Each year, the State of the Union provides a unique snapshot into a president’s thinking, and each one of the thousands of words that comprise the address are scrutinized for what it says about politics and priorities. This year, the health wonk community came to a quick conclusion: President Obama isn’t putting health care front and center.
In total, he spent 44 words discussing perhaps the most far-reaching legislation passed during his tenure, health care reform. The initial reaction was that the president was backing away from his signature achievement. But examining one number from one speech doesn’t tell the whole story. Here are a few more numbers that put the 44th president’s 44 words into context:
- 7: The number of words dedicated to health care in the Republican response, delivered by Mitch Daniels. If Obama was avoiding the topic out of fear of political fallout, the Republicans didn’t call him on it.
- 15: The number of words George Bush used to discuss health information technology in his 2004 State of the Union address. That was enough to launch a multi-billion dollar federal effort, complete with its own “czar.”
- 48. The sum total of Lyndon Johnson’s references to Medicare in his 1967 State of the Union speech, two years after the Social Security Act of 1965 created Medicare. The brevity certainly didn’t dampen the impact of the law.
- 270. The amount of Richard Nixon’s 1974 State of the Union address dedicated to his plan for comprehensive health care coverage. That bests Obama’s total for the last two years, combined. And we all know how much traction Nixoncare generated.
- 34,053: The word count from the administration’s brief to the Supreme Court on the legal challenge to the Patient Protection and Affordable Care Act. With three days of oral arguments before the Court in March and a decision around mid-year, there will be plenty said about health reform, even if it was absent from this year’s speech.
It’s clear that there is no obvious distinction between time spent on a topic and the attention it gets from policymakers, which explains why we don’t have hydrogen cars (116 words in 2003). Millions of words will be spilled on the topic of health reform as the legal argument (and decision) come and go this year. And millions more will be spilled during an election season in which all of the leading candidates have put stakes in the ground about health reform.
That’s not to say that paltry attention to health care in the State of the Union doesn’t matter. But — like so much else in life — the really important stuff can often go unsaid.