UC San Diego

This dissertation examines the cultural currents that appear in public sphere healthcare debates in the U.S. and France. It argues that France and the U.S. are on opposite poles of a continuum of values, ideology, and utilitarian responses to healthcare needs. When France has reduced the generosity of its health benefits, it has been for utilitarian reasons. When the U.S. extends care, it has largely been for utilitarian reasons. In France, healthcare expansions are framed in terms of positive values and ideology, while in the U.S., refusals to extend care are framed in terms of positive values and ideology. These pervasive elements of public sphere discourse are derived form the longue durée culture of a given society, which is then leveraged to justify the shape of health policy. In this dissertation, elements of longue durée culture, which are leveraged by political strategists as they create messaging campaigns and are referenced by diverse interlocutors as they debate policy changes, are identified via media sources such as newspaper articles, ad campaigns, political speeches, public institutions, and letters to the editor. Policy makers and political strategists must rely upon resonant features of longue durée culture in order for their campaigns to be successful. This is why key elements of culture can be located via these artifacts of public sphere discourse.