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Socialized Medicine in Letters to the Editor: an Analysis of Liberal and Conservative

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Socialized Medicine in Letters to the Editor: an Analysis of Liberal and Conservative Socialized Medicine in Letters to the Editor: An Analysis of Liberal and Conservative Moral Frames A dissertation presented to the faculty of the Scripps College of Communication of Ohio University In partial fulfillment of the requirements for the degree Doctor of Philosophy Margaret A. Romoser May 2014 © 2014 Margaret A. Romoser. All Rights Reserved. This dissertation titled Socialized Medicine in Letters to the Editor: An Analysis of Liberal and Conservative Moral Frames by MARGARET A. ROMOSER has been approved for the School of Communication Studies and the Scripps College of Communication by Jerry L. Miller Associate Professor of Communication Studies Scott Titsworth Dean, Scripps College of Communication ii ABSTRACT ROMOSER, MARGARET A., Ph.D., May 2014, Communication Studies Socialized Medicine in Letters to the Editor: An Analysis of Liberal and Conservative Moral Frames Director of Dissertation: Jerry L. Miller In an attempt to unravel the reasons behind the political contentiousness and persistence of the term socialized medicine in discussions of health care reforms, I explored the term’s origins and history, frequency in news items, and meanings in contexts. In the following, I present frequency distributions that illustrate the initial emergence of the term socialized medicine in a newspaper article in 1917 and document its continued presence through 2010. I also present the results of a content analysis pilot study of the term in a sample of newspaper articles from 1993 through 2008, which guided my decision to select letters to the editor as the text for analysis in the framing study that follows. I selected letters to the editor written by ordinary citizens from 1993- 2010 that include the term socialized medicine in the headline or lead paragraph, and since attitudes about socialized medicine appear to break along political party lines, I evaluated the letters through the lens of George Lakoff’s model of conservative and liberal worldviews as described in his book, Moral Politics: How Liberals and Conservatives Think, first published in 1996 and again in 2001. My analysis reveals common liberal and conservative frames that emerged in 1993 and 1994, during the Clinton presidency, and which continued through 2010. My analysis also indicates an increase in the occurrence of pragmatist frames regarding health care reforms, especially iii during and following the 2008 presidential campaign. This study provides support for Lakoff’s theory, and illustrates its potential heuristic value for communication research, particularly in the area of political communication. iv DEDICATION This work is dedicated to my husband, William, our daughters and sons-in-law, my mother, sisters and nieces, and many loving friends for inspiration, cooperation, support, and encouragement throughout this process. v ACKNOWLEDGMENTS I would like to express my sincere gratitude to my advisor, Dr. Jerry L. Miller, for his unwavering support and encouragement throughout this project. I would also like to thank the members of my doctoral committee, Prof. Austin Babrow, Prof. Judith Yaross Lee, Prof. Raymie McKerrow for their guidance, patience and encouragement, and Prof. Mario Grijalva of the Ohio University Department of Biomedical Science for serving as the Graduate Faculty Representative on my committee. Additionally I am indebted to husband for his ever-present faith and encouragement as well as years of practical, hands-on support at home that freed my time and mind. I owe a debt of gratitude to my son-in-law, Christopher Lee Vogel, for transforming my data into attractive and informative figures that fit within the boundaries of a single page. Similarly, I owe a debt of gratitude to several colleagues in Communication Studies: Heather Stassen and Anne Gerbensky-Kerber diligently coded hundreds of articles for the content analysis pilot included in this study; Katie Striley and Laura Russell labored with me to interpret the framing pilot. I also want to thank the participants in the framing pilot: William Romoser, Regan E. Welch, Kelley I. Vogel, Frances J. Meeker, Barabara J. Hores, Roberta Ciszewski, Mary Anne and Roland Swardson, Holly Korn, Gilbert Patt, Lindsay Rose and Shannon Lawson. The vast resources of Ohio University’s Alden Library were made accessible to me through the generous expertise of Communication Librarian, Jessica Hagman. vi Lastly, I am indebted to the School of Communication Studies at Ohio University for the welcoming, intellectually stimulating, supportive environment that faculty, staff and students in COMS value, foster and have shared with me during the last seven years. vii TABLE OF CONTENTS