In my column in Thursday’s paper, I want to know why people get so riled up when you suggest that… (dramatic pause here) America provide health care for all its citizens. Michael Moore’s “Sicko” is the impetus for this column, but I fear that some of the resistance is because some (many?) people just don’t care if other people suffer. Survival of the fittest, they might argue.
<>What do you think? Do you think we have a right to be healthy? If so, why? And if not, please explain this to me.
Responses to “National health care, why the fuss?”
July 26th, 2007 at 3:11 pm
Actually, I do use evolutionary thinking too, but in a different way, to understand why people seem to believe that selfishness is good, and mutual aid is evil.
Human beings have evolved to be reciprocal altruists. When our communities are peaceful and prosperous, and mutual trust exists, we are happy to help people with no thought of immediate returns in every instance. We can generally count on receiving the same sort of help from others. This is all fine and dandy. However, there will be some free-riders and non-reciprocators who will rely on benefits but who will not reciprocate or who will shirk and not do their share of the work, etc. We are sensitive to this, and we have evolved a radar for cheater-detection and punishing rule-breakers even if they aren’t harming us personally (called “altruistic punishment”).
That is a drive or instinct inside of us, that cheater-detection urge, and it is every bit as natural and hard-wired in us as the sexual urge is.
For the past several decades, there has been a public political discourse that has rubbed, tickled, toyed with and inflamed this cheater-detection system. A kind of pornography was developed, not for the sexual instinct, but for this cheater-detection instinct. This pornography was continually used to get people riled up over issue after issue after issue, and then the “rilers” would say that THEY could solve the problem and punish the cheaters, and so people voted for them and espoused their views.
This also built upa kind of defensive tribalism, where you know you belonged to the non-cheater sect if you talked aggressively about how you hated free-riders of any kind, and how everyone should support themselves. It is kind of paradoxical, but by declaring that the world was no longer one in which you could trust that everyone would pull together and be good to each other, and by vowing to be vigilent against any free-riding, you would become trustworthy within this loyalty-group.
So we institutionalized mistrust, basically.
George Lakoff describes how the non-trusting worldview is the “Strict Father” paradigm, and the (perhaps) too-trusting worldview is the “Supportive Mother” paradigm. Since the Cold War, these two groupings within US politics have tried to invalidate and reject each other, which is a true shame, because a family needs both parents, and they need to negotiate between their different perspectives to get the whole picture.
In healthcare, there are some things that are just between you and your doctor, and some things that are about all of us. If a camp full of illegal immigrants develops a strain of the bubonic plague, we DON’T want them to delay in seeking ALL OF THE VERY BEST MEDICAL CARE WE CAN THROW AT THEM AS SOON AS IS HUMANLY POSSIBLE!!! There is a level where it isn’t about you and me, it’s about the little buggy species versus the whole human race, and neither country, nor creed nor insurance provider matters. We stand or fall together.
And certain aspects of healthcare are not like that. There is a such thing as medical malingerers - people who fake symptoms and use up resources to avoid working… so we need BOTH kinds of smarts - ALL kinds of smarts - to manage healthcare well.
When people “take sides”, they lose the cognitive flexibility to come up with the best solutions.
July 28th, 2007 at 12:26 pm
Part of the problem is how you phrase the question. By phrasing it as “do we have a right to be healthy?” and saying people who oppose government run health care you are demonizing anyone who doesn’t agree with you.
DO we have a right to be healthy? Do we have a right to be unhealthy? Seriously, do we have any personal responsibility for our health? What about people who smoke, drink to excess, refuse to exercise, are overweight or obese and suffer health consequences from those choices? Don’t you think when the government (i.e. the taxpayers) takes responsibility for everyones health that society is going to start passing judgement on those choices even more than we do now? Besides the typical arguments about rationing helath care and higher taxes and inefficient government (I don’t see how anyone who has ever visited a DMV could possibly want to put the government in charge of their health care!) which are all very valid arguments, supporters of government run health care better be prepared for MASSIVE intursion into their private lives and choices, even more than is already the case.
Regarding rationing, here is a little personal story. When my middle son was 2 1/2 he was diagnosed with a severe speech disability (apraxia)and we were told he might not be able to meaningfully communicate until he was 8 or 9 years old. We were told to began learning sign language and otehr alternate messages of communication were discussed. My son began receiving intensive speech therapy, 5 days a week, one-on-one with a speech therapist. This was partially paid for by the state and partially paid for by private insurance. An in-home aide was also provided for by the state to teach me how to work with him. Because of all of this intensive effort my son learned to talk much faster than was thought possible and, in fact, graduated from speech therapy last year after 7 years of speech therapy. When my son was diagnosed I got on an online message board and met a mother in Great Britain whose son was the same age as mine and had been diagnosed with same condition. Under their system her son was only getting speech therapy once a week in a large group setting. As a consequence he was still not talking after several YEARS of group treatment. I realize our system is messed up but I am firmly convinced that government run health care will cause more problems than it will fix.
July 30th, 2007 at 8:50 pm
Melanie:
Yes, I do believe that some people really don’t care if others are sick. If you read some of the vile e-mails I get from readers regularly, you might come to the same conclusion. I have no need for nor interest in prods - I get paid the same if a billion people comment or none.
And Lisa: I ask the question: Do we believe everyone has the right to be healthy? because if we can come to some agreement somewhere, then the discussion can progress.
Do we believe that everyone has the right to vote? Until not that long ago, the answer was a resounding no, if everyone included black people. Same for women.
Do we believe that everyone has the right to free education? Yes - and no one would suggest that the public schools are models of educational perfection.
Do you believe everyone has the right to be healthy? Do you? I mean, can we start with that question? Just start there, without making assumptions about what the next step is? Any interest in building consensus and moving forward? Bueller? Bueller?
I don’t offer any solutions - I think whatever we came up with would be messy and probably wouldn’t work well, at first, if at all. But for lots of people, preventative medicine supplied by the government would be a godsend. Government sponsored healthcare would not have to replace private health insurance - another either-or choice that naysayers like to set up. We could do have both.
Again, can we agree somewhere? Can we get past anecdotes of what worked in the U.S. and what worked in Canada and agree that Americans deserve to have quality health care, whether they can afford it or not?
July 26th, 2007 at 9:13 am
I’m guessing your suggestion that some Americans object to universal government funded health care because they “just don’t care if other people suffer” is really to prod us into writing a response – you can’t truly believe that… If Americans didn’t care about the suffering of other people, they wouldn’t give so many charitable contributions to St Jude or the Shriner’s Hospitals or any of the hundreds of other charities that support health care for those in need – I don’t think you see that kind of giving anywhere else in the world, and the rest of the world benefits from the medical breakthroughs that come out of the US health system.
Forget about the rosy picture Micheal Moore paints of the government run programs in Cuba or the horror stories about Canadians coming to the US for medical care because of rationing that is trotted out by opponents. The bottom line is that a majority of Americans have good health care from their employers – we wouldn’t have as good of a health care system as we do if there wasn’t money to pay for it. But let’s face it – employers are in business to make money, and no employer is going to keep providing health care for their employees and their families if the government will take over with a universal plan.
We are comfortable with what we have, and we are afraid of the unknown… and with the track record that the government has dealing with so many other issues, who wants to trust their most important asset – their health – to the government…. I certainly don’t.