Marketing the Markup: Doublespeak in Health Care Policy

In the space of governing, effective marketing is essential to further policy initiatives. The marketing of policy has always been centered on attempts to obscure and re-brand, no matter the issue. Lawmakers, stakeholders, and the media all engage in the marketing efforts of government policy. One of the most interesting ways in which actors may strengthen their arguments for or against certain policies is the use of doublespeak. What makes doublespeak distinct from carelessness is deliberate manipulation: “Doublespeak is not lying, nor is it merely sloppy language; it is the intentional use of euphemisms, synonyms, jargon, and vagueness which pretends to communicate but really does not, or which implies the opposite of what it would appear to be communicating.” 

In fact, the National Council of Teachers of English started a Committee on Public Doublespeak in 1971. In an interview, former Committee Chairman William Lutz described the institution as: ''The purpose of language is to communicate the truth and to facilitate social groups getting together. The doublespeak committee was formed to combat the use of public language by increasing people's awareness of what is good, clear, solid use of language and what is not.” When we allow for these qualifications of “good, clear, solid” to describe certain phrasings, we subsequently label certain frameworks of language as faulty, poor, and obscure. Thus, the Committee on Doublespeak attempts to identify both victories and failures in the battle of preserving transparent communication.

Some critics of this mission do exist. They argue that doublespeak is not something that is in dire need of illumination, at least not in the way that the group usually warns against. For example, they argue that doublespeak is a prerequisite of most advertising and that most consumers are aware of this. While some forms of persuasion may have less genuine motives than others, markets know that marketers have a certain goal: gaining their business. Not surprisingly, most of the recipients of the Committee’s Doublespeak awards, which honors conscious efforts to promote doublespeak and the convolution of language, are either involved in academia or the political sphere. Previous winners have ranged from organizations to individuals including President Donald Trump, President Bill Clinton, the National Rifle Association, and the tobacco industry.  So, what does this acknowledgment of language’s ability to communicate distracting messages mean for the public? It means that different individuals can be swayed on certain issues, whether it be buying a product or supporting a policy, depending on how the subject is marketed to them.

“Appealing to party values⁠—or even certain causes that the individual casting votes has previously supported⁠—can shape how influencers approach those in power.”

Lobbyists use the practice of doublespeak often when attempting to sway lawmakers. Appealing to party values⁠—or even certain causes that the individual casting votes has previously supported⁠—can shape how influencers approach those in power. From this point, the effects of doublespeak can trickle down to the policy “consumer”: those affected by the regulation. This summer, I witnessed the importance of phrasing when I attended a briefing on the integration of AI in the health care sector. Duke University had set an agenda for the briefing which focused on the positive aspects of the new trend, as well as the challenges that it presents. In line with their work, they claimed that by obtaining certain health data points on patients, such as frequency of doctor visits and physical diagnostics, health care providers would be better able to care for patients.

In their example, not only would AI be able to aid in biopsy assessments, but it could also serve as a predictor of what patients might need more attention based on their previous habits. They explained their findings in a way that was mindful of the audience they were presenting to. In certain spaces, the goals of the research institute conducting the studies on AI in healthcare overlapped with the interests of lawmakers. Finding a way to streamline the health care system in reasonable ways should be a common goal for all actors involved. However, there were certain points on which more room for disagreement was present. The general concern for how individuals’ health data could be protected was a large concern. In today’s age, privacy is a contentious topic in many spheres. Within the health care sector, this debate has real concerns regarding scenarios as extreme as involving biological warfare. Additionally, the presence of these data points begs the question of how HIPPA laws will shift the industry of health care innovation. Will the system exist in a way that genuinely resists the coercion of patients handing over their information? These issues are all in need of thoughtful legal deliberation as well as the consultation of those who will be affected at large: all of us.

In order to address the understandable, even necessary, concerns that many actors have about AI, we have to recognize the unique nature of the healthcare industry. According to Forbes Magazine in 2018, “There is a lot of interest from pharmaceutical and medical research companies in obtaining data that has information about patient’s treatment and outcomes but does not include patient’s personal information. These datasets become valuable commodities and can be bought or sold without your knowledge or consent. In fact, it is a multibillion-dollar market, but you are not getting a dime.”

Changing this could allow for the everyday health care consumer to develop a higher stake in their health care practices, rather than only striving to improve their health alone. Not only does this have the potential to stimulate competition between healthcare tech companies, but it also empowers an informed health care consumer to choose how they want to contribute to their own care. Just as we see in examples in everything from “healthier” ice cream commercials to e-cigarettes which are “better” for you—only in comparison to traditional smoking methods, the perception of AI integration will be dependent on how it is marketed. Whether we perceive the proposed technological advancements as helpful or overreaching will depend on which interests are being promoted. Looking to the past, I am certain that doublespeak will continue to rear its head on both sides of the issue—within the healthcare industry and in every other industry which will undoubtedly be touched by the influence of AI.