"If this health care plan is the greatest thing ever, why are Democrats so offended when you call it 'Obamacare'?" asked Joe Scarborough a few weeks ago on MSNBC's "Morning Joe," describing a rendezvous with a Democrat angry at his use of the word.
"Because you got 'Obama,'" he continued. "They like that word. And you got 'care.' Care is a good word. And you put them together and suddenly it's a vulgarity."
Scarborough's interest in the precise implications of the term "Obamacare" is important, but his rather rudimentary unpacking of the term doesn't do the topic justice. While he's right that "Obamacare" is a phrase that's not so neutral, its meaning is far from straightforward. Since coming into use during the 2008 presidential contest -- the earliest use I can find was in the Washington Times on Oct. 26 of that year -- it has come to operate as much more than just a synonym for the unwieldy to title of a health-care bill, the "Patient Protection and Affordable Care Act."
As its early use by the right of center Times makes plain, newspapers and organizations that use the term run conservative; notice the Wall Street Journal has an online "Guide to ObamaCare: A comprehensive collection of our editorials and op-eds." Furthermore, the term often is used as a negative reference to the entire program of the Obama administration, making "Obamacare" more a partisan battlefield than an abbreviation for the president's health-care policy.
"Obamacare" as a term derives from "Hillarycare," again a construct of anti-Democrat forces -- in this case those opposed to President Clinton's attempts at health-care reform in the early 1990s, spearheaded by the first lady. It was a similarly loaded term; Paul Starr, a senior health policy advisor during the Clinton administration, argued that the rhetoric of "Hillarycare" was "partly the result of right-wing misrepresentations of the plan as a 'government takeover' and malicious personal attacks on Hillary."
The rise of "Obamacare" represents the return of a handy catch-all phrase for government interference. Bill Kenyon, Political Director at Fred Davis' Republican Strategic Perception polling company, told me that the term has come to "encapsulate the unease with the government and the idea that we're trying to go too far, too fast. And it never stops, and just keeps coming." Fred Davis concurs, e-mailing that his company has used the term in advertisements because the "connotation of the name is powerful. That he pressed forward with his liberal ideals even though the majority of the country clearly disagreed."
Indeed, says Scott Gottlieb, a fellow at the American Enterprise Institute who uses the term in articles for the Wall Street Journal, "Obamacare" is simply an "easy, one-word way to refer to the totality of Obama's proposals." While he admits that it has attracted negative connotations, he thinks they are "being oversensitive."
The repeated references to "Obamacare" by Republicans have certainly had an effect on voters' opinions of the new health-care law.
Republican polling company Public Opinion Strategies (POS) found that in September 2010, 49 percent of registered voters reacted negatively to the term, compared to 29 percent who saw it favorably. That figure is made more illuminating when considered along with another poll a month later. That poll found that when voters were asked whether they support or oppose health-care reform -- the seemingly more "neutral" term, though some news outlets call it the "health-care overhaul" in the interests of pure neutrality -- the numbers were 45 percent in favor and 49 against. The term "Obamacare" would seem to dramatically decrease positive reactions to the health-care law. And a full 89 percent of voters recognized the word, according to the POS survey.