On the Cultural Foundations for Universal Healthcare: Implications From Late 20th-Century U.S. and Canadian Health-Related Discourse

Abstract

Social constructionists approach framing as a process of “sense‐making” within which elites and journalists strive to produce content that resonates with their audiences. From this perspective, long‐term stability in media content may be viewed as due to cultural limitations on authors' framing efforts. This article provides evidence that Canadians' consistent framing of health‐related matters in terms of their common welfare was likely more a recalcitrant cause than a passive response to changes between 1965 and 1999 in their means of healthcare provision. In contrast, concomitant U.S. health‐related framing alternated among economic, welfare, and other frames, leaving citizens to consider policy proposals more in terms of “why” than “how” they do or do not make sense.

On the social construction of democracy: Modal rhetoric in former East & West German journalists’ post-reunification editorials

“…discourse on ‘why’, not ‘how’) the grist of political rhetoric among interest groups identified with their respective frames. Roberts and Liu (2014) provide evidence for both these dynamics in a historical-comparative study of modal arguments (i.e. reality claims plus associated frames) in two Western democracies’ editorials on health-related topics: Against a background of Canadian civil-law versus US common-law in healthcare legislation, Canadian editorialists’ modal arguments were found to exhibit much greater frame consensus than did those authored by US editorialists.…”

Political rhetoric in the Hungarian press during the communist regime

“…In contrast to the predominance of inevitability claims within welfare-justified modal arguments made in social democracies’ editorials on national matters (cf. Roberts and Liu, 2014), our pre-1989 Hungarian editorials have less than 9 percent of modal arguments’ rationales referencing the Hungarian people’s welfare – possibly as part of a strategy to keep Hungarians’ well-being from officially becoming a topic of debate. Instead, the most frequently mentioned rationales were (less controversial) justifications based on Hungarians’ culture (e.g.…”

“…Finally, it should be noted that modality analysis is a text analysis methodology that lends itself to historical-comparative research beyond the Hungarian case. The method has already been applied in studies comparing health-care discourse in the United States and Canada (Roberts and Liu, 2014), political communications by former East versus West German journalists (Roberts et al, 2016), reports of domestic terrorism in the United States and Japan (Roberts and Wang, 2010), editorials published in India and Saudi Arabia (Roberts et al, 2010), as well as in Népszabadság between 1990 and 1997 (Roberts et al, 2009). As further extension of this study, its modality analysis might be replicated in present-day Hungary (or in other Central East European or Western states) to study, for example, changes in modal argumentation associated with recent increases there in nationalism and populism in the public sphere.…”

“…Rationales associated with each modal statement were classified based on categories developed in Popping and Roberts (2009) and that have been recurrently found in studies on how national news is framed (De Vreese, 2005; De Vreese et al, 2001; Neuman et al, 1992; Price et al, 1997; Roberts and Liu, 2014; Semetko and Valkenburg, 2000; Zillmann et al, 2004). In sum, each modal argument was encoded in accordance with the following ‘readable’ template…”

“…On the other hand, evidence of an expanding ‘modality of necessity’ (aka necessity rhetoric) was found in increasingly frequent mentions of political reasons for Hungarians’ inevitabilities (or necessities). Given that the latter trajectory is steeper than the former, the authors conclude that as late as 1997 Hungarian political discourse was heading more toward a modality of necessity (like the predominant political modality in Western Europe) than the achievement modality that is more prominent in US political discourse (Roberts and Liu, 2014).…”