Saturn Smith

Orbital Matter
Editor’s Pick
SEPTEMBER 9, 2009 10:19PM

On Health Care, Now It's Our Turn

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The hardest argument the Obama administration has to make, and the one that I feel the president is still not making to the best effect, is that things must change. It's evident to the 40 million uninsured Americans that we need a fix, and it's evident to anyone who's been dropped from their health insurance, denied coverage because of a preexisting condition, or reached that ever-dreaded cap and had to start paying out of pocket to survive. It's also evident to anyone who's studied national bankruptcy statistics or a breakdown of our national debt.

That's still not a majority of Americans.

What we don't talk about that often is that there are still over 100,000,000 Americans who are pretty happy with how things are. These are people who feel no personal urgency to get better health insurance coverage passed. They were the crowd the president started speaking to this evening, and they are the crowd that Republicans and those against a public option have been pursuing from the start.

This discussion so far has often become one of political policies and ideology, and yes, that's part of our debate. But if health care in America is really to believed as an urgent problem that must be solved, it must be couched in personal, affecting terms -- not because its passage should depend upon emotional appeals, but because people need to realize how vulnerable they really are.

It's easier for someone who has health care to believe that the stories the president tells about some distant figure dying are exceptions than it is to believe they're the rule. To accept that these stories are true and that they really can happen to anyone, you have to accept that bad health and bad fortune can happen to you. You have to accept that you're vulnerable.

Most of us have a lot of difficulty accepting that. Young, healthy Americans will struggle with this. Americans who still say, "my dad ate bacon every morning and never saw a doctor in his life, and he lived to be 90" will struggle with this. Americans fortunate enough to have certain employment or personal wealth will struggle with this. Americans who have and have always had reliable health insurance will struggle with this. Yet every one of those groups is in danger of facing a sudden reversal of fortune -- one catastrophic car crash, one debilitating stroke, one fight with unpreventable cancer, and your mind will change.

Short of 3-D horror films, what will overcome this adherence to the status quo? Two things: first, honesty from our political leaders about what their plans aim to do and what they cost. I hope the President was serious about calling people out when they misrepresent his plan; I hope the media will also dig in and call out both sides when they exaggerate. If those who like the status quo are convinced that they can basically keep it -- that they can have "status quo plus," -- they will be less likely to be frightened, and more likely to be supportive.

Second, in the same way that a person's mind is most likely to be changed about the wisdom of gay marriage when they know someone who's gay, a person's mind is most likely to be changed when they know someone who has faced physical or financial ruin because of a health problem. This is one time when anecdotes are helpful.

I think there's a lack of open discussion about health problems in America. Sure, older Americans might make their daily aches, pains, and medications the centerpiece of their lunch chatter, but it's pretty rare for younger Americans to talk with their friends about these things. Yet if you know someone who's having her life turned upside down by unpaid medical bills, you're more likely to start wondering seriously whether that could ever happen to you. If you have a friend at work who isn't on the offered plan because her pre-existing condition -- something as insidious as, say, pregnancy -- didn't allow her to enroll, wouldn't you be tempted to check and see what, exactly, you're covered for? And if you made that investigation -- wouldn't you (like many, many, many Americans) be very likely to find out how vulnerable you are?

I say, for the next month or so, the personal story is the best weapon. If you have a story, tell it -- tell it here, tell it at the watercooler, tell it at your family reunion, your church picnic, your book group. More than speeches and town halls, from here out, stories can be what will save us.

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Thanks for this. The number of personal stories I've seen here on OS about people getting screwed by their insurance company should illustrate just how widespread these practices are.

There are simply too many such stories in this small pond to dismiss as statistically insignificant or just random anecdotes.
You make a good point. Obama spoke to the problems that people having problems will resonate with, but for the people happy with their scene all he offered was assurance that they could keep their insurance. I think a better case could have been made (instead of a passing mention) of how important health care is to the economy and, yes, how vulnerable everyone is who think they're *okay*.

There's an attitude of not wanting to help Others... The screaming about illegals is a 'safe' way of doing this, but it's other people who are the true target of the antipathy that is bubbling up...

And Americans seem to be oblivious to how ridiculous they sometimes look to the rest of the world, how backward and ignorant, as in this health care thing. And how arrogant - the rest of us in the industrialized world have health care systems, but Americans just can't see how they should emulate anyone else. (Okay, maybe it's mostly Congress members and some of the screaming right...)

Yet the country has thrown up a president who is intelligent, compassionate, blah blah....and BLACK. (Yet, weirdly, has been immediately repudiated by the people...) Eh, I give up trying to make sense of it all...
yup. yup.yup. rated.
One day the balance will tip. Maybe this year; maybe another year. But the balance will tip.
You wrote -
"You have to accept that you're vulnerable."

You have to accept that you are mortal; you're a conscious being that will one day die. There's a fairly well written article in Wiki on Terror Management Theory that fits very will into this conversation.

http://en.wikipedia.org/wiki/Terror_management_theory

People don't like to contemplate their own deaths very much, it tends to make them irrational. They would rather keep their belief that "it could never happen to me" as opposed to believing that existence is often absurd and that it could indeed happen to you. Or me. Or anyone.

To force people to think about their own need to possibly consider healthcare is to force them to look at their own mortality. This strange perversion of charismatic Christianity (that bears little resemblance to anything I would consider actual Christianity) covering our culture in this blanket nightmare of don't think, don't question, God protects the Good People... I don't think it's helping, their combination with the corporate friendly Republican party causes people embracing that ideology to do some odd things. (Like.. be unable to put themselves in the shoes of "the other," for one.)

