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The Boston Globe

Ideas

The long, lurid tradition of public health propaganda

How the scare tactics of the past shape the Affordable Care Act debate today

The Affordable Care Act has prompted a Supreme Court case, polarized Congress, and defined a national election. It has also inspired a secondary battle in the creative realm. Opponents of the law have produced videos in which a creepy-looking Uncle Sam prepares to administer a prostate exam; they’ve altered photos of the president to look like Heath Ledger’s sadistic Joker in “The Dark Knight.” Meanwhile, government agencies charged with enrolling people have responded with friendly animations that promote how the law works, while left-leaning groups have contributed zany pro-ACA ads in which recently insured college “bros” perform keg stands, worry free.

There’s a name for all of this, of course. The campaign to get people to embrace the Affordable Care Act, and the countervailing effort to cast doubt on it, is essentially a propaganda war. And though propaganda might seem like a heavy weapon to deploy on an already-passed health care law, public health has been the site of intense propaganda wars for more than a century—sometimes with lurid, dramatic imagery that makes the tussle over the ACA look tame.

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