THE BLOG

AMERICAN SELF LOATHING

10/09/2008 05:12 am ET | Updated May 25, 2011

Four years ago, at about this time, I did an emergency operation on a young man who had no health insurance. A couple of days after the surgery and as we talked about the elections he volunteered that he had voted for GOP's George Bush.

I was curious, if he knew the health care policies of the two presidential candidates. Yes, he said, he knew that Bush believed in market forces dictating how Americans got their health care, while John Kerry wanted to reform it so that more people, like him, could get coverage. "Socialized medicine," he scoffed in derision. Still I was curious as to why he didn't support Kerry's position.

He had voted for Bush in 2000 and felt safer with Bush at the helm. Kerry was a wimp who had lied about his Vietnam military service, the man said, proving that "Swift boating" as a political tactic, worked. Everything my patient said was weighted down with pounds of unmitigated ignorance. To my way of thinking, this man - like many others like him - had voted against his own well-being and interest. And even after we discussed the economic implications of his illness, and that he would owe about $50,000, he still believed he had done the right thing.

The last two decades have seen a steady rise in the number of uninsured Americans, even as the GOP's stranglehold on power has tightened. As a healthcare provider, I have watched with dismay and wonderment about how many uninsured Americans would rather keep the GOP in power even as their own fortunes sunk. Indeed, many of the uninsured are staunch Republicans.

Why would someone vote for a party that guarantees to bury him in more debts, leaving him more impoverished and disenfranchised? In other words, why would someone shoot themselves in the foot, as millions of Americans continue to do each election cycle? Without placing blame on them, liberals have, during that time, continued to ignore this phenomenon allowing the GOP to have its way with a misguided, poorly-informed populace. Rather than trying to understand and to bridge the gap between them and the poor conservatives, liberals behave as if they despised them.

My patient served to point out one fact to me: a confused pattern of thinking occupies the minds of many Americans. It has been particularly eye opening to me that so many Americans live with blinders on; seeing but a tiny space around them; never seeing further than their small horizons. This is amazing since the relevant information is always at most Americans' finger tips.

As someone born elsewhere, I was clearly more informed about the politics of today's America than my patient. Unlike many Americans that I come across on a daily basis, I know so much more about our nation's affairs because I make it my business to inform myself about the intricacies of various political actors' opinions. The political season's noise serves to deafen anyone without a keen sense to pay attention to what is being said or done. Understanding requires a degree of political education that many Americans lack. Add that to the fact that a thousand lobbyists, deep pocket corporations, including HMOs and for-profit hospital groups, each with an oar in the political pond, served to muddy the waters.

I felt sorry for my patient; for his ignorance; his apparent absolute certainty that his President had his well-being at heart despite what we had all witnessed for four years of the Bush rule.

What comes across in Thomas Frank's book, What's The Matter with Kansas is that Mid-Westerners of my patient's social caliber and intelligence feel they have been looked down on by the intelligentsia and the elites. They are more comfortable voting for the Bushes of the world - who have been courting them over several decades.

To many of these people, Democrats are godless, arrogant, unpatriotic, un-American - no matter that they promise to make poor people's lives better. Poor conservatives consider Democrats elites and the likes of Cheney, Rumsfeld and the Neocons are members of a rational ruling class - David Brooks' "Bobos in Paradise." Universal health care is socialized medicine and - as repeated so often by conservatives -- a dirty, evil thing. That every developed nation has adopted this model is unknown to many of these folks.

People who won't vote for what's good for their families and their neighbors affect all of us negatively. There's no question that had we elected Al Gore or later John Kerry we would now have a more equitable healthcare system in America. 18,000 Americans die each year because they lack health insurance. Many healthcare providers give hundreds of hours of uncompensated service to uninsured patients.

As we approach the coming elections, I wonder what we who are more enlightened can do? As Sarah Palin attracts more and more of our less informed neighbors to John McCain's ideas starved campaign, I fear we will in short order see the rolls of uninsured Americans top the fifty million mark.

We must find a way to neutralize the Right's, the corporate message to our less informed voter by not talking down to, but talking to him. Our non-corporate media must find a way to explain our health care system by disentangling the details of, comparing, in a sensible way, how other nations cover their citizens.

But for us to do it so it affects the forthcoming elections, we must make haste which is a tall order. Time is indeed short.