Public Discourse and Public Policy: Some Ways That Metaphor Constrains Health (Care)

Since the terms of the health policy debate in the United States and Canada are largely supplied by biomedicine, the current “crisis” in health care is, in part, a product of biomedical rhetoric. In this essay, three metaphors widely identified as being associated with biomedicine—the body is a machine, medicine is war,and medicine is a business—are examined with a view to the ways in which they influence the health policy debate, not only with respect to outcomes, but also with respect to what can be argued at all. The essay proposes that biomedical language itself be foregrounded as the constitutive material of public discourse on health policy.