Is Lack Of Kindness The Greatest Barrier To Healthcare Reform?

Ancient people couldn’t understand why solar eclipses happened, so they looked for explanations that fit what they saw:

A recurring and pervasive embodiment of the eclipse was a dragon, or a demon, who devours the sun. The ancient Chinese would produce great noise and commotion during an eclipse, banging on pots and drums to frighten away the dragon.

They weren’t crazy, although if we accept their explanation, their solutions seem pretty illogical.  I mean, would a dragon big and powerful enough to eat the sun really be scared away by people banging on pots and drums?

I guess I don’t understand the skittishness of giant sun-devouring dragons.

But this the trouble.  When you come at a problem with a faulty premise — and insist on keeping that premise — it leads you down some very strange paths.

Such is the case in a recent blog post by Professor Uwe Reinhardt of  Princeton University.  He wonders if the opposition to health care reform bills (now at 61% according to CNN) is because Americans just aren’t very kind people.

The theory here is that in all modern nations, the better-off members of society would like to provide kind acts for the less well-off. The kind acts in question include financing health care for the less fortunate who cannot pay for that care with their own resources. . . . [but] thanks to the expensive and often wasteful manner in which our country’s health care providers and insurers have managed their affairs, they have helped to price kindness out of America’s soul.

This lack of kindness, according to Reinhardt, can be seen in opposition to parts of the reform bill like subsidies for people who can’t afford insurance, making insurance mandatory, and outlawing insurance company practices that allow them to charge different amounts of premium to sick versus healthy people.

Now, one can argue (kindly) that rules like these have helped make health insurance so expensive in the first place.

Or one could be more cruel and point to Massachusetts.  Massachusetts has perhaps the highest health care costs in America, and yet somehow escaped Reinhardt’s theoretical descent into unkindness.  In 2006, that state, under a Republican governor no less, passed reforms that did the very things he says Americans oppose out of a lack of kindness.

It’s almost as if the sun came back without anyone banging a single pot or drum.  How could this happen?

Here’s how: Reinhardt’s premise is wrong.  Americans are kind and generous. They make more private charitable donations than any people on Earth, including Europeans, whether measured in raw dollars are as a percentage of GDP.

What is different about Americans is that – fairly or unfairly – they don’t trust the government to be very good at dealing with most problems (”Hi, I’m from the government and I’m here to help” is a joke, not a relief).  Americans are suspicious of anyone selling something who is in a rush to get you to buy it.  Indeed, American popular culture is loaded with cautionary tales of people being taken advantage of in just this way.

Now, put aside the specific policy proposals and look at how reform is being sold to Americans.

It needs to be done now. The only way to do it is through massive and not well understood legislation.  It will cost a trillion dollars, but it will save money.  You won’t be affected by it unless you want to.  Well, except that your care is going to get better and cheaper.  And don’t raise questions about it.  Your questions are motivated by politics or financial self-interest or much worse.  In its own way, you could say this approach is brilliant in how it has touched on so many negative associations.

So, no, Professor Reinhardt, Americans are plenty kind.  The reason reform is going badly isn’t because Americans don’t want to take care of those in need.  It’s because reformers have failed to convince them that this is the way to do it.

*This blog post was originally published at See First Blog*


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