Tuesday, October 27, 2009


Yesterday, the Senate Majority Leader announced a compromise health insurance bill, which will go before the full Senate. To the relief of many, the bill contains provisions for a public insurance agency to compete with private insurers. The details of the public option to come are important, of course, but what I want to know is: What's it going to be called?

The government has a rocky history with names. The three existing federal health insurance plans are good examples. "SCHIP", the most recent, is also the most clunky. "State Children's Health Insurance Program" is certainly descriptive, but it telescopes into an acronym nobody knows how to pronounce. Is it s-chip? Ship? Skip? Wikipedia doesn't even venture a guess.

"Medicare" is just dumb. Is it supposed to be short for "Medical Care"? Of the various concepts involved in the Medicare program, retirees and insurance didn't make the cut, ousted by a smash-up of two words that express one concept between them.

"Medicaid," by constrast is a rare success. In parallel with "Aid to Families with Dependent Children," Medicaid expresses the notion of medical aid, to the poor being strongly implied.

Other government programs are seldom better. Some are illiterate acronyms, like the DEA, which stands for "Drug Enforcement Agency." Others are even worse, like "Social Security," a name so vague it could literally be applied to any government program with equal plausibility.

Legislators are seldom careful, but in this case I think they should take a moment to select an appropriate name for their baby. The government, and a few key legislators in particular, have the power to control the words that hundreds of millions of people use. Every psychotic on the street has the CIA on his lips. The fact that our mental wards aren't full of people raving about the OSS is an accident of nomenclature. Except for the IRS, the post office and the voting booth, most of us have very little tangible interaction with our government. Conservatives are afraid that the government will exert control over our everyday lives, but as it stands, only 10% of Americans will even be allowed to buy into the public option. What will it be to the rest of us? Just a name.


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