Reframing the Debate on Health Care Reform by Replacing Our Metaphors

The traditional metaphor of American medicine, the military metaphor, was displaced by the market metaphor in public discourse and led Congress to defer to market forces to “reform” the financing of health insurance in the United States.

Abstract

Metaphors matter, as our sterile debate on the fi-nancing of health insurance demonstrates so well. In that debate the traditional metaphor of American medicine, the military metaphor, was displaced by the market metaphor in public discourse. Metaphors, which entice us to understand and experience “one kind of thing in terms of another . . . play a central role in the construction of social and political reality.”1 The market metaphor proved virtually irresistible in the public arena and led Congress to defer to market forces to “reform” the financing of health insurance in the United States.We live in a . . .