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The Exaggerated Life of Death Panels? The Limited but Real Influence of Elite Rhetoric in the 2009-10 Health Care Debate

Experiments demonstrate that elites can influence public opinion through framing. Yet outside laboratories or surveys, real-world constraints are likely to limit elites’ ability to reshape public opinion. Additionally, it is difficult to distinguish framing from related processes empirically. This paper uses the 2009–2010 health care debate, coupled with automated content analyses of elite- and mass-level language, to study real-world framing effects. Multiple empirical tests uncover limited but real evidence of elite influence. The language Americans use to explain their opinions proves generally stable, although there is also evidence that the public adopts the language of both parties’ elites symmetrically. Elite rhetoric does not appear to have strong effects on Americans’ overall evaluations of health care reform, but it can influence the reasons they provide for their evaluations. Methodologically, the automated analysis of elite rhetoric and open-ended questions shows promise in distinguishing framing from other communication effects and illuminating elite-mass interactions.