Schimmel, Noam
(2013)
Presidential rhetoric justifying healthcare reform: continuity, change & the contested American moral order and social imaginary from Truman to Obama.
PhD thesis, London School of Economics and Political Science.
Abstract
The original contribution to knowledge of my thesis is a comparative historical analysis of the rhetoric used by four Democratic presidents to expand access to and affordability of healthcare.
Specifically, the thesis situates Democratic presidential healthcare reform rhetoric in relation to opposing conservative Republican ideologies of limited government and prioritization of negative liberty and their increasing prominence in the post-Reagan era. It examines how the American moral order and social imaginary has evolved and how Democratic presidential healthcare reform rhetoric was both informed by and responded to it.
I employ Aristotle’s tripartite categories of ethos, pathos and logos to undertake rhetorical analysis. I illuminate how each president sought to persuade audiences, what rhetorical strategies they used and how they justified their healthcare reform efforts. I pay particular attention to the compromises entailed by the usage of specific strategies and their rhetorical effects.
The thesis illustrates how Presidents Harry Truman and Lyndon Baines Johnson contextualized healthcare reform within their broader efforts to secure positive liberty and social and economic rights in the Fair Deal and Great Society, respectively. This is in contrast to Presidents Bill Clinton and Barack Obama who did not advance a comprehensive vision of government guaranteed positive liberty and citizen welfare. Rather, they made arguments for healthcare reform based on pragmatism and economic efficiency and appropriated tropes of conservative rhetoric such as efficiency to critique market failure. They showed deference to the conservative principle of maximizing the role of the private sector in healthcare provision.
There is a marked contrast between Truman and Johnson’s explicit expressions of care for economically disadvantaged and working class Americans and Clinton and Obama’s rhetorical elision of these populations, and their focus on the ‘middle class.’ Despite these substantive differences a major continuity in the rhetoric is an enduring appeal to communitarian solidarity.
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