As we all know, health care reform is moving through Congress like a kidney stone. For all of the news that the health care debate has generated, you might think that the American public would be very well informed about the different proposals circulating in Congress right now. Alarmingly, but perhaps not surprisingly, you would be wrong.
This is true even at Yale. While I have not quizzed a sample of the student population to get a sense of what percentage of Yale students know that, for example, the Senate Health Committee bill would cost $611 billion, the Senate Finance Committee bill would cost $829 billion, and the House bill would cost $1 trillion. I think it is fair to say that very few of us could explain the specific differences between the five bills that have now been passed out of five different committees. I certainly couldn’t.
Some of us know about competing proposals for a public option, a public option trigger, an opt-out public option, or a co-op. But do any of us know for sure how many people each would cover and at what cost?
Of course not. And with good reason. This stuff is really, really complicated. Even Congress doesn’t really know; members rely upon the Congressional Budget Office to crunch the numbers and try to make sense of what the different bills would actually do.
This collective ignorance is not necessarily a problem. After all, unlike some political issues where people have legitimate ideological differences and support different ends (abortion is an obvious example), health care is something about which we should all generally share the same goals. We all want the best care for the most people for the best price. The details of how to achieve this are undeniably complicated, and those of us who aren’t health care policymakers should be able to leave the policymaking to the experts. That is why we have representative, not direct, democracy.
But reality in the health care debate is much messier. Unfortunately, ideology has not been eliminated, particularly on the Republican side, where hostility to the public sector cannot be overcome by facts. For many right-wingers, the public option is “socialized medicine” and is thus unacceptable even if it would result in everyone being covered at less cost and with better medical outcomes. The successful systems in just about every other industrialized country suggest this would be so, but conservative Republicans remain unswayed.
Additionally, those with a vested financial or political interest in the status quo (and perhaps those advocating one specific reform package over another) tend to manipulate data to claim that their proposed course of action will have the best results. Now, I am well aware that the data is complicated and that it can have multiple interpretations. But those who cherry-pick in order to support a personal agenda at odds with the public interest are categorically different from those who honestly believe the data implies different things. The latter can work out their differences — and the reform bill will be better for it. The former just obstruct.
With a debate between those who want to provide better care at a better price and want to find the best way to do that on one side and those who want to preserve the status quo (whether their reasons be ideological, financial, or political) on the other, an unfortunate lack of symmetry skews the debate. The naysayers don’t really care about making factually consistent arguments, as we saw both at the town hall meetings in August and from arguments (or just yelps) by Governor Sarah Palin, Congressman Joe Wilson, and others who should know better.
Those who recognize the need for reform, on the other hand, do care about facts. But many of us don’t know the facts.
As a result, the debate has been driven by those who scream the loudest. Although their claims have seemed preposterous, they are difficult to refute with the actual facts. Voters on the fence are left confused. Given a choice between the known and the unknown, they opt for the known, even though they don’t like it. Without public support, momentum for reform in Congress has slowed.
Since the end of August, beginning with President Barack Obama’s speech to Congress, those in favor of reform have done a better job making their points. But the fight is not over.
Those of us who want to improve the health care system — and I think most of us do — need to read up and understand how the proposals in Congress right now will improve the health care system and why a public option will cover more people at a lower cost. When confronted with an anti-reformer who says something that seems ludicrous, we need to be able to say more than “I really don’t think that’s right.” We need to have enough knowledge to correct them.
This debate is about more than politics; it is about people’s lives. The American Journal of Public Health estimates that nearly 45,000 deaths every year can be associated with a lack of insurance. Young adults are more likely to be uninsured. So get the facts. The life you save could be your own.
Matthew Ellison is a senior in Branford College.