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5 Rhetoric Analysis of Truman’s Special Message to Congress Concerning Healthcare Reform

5 Rhetoric Analysis of Truman’s Special Message to Congress Concerning Healthcare Reform

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right to healthcare irrespective of economic means and to freedom from

fear of impoverishment due to illness, and it is the government’s obligation to guarantee these rights:

In my message to the Congress of September 6, 1945, there were enumerated in a proposed Economic Bill of Rights certain rights which ought to be

assured to every American citizen. One of them was: “The right to adequate

medical care and the opportunity to achieve and enjoy good health.” Another

was the “right to adequate protection from the economic fears of sickness.”21

After reaffirming these two principles, Truman illustrates the gap between

these rights and the current American social reality, creating a sense of

urgency and linking the ethos of rights with the logos of his healthcare

reforms, and arguing for healthcare reform on the basis of the ethical principle of equal opportunity:

Millions of our citizens do not now have a full measure of opportunity to

achieve and enjoy good health. Millions do not now have protection or

security against the economic effects of sickness. The time has arrived for

action to help them attain that opportunity and that protection.22

Truman’s emphasis on “security against the economic effects of sickness”

is significant because by framing the argument for universal health insurance in this way, he builds upon an already widely accepted ethos and

history of legislation passed by Roosevelt and embeds universal health

insurance within the larger ethical argument about economic rights, social

security, and the struggle to defeat poverty he earlier presented in other

speeches, including in his 21 points. This reflects the rhetorical strategy of

historical temporality. Thus, while he begins the speech with an affirmation of the specific right to healthcare, he simultaneously notes that this

right is part of a larger collection of economic rights which together form

a liberal social imaginary and moral order of expansive, activist government actualizing citizen welfare and thus positive liberty.

Truman affirms the ethos of his speech by succinctly establishing its

normative parameters with an impassioned series of staccato denunciations of deprivation of healthcare across the nation, reflecting the strategy

of moralization:

No area in the Nation should continue to be without the services of a fulltime health officer and other essential personnel. No area should be without



essential public health services or sanitation facilities. No area should be

without community health services such as maternal and child health care.23

The normative thrust of his argument on the basis of equality and government responsibility for the welfare of all citizens alike is interwoven

throughout the speech. It appears again in the speech’s conclusion, where

Truman reasserts the ethical principles that motivate his healthcare reforms.

Throughout the speech, a statement about equality of opportunity

appears in similar forms, but with slightly different iterations, each time

reinforcing the principles of maximal equality of opportunity and communitarian solidarity, and a right to healthcare with a slightly different wording and emphasis. As such, the following statement is similar in content to

the one I have just considered, the primary difference being its linguistic

construction which affirms the provision of services rather than criticizing the deprivation of services. Emphasizing the collective, universal, and

non-discriminatory principles of his healthcare reforms, Truman states:

Hospitals, clinics and health centers must be built to meet the needs of

the total population, and must make adequate provision for the safe birth

of every baby, and for the health protection of infants and children …24

Everyone should have ready access to all necessary medical, hospital and

related services.25

Similarly, the following passage—also employing a strategy of moralization—incorporates a fervent statement of ethos asserting the paramount

value of equality; the necessity of government action to guarantee health

insurance that meets the needs of the poor for better access to healthcare

and better-quality healthcare, and the principle of non-discrimination in

healthcare provision. This final principle is a particularly radical revision of

the American social imaginary as it undermines social norms given segregation in the American South26 and informal but still powerful forms of

racism prevalent in northern parts of the US during the Truman era. As we

discussed in Chaps. 1 and 2, segregationists (especially many Democrats)

had been vociferous antagonists to the expansion of healthcare well into

the 1960s and 1970s:

