority is opposed and if it ever could have gotten to 60% pro the Repub governors might all be focusing upon implementation instead of so many of them on repeal.

  4. I don't like either "Affordable Care Act" or its abbreviated form, "ACA." "ACA," let alone "PPACA," sounds too bureaucratic. "Affordable Care Act" sounds propagandist. I mean, it's not as galling as "Repealing the Job-Killing Health Care Law Act," but it still sounds like a name chosen as a posturing move, and I don't like it.

    I just like to call it "Health Care Reform," since that's what it's supposed to do. I like "Obamacare" too... I think it was originally meant to be derogatory, but it's caught on with neutral observers and supporters because it's so catchy.


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