Technical specialists like to name social problems using the language of their disciplines, and of whatever narrow policy community they belong to. What they often forget is that to secure broad support within the relevant political community how you define the problem that you are asking society to focus on and do something about matters. It matters a great deal. In fact, it can be the difference between getting the attention of legislators and broad publics or having your issue ignored.
For a live example consider the current efforts to implement health-care reform in the United States, something that presidents have been trying to do for about 50 years. Let's ask: What's wrong with America's health care system? What needs to be fixed? In other words what is the definition of the problem?
It turns out that there are two rival problem definitions in the public sphere right now. For some, access is the issue. They wail: how can you have a country as rich as this one and yet 50 million of its citizens have to access to health insurance? Is that not an outrage?
For others the issue is cost. They wail: America has the most expensive and wasteful health-care system on the planet, has little to show for it, health care costs ruin citizens, businesses and if they are not reined in will ruin the country itself.
If you listen to the tenor of the public debate on health care right now the prevailing problem definition is...it is all about cost. Congressional leaders and the president are trying to expand coverage significantly but the public case is all about reining in costs. That is largely because for most Americans the issue is cost, not universal coverage. The uninsured have little political clout. And if you want to build the broadest public support you use it-is-too-expensive-folks problem definition while still trying to improve coverage.
Smart politics. The entire world is watching as the reform battle progresses. The lessons for practitioners in international development is obvious yet usually ignored. The place to start building a coalition in support of reform initiatives is with the definition of the very problem you want that society to focus on and solve. Get that wrong and yours is likely to be a long, lonely.and ultimately futile effort.
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