Stop Talking About Health Care, Start Talking About People

Movements for progressive change consistently succeed when they begin and end with people, not things.

The success of the American Civil Rights Movement, for example, was largely a response to TV images of real people. Most people had no clue about the finer points of the legislation; they just wanted to stop innocent people from getting hurt. Mothers Against Drunk Driving was not about legal blood-alcohol limits and breathalyzers; it was about saving loved ones’ lives. Support for gay marriage grew swiftly when the conversation moved from an issue about equal rights to the highly personal message of love and commitment.

Conversely, consider decades of interventions—all aimed squarely at things, not people—where no matter what we try, nothing seems to work:

• The war on drugs (vs. helping people be whole and healthy)
• The war on poverty (vs. helping people reach their potential)
• The war on terror (vs. alleviating the suffering that motivates people to blow up themselves and others

Criminal justice system reform. Abolishing the death penalty. Gun control. Neither the names we bestow on these conversations, nor the conversations themselves, focus on people. Instead, we talk about things—mandatory sentencing, waiting periods, gun safety.

The health care conversation in the United States has followed that same pattern:

• Health care (vs. people being healthy, well, and happy)
• Pre-existing conditions (vs. people being sick and suffering)
• Single-payer (vs. people being able to afford the basic necessities of life)
• Medicaid (vs. people who have lost their life savings to take care of a loved one, ending up destitute with no health care for themselves)
• Insurance companies (vs. the people who get to decide what care my mother can have)

If we really want to make life better for people, where are the people in these conversations? Conversations that create real change aren’t about systems or money; they are about what people really want.

I want to be healthy. I want to know that if I am sick, I will be cared for with love, compassion, and wisdom so that I can once again live a healthy, vital life. I want the same for the people I love. And I don’t want to have to fight for that when I’m at my weakest or sickest.

To win hearts and minds—and votes—we must shift our national conversation to these basic conversations about people. 

Language and the brain

I want to be healthy. I want to know that if I am sick, I will be cared for with love, compassion, and wisdom so that I can once again live a healthy, vital life.

It is no coincidence that the successful campaigns for marriage equality and stiffer drunk driving laws seemed to happen overnight. Those people-focused approaches are rooted in the wiring of the human brain.

The brain’s first job is to keep us alive. Reactive brain functions like fear and empathy, for example, protect us as individuals and as a species. Neuroscientists have found that the brain’s centers for reason and creativity respond more slowly than these hard-wired survival reflexes.

Because those survival functions are similar in all of us, most of us tend to agree that we want people to be healthy and safe, free from danger, living as joyfully as possible. And because the more analytical and creative parts of the brain vary widely from person to person, we are more likely to disagree about how to accomplish those end results.

In language terms, we tend to agree on the “why” of human safety and health. Conversations focused on people get to the heart of that “why.” Conversely, we all tend to have our own unique ideas about “how.” Conversations about things are almost always about “how.” As a result, the words we choose determine whether a conversation begins where we all agree, or sets us up to disagree from the start.

It is also important to understand how the human brain processes the words we hear. To maximize efficiency in handling so many complex operations simultaneously, our brains regularly use shortcuts, such that a single word or image can represent a complex chain of thoughts and emotions. That is why, for example, the mere mention of the name of a politician can elicit instant appreciation or rage. In our brain’s shortcut, that one name represents every thought and emotion we have about that person.

Combine our hard-wired empathy and fears with our brains’ system of creating shortcuts, and we see that it makes sense to choose language that intentionally creates an empathetic shortcut. And because we are also wired to disagree about the “how,” it makes sense to avoid language that divides us—the “how” language of “things.”

The power of people: naming the conversation

What we name a conversation can evoke empathy and connection, and generate a starting point of emotional agreement—or not.

A name might suggest that we all want a country where every person is as healthy as possible—whether that goal is based on your own personal health, compassion for others, or business productivity. Or a name might suggest that we all want a country where your sickness doesn’t make me sick. The reason we have community firefighters, for example, is because a fire at your house could quickly become a fire at my house. Just like we don’t want fire to spread and wipe out our whole neighborhood, we want to protect our families and our employees from the flu or measles. We want to protect our neighborhoods from the increase in crime that so often correlates with addiction to alcohol or drugs.

Imagine the difference if we called “health care reform” the Healthy Americans Act, or the Healthy Families Healthy Neighbors Act, or the People’s Health Protection Act. Imagine the power of a title that loudly proclaims, “This is about you. It is about how you will stay healthy, and what will happen to you if you get sick.”

