If the public is overwhelmingly for health care reform, 70-80%, then why are they against legislation that attempts to do something about it? In Real Clear Politics David Kuhn offers a reasonable analysis of the polling outcomes in his "The Health Care Reform Paradox." From his work can be gleaned a sense that progressive thinking is swimming against a current of public opinion that was set in motion thirty years ago. Simply, the public wants government to do something but does not trust it to do anything. Mr. Kuhn, not to disparage in any sense, but that is not a paradox, it's a tragedy of conflicted sentiments.
With the exception of some rare and well documented psychiatric conditions, what makes people crazy is conflicting goals. Two competing and mutually exclusive goals will melt down even the better brains of the body politic. In health care, the desire for reform is in conflict with the perception of increased personal costs. The entire argument that personal costs will increase due to government involvement is built on a spurious notion. Unfortunately, the spurious notion that government can't do anything right is a notion that is not easily dispelled. After all, it has taken thirty years of right wing propaganda to make the delusional, paralyzing, bed in which we now lie.
Congress, now, perfectly reflects the mental status of the nation with regard to health care. Congress is no more or less conflicted, albeit for less honest reasons, than is the public and in roughly the same proportions. Senators and Representatives from districts that have the highest distrust of government are those most likely to be wary of government solutions. They focus the craziness of their constituents on the problem and therefore make it harder to solve. To them I might say that if you do not believe in the efficacy of government action, what are you doing serving in government?
Much ink is devoted to the effects of lobbyists and well financed direct ads funded by vested interests. That is certainly a concern. But the fact remains that the public is disposed to listen to the lies that exploit their fear of government. In this and many cases, that fear is used to influence the public to act against their own best interests.
In a broader perspective, this is a battle that was won for the right when Ronald Reagan took office. The RNC has fed and nurtured the "government is the problem" meme for two generations now. And that meme was designed to do exactly what it has done, make the public quite crazy with regard to government. The poll numbers, as Mr. Kuhn's raw data show, perfectly reflect this.
"Government is the problem" has been around so long that it is never even questioned by a disturbing plurality, both left and right. Is there something special about American government that makes it less trustworthy, or are all governments innately incompetent and corrupt? Is the Constitution, a product of an effort to create a better form of government, also to be distrusted because it is, ultimately, yet just another form of government and all governments are corrupt?
Working in and starting up some of America's corporations might lead one to believe that all corporations are corrupt and incompetent. I have been there and done that. Waste and fraud and crime are not an exclusive attribute of government by any means. Poor decisions are made, all day every day, by CEOs and board members and line managers in every company in America. Some are better than others. Some can produce five times the product with a fifth of the staff of others. Some stay in business by means of monopolistic practices. Some businesses exist only by means of cannibalizing others in mergers and acquisitions, wonton destruction more often than not. According to Booz Allen Hamilton, a management consulting firm, two thirds of all mergers fail. One in ten start up businesses succeed. Have two thirds of all government programs failed? Have nine of ten government programs failed?
Government and businesses are run and staffed from the same source, us. The 80/20 rule applies no more or less to both. 80% of the work is done by 20% of the people. Corruption and incompetence in either of government or business is simply a reflection of us, our decency and our ethics.
So to win the health care debate with the public, the prejudices of thirty years of conditioning must be undone. It is doubtful that this can be accomplished in a fortnight. But what makes the task a bit less onerous is that the election of a Democratic President and Congress reflects a sea change in sentiments about government competence. Ultimately, it is the task of those elected officials to win the hearts and minds of the untrusting public through positive results.
There will always be a Republican-like party out there, lying, distorting, twisting and intimidating for profit. There is never enough profit. But to undo their disproportionate influence on society is best served by proving government to be trustworthy, to be at least as trustworthy and competent as private enterprise is falsely vaunted to be.
Pass the health care reform bill that honestly will garner the best result for the public in both caring and cost. Pass it and sign it over the objections of a public that is, by way of Republican investment in untruth about government, conflicted and therefore unable to make up their damned minds. It's the right thing to do.