This is an emotional argument, of course. People's lives are literally in the balance. If I see that "people over 60 shouldn't have to suffer so young people can get health care" one more time I'll just lose it. We live in a complete culture of fear and I think the only thing we CAN do is have as many calm, rational conversations as we can on a true grass-roots level. The people have to demand it before it's too late.
since you can't vote in a referendum, your choices can only be informal.
1. whine on a blog.
2. join 40 million uninsured people in walking toward the capitol building.
3. or face the fact that you've got the government you deserve.
Saturn: What you say is and always will be true: whenever did a person change his mind or behavior because of statistics or ideology? One good personal story illustrating the cancer-like crisis represented by the status quo is worth a thousand new studies.

The heart needs to be engaged for anything substantive to change, personally or politically. There's a fear that by dealing in the emotional realm, the arguments will be mushy, sentimental, and so on. Breaking news: this is frequently an effective way to get through to people. It may not be the way I chose to go when I write either about my own or other people's experience, but it works. I say "dare to be corny" if need be.

We're all writers at OS, we all tell stories. As the Cap'n says, we've all read many examples here of how badly the system doesn't work (see Dorinda Fox's amazing post from Wednesday). I'm sure there are many more.

So let's see some re-postings of past stories, perhaps with new introductions pegged to the need for reform. And let's see new personal stories that illustrate how easily the status quo caan become hell on earth. And let's get our stories out beyond the welcoming confines of OS. The story of health care in America is a heartbreaking one. So tell those stories, break some hearts with your words, so that more people won't suffer and die in the future.
I will never, ever understand. There are people who are dying, who are in pain, who are suffering, who are losing everything...because they got sick. I will never understand those who shrug and say, "who cares?"
Good points, Saturn, and I think you're right. People are inherently selfish and also limited by their personal experience.

I haven't had a health disaster but I've been paying for my own health insurance premiums entirely for nearly 15 years since becoming self-employed. K does too. It really changes your perspective! Having them even partly much less largely subsidized by your employer (and having coverage guaranteed to be provided) lulls you into complacency, I think. You don't get how expensive health care is in this country unless you pay its full cost, at least in full premiums. Then you start to wonder if it it's worth what you're paying esp vs. other countries with cheaper yet better care.

The other thing that opened my eyes was working in a hospital. But far fewer people will work in the HC system. But trust me, people who do work in it are more aware of its shortcomings than anyone else.
you tell 'em Saturn. I'm trying...

my story ...

http://open.salon.com/blog/fabflamingo/2009/08/27/beware_health_insured_kiss_that_american_dream_good_bye
As more and more people are devastated in this way, more of the complacent will get it. I hope.
Thank you for saying this. I had the same thought and woke up this morning and blogged about my own personal experience here.

BTW, I always love your posts...
Jeremiah - I change my mind more from statistics than anecdotes. You can find an anecdote to support any conclusion.

However, it's worth asking people what they would do for insurance if they lost their jobs. COBRA, but what if while on it they got an expensive, chronic disease? What then?
Isn't it true that people don't really know how much their health care is lacking because there is no point of reference for comparison? Minority groups often cannot see the full extent of discrimination until some form of consciousness-raising is done. We must be able to conceive of something better before we want it.

How might an individual's care be improved by these changes? What do national health care programs in other countries have that we do not?
My aunt is conservative and always railed against any kind of social support. She is now widowed and presumably living on some form of welfare. But she believes her case is different. How is it different? I have no clue.
Earlier today I made my first post, on the difference between scary fairy tales and the actual experiences people have in a single-payer nationalized health-care system: http://open.salon.com/blog/bills_dubious/2009/09/10/single-payer_health_care_no_waiting

My American friends obviously aren't going there, but feel free to use this in debates with the ill-informed...
Stories are not going to help you. What you need is what was promised last night and not delivered, facts and details.

I know nothing more today than I did yesterday about what is going to be in the bill and exactly how it's going to be paid for or why the watch dog bodies of Congress say it's not revenue neutral or even close.
Why shouldn't we raise taxes to pay for this? I'd happily pay more taxes to get health care for all.
Malusinka: I was too-encompassing in my statement; I should have said that I've never changed anything in my life based on numbers, studies, polls, etc. It's also been my experience as a newspaper reporter that the stories that have the largest discernable impact have been what used to be called "human interest stories," tales of unexpected survival, heroism, tribulation, going against the odds. Those are the sorts of stories I'd suggest that grab people's interest and -- in my experience -- can bring them to new understanding and action.
Not all apples are bad for you. Look what they did for Cezanne. If for one day EVERYONE drove past the junk food parlor, got out of their car at the local market for a little exercise and time waste to discuss with those next to them in line why they were there to buy an apple, it just might shake some trees, down to their roots. Some campaign promises, like health care, might get kept. Cezanne gave us a lot of apples to talk about.
Myriad typed: "There's an attitude of not wanting to help Others... The screaming about illegals is a 'safe' way of doing this, but it's other people who are the true target of the antipathy that is bubbling up..."

I think the attitude is one of fear that there are not enough resources to help ourselves and others, and it is an attitude intensely encouraged by the folks with money, the ones who are> selfish.

Unlike Silkstone, I don't think that is an inherent quality of people. I do think that fear is how people end up being selfish.

If, as Catnlion says, "Stories are not going to help you," why is it that stories are the weapons of choice of the right wing?

And Leslie gives a clear example of how effective stories are:
"I'd happily pay more taxes to get health care for all."But universal health care costs about half or less of what the US pays per capita. Leslie bought the story being dealt by both sides: that we can't afford decent health care. That's a lie. What we can't afford is the system we have now.

And then there's al loomis: "face the fact that you've got the government you deserve." A cynical and untrue statement. I have been working against this system since I was about twelve. I don't deserve this government. Nor do people who have had fewer advantages than I and have been easily fooled into voting against their own self interest.

To re-form a cliche, if you have nothing useful to say, al, don't say anything.