Sunday, August 30, 2009

DON'T BE NAIVE, STEVE

Steve Benen is a terrific blogger and has been a great friend to this blog, but this seems to miss the essential nature of America and its people:

In some ways, conservatives couldn't possibly win the [health care] argument -- the status quo is ridiculous. We spend too much and get too little. Tens of millions of Americans go without coverage, and thousands die as a result of not having insurance. The existing private system screws over consumers, is a drag on the economy, and undercuts wage growth. The two groups of Americans best served by the status quo are seniors (in a Canadian-style, socialized system) and veterans (in a British-style, government-run system). Everyone else is in, at best, a precarious position.

Left unchecked, the dysfunctional, inefficient, patchwork health care system threatens to bankrupt the country. Reform was a no-brainer.

In this sense, Republicans, their allies, and their media partners had a seemingly impossible task.


No, that's wrong. They didn't have an impossible task, because they know that most Americans don't see health care the way we cerebral, wonky, well-read types see health care.

We're looking at the big picture -- all the things Steve describes. Most Americans are looking at themselves, or people like themselves. Poll after poll shows that most Americans are satisfied with their current health care -- yes, that just they're satisfied for now, but that's all that matters. Sure, we know that quite a few of them are facing serious pitfalls -- denial of coverage after a serious illness because the insurance company will now motivated to find a preposterous excuse to stop paying claims, loss of coverage because of unemployment, and so on and so on -- but most Americans who aren't in dire straits right now just aren't thinking about these risks.

They aren't thinking about the complex ways expensive emergency-room care for the uninsured gets tacked onto their premiums. They aren't thinking about (or don't know about) the fact that there are multiple treatments for many conditions, and the use of more expensive ones is making the whole system more expensive, which raises their premiums, frequently without making any more people healthier. And on and on.

And they certainly aren't thinking about the relative administrative costs of private and public insurers. What could be more boring?

The system is complex. We wonky lefties have at least a rough notion of the whole complex system in our heads. Most Americans don't.

So it's easy to scare most Americans with a complex-looking chart of a proposed Obama health care system because they don't ever think about the fact that our current system is scarily complex. They never think about the big picture. It's easy to scare them with talk of evil bureaucrats emerging from the shadows to thwart their heath care wishes because most people, at this exact moment, aren't going through that with an insurance company. It's easy to deceive them, in other words, because they simply never think about what's true regarding our existing system. It's just not of interest to them, except when they need to deal with it.

Steve goes on to say:

There are plenty of old sayings about the most effective sales professionals -- they can sell sand in the desert, they can sell ice to the Inuit, etc. The right's challenge was the opposite -- they had to tell a drowning country not to accept a life-preserver. That's an extremely difficult task.

But that's just it: most Americans think they already have a life preserver -- either private insurance (they choose not to think about the fact that it could be snatched away from them, or turn out to be a fraud at the worst possible moment) or government insurance from Medicare, the VA, or Medicaid (which they don't think of as government-run, because New Deal/Great Society rhetoric is a dim memory, while the dominant Reagan/Murdoch/Limbaugh/Beck rhetoric tells them that all government social programs are evil; they know that's true and yet they know their own health care system isn't evil, so they just choose not to ponder the contradiction).

If this discussion had started with a national Health Care for Dummies conversation -- today, class, we're going to explain where Medicare comes from: it comes from the government -- maybe we wouldn't be in this mess. But we were never going to start there, because we wonky Democrats always think Americans start with the knowledge base we take for granted.

Republicans know better. That's why they win.

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