The power of people: inside the conversation

By changing the substance of our conversations at dinner tables across the country and in the US Congress, we have the power to change our focus from issues to situations, from things to people, from jargon to the real-life language we all speak—to the health of people.

By changing the substance of our conversations, we have the power to change our focus from issues to situations, from things to people, from jargon to the real-life language we all speak.

In our real lives, health isn’t an issue; it’s a situation. Issues are theoretical constructs, and there is nothing theoretical about the situations we Americans face when it comes to our health. In our real lives, we don’t have debates about health; we lament, we tell stories, we have emotional, meaningful, heartfelt conversations.

When conversations around “health care” arise, therefore, we have the power to use words that describe what life looks like in the day-to-day. We can stop using the insurance company jargon of “pre-existing conditions,” and talk instead about what I have to do to get care for my daughter, who was diagnosed with an auto-immune disease at age 15 and who at age 30 can’t get treatment because her insurance won’t cover the one thing she needs to stay alive and healthy. Each of us can make that conversation personal because health is personal.

We also have the power to use words that describe what the economics feel like in the day-to-day. Policy people talk in annualized expenses and percentages. But real people don’t pay bills annually. Nor do we keep running pie charts in our heads of what percent goes to what. Real people pay their bills monthly. Most of us could rattle off by memory our mortgage or rent costs, our food costs, our utility bills. Most of us know instantly whether our income each month will cover that. And many of us know what it feels like to be worried, not annually but monthly. What will it cost monthly if we go to the “everyone is healthy” plan vs. the “you better not get sick” plan? That’s what it means to use language that describes what economics feel like. And we all have the power to change that conversation.

The more we use the language of real people in every aspect of our conversations, the faster minds will begin to focus on what we all agree on: Everyone should be healthy.

We also have the power to remember what real conversations sound like in the day-to-day, mindfully eschewing jargon in favor of real words. When policy people want to make the case that Americans do not have “the greatest health care on the planet,” they talk about theoretical issues in annualized percentages, such as “infant mortality rates.” Imagine instead hearing this talking point on cable or in congressional debates: “More babies die before their first birthday in the United States than any other developed nation. That could be your baby. It could be your grandbaby. Is it OK with you that a baby is more likely to survive in Italy than in the United States?”

What we will find is what has happened throughout history: The more we use the language of real people in every aspect of our conversations, the faster minds will change to that thing we all agree on—that we want everyone to be healthy.

The power of people: having the conversation

The last aspect of conversation that has historically created progressive change all around the world is making sure to have conversations—real conversations with real people. Politicians and policy wonks attend meetings to discuss issues. Real people make their decisions in small conversations with people they care about and trust. Those decisions then influence the actions they take, from the decision of who to vote for to decisions to take a more activist role.

If we want to change hearts and minds regarding people having access to quality health care, it’s time to take a page from Community Organizing 101. Meet in settings people trust—places of worship, people’s living rooms. Especially in a time of so much misinformation, the more the information comes from people they trust, the more people will be messengers in their own circles. Rallies and town hall meetings are great for many reasons, but they cannot replace the power of small groups gathering with compadres who have the same problems, worries, goals, and dreams.

Which leads to another place we need to be connecting as people—calls to congressional offices. Even the people in that inner sanctum split duties between people and things. If you call to register your position on an issue, it goes to legislative staff (legislation = a thing). If you have a problem with the Internal Revenue Service or the Department of Veteran Affairs, you talk with constituent staff (constituent = a person). And in every Congressional and Senate office, regardless of political party, there is someone in charge of constituent services—helping real people facing real problems.

The action that makes sense is therefore to make two calls to legislators. The first will register your position on the issue. The second call will be the people call—a call to your elected officials’ local offices, where you can ask for help, connecting in real human language, telling your personal story:

“I have a heart problem, and I can’t afford my medication. Can you help me?”

“My daughter has bipolar disease, and I’m afraid she won’t be able to get her medications under the new plan. Can you help me?”

“My wife was just diagnosed with Parkinson’s disease. If we have to change plans, we won’t be able to afford her treatment. Can you help me?”

Just like representatives count the numbers of calls about an issue, they pay attention to the number of people calling about problems they’re having with government agencies.

The bottom line is that we the people can make a difference in the fight to ensure that every person in the United States is as healthy as possible. It will take a conversation that has people in its title, is about people, and involves real people talking to each other. Because that is how progressive change has always happened.

Read more stories by Hildy Gottlieb.