A couple begins to argue about how to spend their money or discipline their children. Before long, they are saying hurtful things and shouting at each other. Seeing this, we are likely to think that the issue underlying the shouting may really be something else. The level of their voices and the bitterness of their escalating language make us wonder if more basic needs are at the heart of the matter yet remain unstated or even undiscovered.
The same question may be worth asking about the health care reform debate. Are access to health care, the cost of reform, government debt, the individual mandate, government intrusion, and the appropriate level of regulatory oversight the core issues of the debate, or are we arguing - and seeking to be heard - about something deeper?
Political arguments are always immersed in a social context. A deep recession began in late 2007 and, GDP data notwithstanding, it still feels like a deep recession. Foreclosures continue as if oozing from a wound that refuses to heal. Unemployment may take years to return to more reasonable levels. Laid off workers have lost or are in the process of losing their life savings. Even more Americans have suffered a decline in net worth due to the collapse or withdrawals from retirement plans and plunging home values. Amidst all of this, the costs for higher education and health care routinely outpace inflation, and energy price rises loom on the horizon, an unwelcome companion when the economy shows signs of getting better. These multiple sources of distress and a lack of control over them are being felt by many Americans as a dual and troubling message: the best of times are over and the next generation (even the current one) will have a lifestyle worse than we have now.
On the left, which tends to look to government to solve problems, the anger has been directed at big insurance. The greatest fear seems to be that people will be pushed over the abyss into poverty by losing their health care or having to drop it - because of insurance company practices geared to cream off only the healthiest patients or aimed at continually high premium increases. On the right, which tends to trust the market to solve problems, the anger is directed at big government. The greatest fear seems to be, as Jefferson put it so articulately in his First Inaugural, that an unrestrained national government will "take from the mouth of labor the bread it has earned." Whether its big business or big brother, the American middle class sees someone pushing them down the economic ladder.
Buried underneath both sets of fears is perhaps a deeper one. The American Dream seems more tenuous, accessible only in the imagination. Our collective story, that we are a chosen country carved out of the wilderness to demonstrate the power of faith and hard work to make our world shine with promise and plenty, is being questioned. When faith and hard work no longer seem to guarantee the future, we are left with the question of whether we are truly exceptional after all or whether we are just confronting the challenges of finding a way to balance economic, political, and social demands and resources the way that all other nations and peoples already must.
If the end of the nineteenth century saw the close of the frontier, the end of the twentieth may have witnessed the close of an ever-expanding economy. The American Dream has been built on a foundation of plenty - natural resources, investment capital, jobs, and consumer demand. These seemingly boundless assets have translated into both opportunity and optimism. Cheap land and the lure of the West provided these for our first two hundred years. Industrial and scientific expertise and the growth of individual rights provided them for the last one hundred. What will provide them in this century? Or is the American Dream turning into the American Nightmare?
While shouting at each other, both the left and right may hardly recognize a shared concern: the sense that they are caught amidst economic forces that threaten the self-sufficiency and control over one's destiny so central to what we have always believed was the promise of being American.
True, political rhetoric on both sides of the health care debate refers to the impact of proposed policies on economic well-being. Democrats promise that reform will save money for the government and individuals just as passionately as Republicans charge it will cost both heavily. But these are arguments about byproducts, the side effects of enacted reform. The underlying disease goes largely undiagnosed as a source of the conflict. We argue about health care as a proxy for a condition we cannot quite see and don't know how to face. What legislation can one craft to rescue the American Dream?
Nor will health care be the last proxy fight. Anger over immigration reform, fears about how we will rescue Social Security and Medicare, the pressure within states on Medicaid costs, and demands to reduce the debt (by making someone else pay the cost) suggest that worries about the American Dream lie under far more issues that health care.
Perhaps, like the shouting couple, we need a societal time out so we can see and address the core problems we have to solve. Perhaps we need to recall that mutual respect and careful listening are essential to a healthy relationship. And perhaps we need to accept that solving deeper problems requires giving something up, that we can be better together only if we seek to meet another's needs, not just our own.