In the past, the benefits of modern medical science have not been enjoyed

by our citizens with any degree of equality. Nor are they today. Nor will

they be in the future—unless government is bold enough to do something

about it. People with low or moderate incomes do not get the same medi-



cal attention as those with high incomes. The poor have more sickness, but

they get less medical care. People who live in rural areas do not get the same

amount or quality of medical attention as those who live in our cities. Our

new Economic Bill of Rights should mean health security for all, regardless

of residence, station, or race—everywhere in the United States. We should

resolve now that the health of this Nation is a national concern; that financial barriers in the way of attaining health shall be removed; that the health

of all its citizens deserves the help of all the Nation.27

The final sentence affirms the principle of communitarian solidarity and

this passage condenses the overarching ethos of Truman’s speech, with

its emphasis on equality and universality and the conviction that government programming is a legitimate and necessary tool to strengthen public

welfare and social solidarity.

Truman squarely places the burden explicitly on the government to

address the injustices of healthcare inequality and deprivation repeatedly

in this passage and at numerous junctures throughout the speech, as we

will see. For example, when articulating the need for children to have better healthcare, he affirms that the government has a fundamental role to

play in assuring that their health needs are met: “The health of American

children, like their education, should be recognized as a definite public

responsibility.”28 His argument for universal healthcare then is inseparable

from his argument for government responsibility and capacity for ensuring

citizen welfare. We shall now proceed to examine the logos of his speech.




The statements of ethos discussed above speak in general terms and illustrate problems of inequality and insufficiency without providing detailed

data to back up the claims. But throughout his speech, Truman assiduously details with statistics the gap between the ethos of his plan and the

current social reality, stating, for example:

Inequalities in the distribution of medical personnel are matched by inequalities in hospitals and other health facilities. Moreover, there are just too few

hospitals, clinics and health centers to take proper care of the people of the

United States. About 1,200 counties, 40 percent of the total in the country,

with some 15,000,000 people, have either no local hospital, or none that

meets even the minimum standards of national professional associations.29



Although we will see such use of statistics as a central element in the logos

of each of the presidents we are examining, Truman’s rhetoric is the most

impersonal, lacking the humanizing, individual examples that are major

rhetorical features of the logos of Bill Clinton’s and Barack Obama’s

speeches on healthcare reform. In the logos of his speech Truman reveals

the policy details that actualize the principles of ethos that provide the

normative impetus for the plan. Setting the parameters of universality, he

defines its terms incorporating every type of American—first delineating

the different types of workers who will benefit from the healthcare insurance and then explaining that it will also provide coverage to the economically disadvantaged, including the unemployed.

Significantly, Truman makes direct reference to the most impoverished,

rather than appealing to the “middle-class” category, a strategy we will

see that Clinton and Obama favor and who render the working class and

economically disadvantaged largely invisible in their rhetoric. In part this

is because during Truman’s era, the middle class had not yet expanded

greatly, and many Americans confidently self-identified as working class.

However, a post-Second World War shift in patterns of settlement, including suburbanization and increased economic growth, began to consolidate the notion of an expanding middle class to which most Americans

aspire.30 Still, Turman’s explicit advocacy for the most economically disadvantaged contrasts with that of Clinton and Obama. He could have chosen to emphasize the middle class at the exclusion of the working class and

most economically disadvantaged, given its enormous expansion in the

years immediately following the Second World War, but he insisted upon

asserting the rights of the most economically disadvantaged:

I am in favor of the broadest possible coverage for this insurance system. I

believe that all persons who work for a living and their dependents should be

covered under such an insurance plan. This would include wage and salary

earners, those in business for themselves, professional persons, farmers, agricultural labor, domestic employees, government employees and employees

of non-profit institutions and their families. In addition, needy persons and

other groups should be covered through appropriate premiums paid for

them by public agencies.31

Truman explains that in order to meet these needs, the federal government will provide funding for the construction of hospitals, health clinics,

and associated health facilities, and that additional funding will be given to

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5 Rhetoric Analysis of Truman’s Special Message to Congress Concerning Healthcare Reform

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