The US Healthcare Narrative: Democrats vs Republicans

With the November 2020 US presidential elections just around the corner, it will be important to understand whether these sentiments are shared in the public communications of the two candidates: Donald Trump of the Republican party and Joe Biden of the Democratic party.

For this analysis, we created a corpora of the speeches from the Democratic National Convention (DNC) and the Republican National Convention (RNC). Datasets have been downloaded from Kaggle. We also used NodeXL Pro to gather the most recent 25,758 tweets that mentioned either Joe Biden or Donald Trump alongside “health care”. These corpora were compiled and processed using Sketch Engine for keywords, concordance, and parts of speech analysis. Then, they were individually run through Cowo to identify conceptual associations at the sentence level, i.e. pairs of concepts that most frequently appeared in the same sentence were identified and mapped out.

We utilized Gephi to calculate network centralities to help determine the most important concepts in the network, modularity class to cluster the concepts with the strongest associations with one another, with each cluster representing a sub-theme of the overall narrative network, and to visualize the networks using the Circle Pack algorithm. We used a similar approach in our previous article about the discussion on race among Twitter users.

Healthcare Received Minimal Attention in the Republican National Convention Speeches

“Health care” as a concept was not a top keyword in the RNC speeches. “Big pharma” has been the only health-related concept in the top 50 terms, according to typicality score (85.45, 10 mentions). “Frontline health care” ranked only 557th in typicality score (20.08, two mentions), and “federal health care” ranked 931st (17.62, two mentions).
“Health care” also only appeared six times in the speeches (with four of those instances being in Trump’s speeches), and the word “health” only appeared 22 times out of a corpus of 89,246 words (0.02%).
These are illustrative examples of how “health care” was used in the speeches:

• “Joe Biden recently raised his hand on the debate stage, and promised he was going to give it away your health care dollars to illegal immigrants, which is going to bring a massive number of immigrants into our country.”
• “Massive numbers will pour into our country to get all the goodies that they want to give. Education, health care, everything. also supports deadly sanctuary cities that protect criminal aliens.”
• “We will ban deadly sanctuary cities, and ensure federal health care is protected for American citizens, not for illegal aliens. We will have strong borders.”

Thus, we can see that health care was not given substantial play in the RNC. At all times, it was placed within the context of immigration and crime (including a “drug crisis”, which had a typicality score of 77.06 (eight mentions)). 

Big Pharma was used as an example of Trump’s positioning of taking on monopolies and entrenched bureaucracy 

“Big pharma” was mentioned ten times in the RNC speeches and was used to position Trump as an anti-establishment leader willing to take on entrenched moneyed interests. We can see this in both Trump’s speeches and the speech of his son.

• “Big pharma, they call it for a reason. There’s nobody that gives the politicians more money than big pharma. Nobody. Not even close. So I said, “Well look, if you’re not going to negotiate a fair deal, we’re going to do a favored…”
• “Last month, I took on big pharma. Do you think that’s easy? It’s not. And signed orders that would massively lower the cost of your prescription drugs, and…”
• “My father is the only person to challenge the establishment, the entrenched bureaucracy, big pharma, and media monopolies, to ensure that Americans’ constitutional freedoms are upheld and that justice and truth…”

 

The COVID-19 pandemic was described in the RNC as a means for the Democrats to defraud Americans by giving millionaires tax breaks through the COVID relief bill, and to steal the elections

“COVID-19” was mentioned 16 times in the speeches and “pandemic” was mentioned 48 times. These however were typically not used within the context of public health, but tax legislation, election reform, and the American war on drugs.

• “…but they’ve spent the entire pandemic trying to sneak a tax break for millionaires and Democrat states into the COVID relief bill. Then they attacked my father for suspending the payroll tax for middle-class workers.”
• “…What they’re doing is using COVID to steal an election. They’re using COVID to defraud the American people, all of our people, of a fair and free election. And we can’t do that. And don’t let them.”

The pandemic was also used within the context of what was characterized as a drug crisis in America, again tying health issues to crime and law and order.
The pandemic was also used as a vehicle for the RNC’s emphasis on the idea of a great American nation and American exceptionalism, standing apart from geo-political rival China:

• “In recent months, our nation and the world have been hit by the once-in-a-century pandemic that China allowed to spread around the globe. They could have stopped it, but they allowed it to come out.”

 

Alternative COVID-19 treatments being developed in America were mentioned in Trump’s speeches

Convalescent plasma – which has not yet been cleared by the US FDA – was described as a “powerful therapeutic for COVID-19”, and was used to differentiate Trump from Biden’s position that “no miracle treatment was coming.”

• “We developed a wide array of effective treatments, including a powerful antibody treatment known as convalescent plasma . You saw that? On Sunday night when we announced it. That will save thousands and thousands of lives.”
• “As we speak, we’re developing a growing number of treatments, known as therapeutics, including convalescent plasma that are saving lives all across America. Now, last week, Joe Biden said that no miracle is coming. But what Joe doesn’t…”

 

Healthcare was also not a major topic in the DNC speeches

 While the DNC speeches were much more compact than the RNC speeches, with a corpus of only 19,964 words, the same NLP techniques can nevertheless be used to surface the major themes in this collection of speeches. Interestingly, and in a similar fashion to the RNC speeches, the DNC did not give much attention to health care relative to other issues such as systemic racism (highest typicality score of 158.71) and the economy (104.11), with “maternal health care” (41.45), “public health crisis” (39.32), “home health care” (39.08), “health care system” (15.95), “health insurance” (8.28), “public health” (1.94), and “health care” (0.9) only being mentioned once in the set of speeches, for a total of only seven instances of the word “health”. 
But even if mentions of health care were few and short, direct references to health systems and health insurance were made, and health care was placed within the context of a public health plan rather than to other issues like immigration or crime:

• “That’s how the economy will keep getting skewed to the wealthy and well-connected. How our health systems will let more people fall through the cracks. That’s how a democracy withers until it’s no democracy at all and…”
• “great nation is now living in an unprecedented moment. We’re facing the worst public health crisis in 100 years and the worst economic collapse since the great depression. We are confronting systemic racism and…”
• “This president is not just a threat to our democracy, but by rejecting science, he has put our lives and health in jeopardy. Trump has attacked doctors and scientists trying to protect us from the pandemic while refusing to take…”
• “Since this pandemic began, over 30 million people have lost their jobs and many have lost their health insurance. Millions of working families are wondering how they will feed their kids and they’re worried that they will…”
• “Who was standing in the way? Mitch McConnell and Donald Trump. Our nation faces the worst health and economic catastrophe in our history. More than five million Americans are infected by the coronavirus.”

Here, we can see that while the DNC was not used as a platform to discuss details of Biden’s health plan, health care was at least directly addressed as an issue affecting the November 2020 elections instead of a mere launchpad for other priority areas (in Trump’s case, immigration and American exceptionalism).

On social media, recent pro-Trump tweets talked about the “Democrats’ socialist takeover of health care” while pro-Biden tweets emphasized Trump’s lack of a healthcare plan