Page Abstract ......................................................................................................................... iii Dedication .......................................................................................................................v Acknowledgments ......................................................................................................... vi List of Tables...................................................................................................................x List of Figures ............................................................................................................... xi Introduction .....................................................................................................................1 Chapter 1: History of Socialized Medicine 1870s - 2008 ..................................................8 Chapter 2: Frequency Distributions, Content Analysis Pilot, Text Selection................... 20 Chapter 3: Frame Analysis, Framing Pilot, and Metaphorical Analysis .......................... 46 Chapter 4: 1993…………………………………………………………………………..8 Chapter 5: 1994…………………………………………………………………………121 Chapter 6: 1995-2000…………………………………………………………………..158 Chapter 7: 2001-2006…………………………………………………………………..203 Chapter 8: 2007-2008…………………………………………………………………..247 Chapter 9: 2009-2010…………………………………………………………………..284 Chapter 10: Framing Socialized Medicine: 1993-2010………………………………...340 Works Cited ................................................................................................................ 376 Appendix A: Harvard School of Public Health Poll Data ............................................. 392 Appendix B: Content Analysis Pilot……………………………………………………398 viii Appendix C: Framing Pilot……………………………………………………………..447 Appendix D: Categories of Moral Action with Metaphors and Entailments…………...462 Appendix E: Stages of Harry and Louise Campaign…………………………………...469 Appendix F: List of Letters Quoted…………………………………………………….471 ix LIST OF TABLES Page Table 1: George Lakoff’s Metaphors of Morality ........................................................ 74 Table 2: Political Persuasion in Letters to the Editor in 1993 ...................................... 85 Table 3: Political Persuasion in Letters to the Editor in 1994 ................................... 122 Table 4: Political Persuasion in Letters to the Editor in 1995-2000 ........................... 159 Table 5: Political Persuasion in Letters to the Editor in 2001-2006 ........................... 204 Table 6: Political Persuasion in Letters to the Editor in 2007-2008 ........................... 248 Table 7: Political Persuasion in Letters to the Editor in 2009-2010 ........................... 285 x LIST OF FIGURES Page Figure 1: Mentions of Socialized Medicine in American Newspapers 1991-2010 ....... 22 Figure 2: Mentions of Socialized Medicine by Presidential Term 1901-2010 .............. 24 Figure 3: Health Policy and Program Coverage in Content Analysis Pilot ................... 30 Figure 4: Issues Related to Health Policy and Program Coverage in Content Analysis Pilot ............................................................................................................................ 32 Figure 5: Values Mentioned in Content Analysis Pilot ............................................... 33 Figure 6: Section of the Newspaper in Which Articles Were Published in Content Analysis Pilot ............................................................................................................. 34 Figure 7: Person or Persons Cited in Content Analysis Pilot ....................................... 36 Figure 8: Documents Cited or Referenced in Content Analysis Pilot ........................... 38 Figure 9: Argumentation Methods Used in Content Analysis Pilot .............................. 39 Figure 10: Types of Support for Arguments in Content Analysis Pilot ........................ 40 Figure 11: Audiences Specified, Called to Action, Praised or Blamed in Content Analysis Pilot ............................................................................................................................ 41 Figure 12: Paul D’Angelo’s Three-Step Model of Frame Construction ....................... 55 Figure 13: Illustration of George Lakoff’s Liberal and Conservative Family Models .. 76 Figure 14: George Lakoff’s Moral Action Categories ................................................. 86 Figure 15a: Conservative Frames in 1993 ................................................................. 118 Figure 15b: Pragmatic Frames in 1993 ...................................................................... 119 Figure 15c: Liberal Frames in 1993 .......................................................................... 119 xi Figure 16a: Conservative Frames in 1993-1994 .......................................................
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