Let Them Eat Cake: Stepping Outside the Health Care Reform Comfort Zone

How would Ms. Antoinette
ponder health reform
with her advisors?

While commonly attributed to Marie Antoinette, the phrase may actually be testimony to Jean Jacque Rousseau's genius in using four words to capture an elites' inability to grasp the plight of a struggling underclass.  For a more modern depiction of a lifestyle bubble, think of the 1% not getting just how difficult it can be to make a living wage.

And it's not just the 1%. African Americans, with some justification, note that whites have yet to grasp "the set of experiences and a history" that perpetuates racial inequality. It's not just the "facts" but how facts are sorted, prioritized and interpreted by a brain wired by decades of being surrounded by like-minded people caught up in their information loops.

But it cuts both ways. When confronted by the hostility of tens of millions of Americans to the Affordable Care Act, liberal-progressives likewise respond with similar puzzlement. Who can blame them for rationalizing things with attempts to provide more "education" or blaming it all on obstinate Tea Bagger and "Birther" wackiness?

It's not that simple.  As pointed out in this The Atlantic article, conservative skepticism about the size, regulatory reach and spending of government was well underway long before Mr. Obama set foot in the White House.  Focus groups have little trouble finding deeply held opposition to expanding government entitlements, middle class dependency, pro-business globalization, wealth transfers and scary levels of deficit spending. Given the big picture,  Obamacare is less of a problem than a symptom. 

As result, even if the White House and its Democratic allies prevail on the shutdown showdown, successfully raise the October 17 debt ceiling, cancel the January 1 2014 sequester and take back the House in November 2014, the opposition to the health care law isn't going to simply fade away.

But, say my liberal friends.....

1. Much of the Affordable Care Act is based on Republican ideas, including the mandate and Romneycare.

The mandate and Romneycare were never intended to be imposed nationally, but adapted by each of the states. 

2.  It will save money.

Health care consumption declined before the passage of the Affordable Care Act. Experts legitimately disagree on the impact on future health care costs but it stands to reason that more people with insurance will lead to increased demand and higher spending..

3.  The health care system is broken

Actually, the part of the system that was broken was the individual insurance market.  This objective OECD Report summary points out that, compared to many other developed countries, U.S. quality has been quite good and our cost trends are lower.  And while it's too early to tell, the health insurance exchanges travails combined with multiple other self-inflicted wounds suggest that the cure may end up being worse than the disease.

The point here isn't who's wrong or who's right.  Rather, it's clear that skepticism over Obamacare's ability to deliver on all its promises is not crazy.  Its critics not only deserve their time in the public square but to have their preferences reflected in policy and legislation..

What's more, the Obamacare dust-up is part of a bigger concern over the expanding role of government that tens of millions of Americans find potentially intrusive and unaffordable.  The inability of the DMCB's liberal progressive colleagues to comprehend that may be a less a function of their superior intellect or the stupidity of the opposition than an Antoinette-esque inability to step outside their familiar biases and ponder a different point of view. 

Valuable Personal, Political and Health Reform Lessons, Courtesy of the Federal Government Shutdown

Coming to consensus
the old fashioned way

The Disease Management Care Blog views the federal government shutdown with the same morbid fascination of watching personal injury lawyers justify their double digit malpractice suit contingency fees: it's so awful, it's hard to look away.

The good news is that that doesn't mean that the shutdown doesn't hold some important personal and political lessons.  They can make DMCB readers better citizens and our political class a credit to our Republic. 

To wit......

When the DMCB spouse expresses consternation over the boneheaded actions of her husband, the DMCB can now respond by:

1. changing the subject,
2. retreating to the DMCB World Headquarters and blogging about the spouse's unreasonableness,
3. referring to the alleged lapse as a "glitch."

Things don't go well in the opening day of a widely anticipated unveiling of the largest health care achievement in the history of the United States.  If you were in charge, you would respond to the health insurance exchange breakdown by:

1. recognizing the problem and promising to fix it,
2. reminding the public about the painful gap between lofty campaign promises and disappointing bureaucratic reality,
3. shrewdly drawing flattering comparisons to Apple, the most widely admired brand in the world.

As the leader of a political coalition, you are stymied by the division of powers in the world's longest lasting democracy.  In response you:

1. seek consensus
2. deploy ad hominem attacks in press conferences
3. offer to compromise by allowing the opposition to do things your way.

Wanting to be an informed member of the electorate, you regularly watch either CNN, FOX News, MSNBC, PBS, CBS, NBC or ABC because:

1. These broadcasts' news editors subtly frame their closed information loops to meet your own political biases,
2. You haven't discovered BBC or Al Jazeera
3. There aren't any movies on TV featuring svelte vixen vampire babes having their way with their mesmerized male victims.

By pointing out that Obamacare is "the law of the land," you are really saying:

1. Our representative democracy passed legislation that was signed by the President and upheld by the Supreme Court, so get over it,
2. Now wait a minute, our representative democracy can modify or even roll back health care laws.
3. Enough with the debate, time to move on and figure out how to make preschool education, low interest mortgages and low-fat frozen yogurt protected federal entitlements.

Being a Game of Thrones fan, you wonder if the following might not be useful in settling the budget impasse:

1. Asking what the honorable Ned Stark would do, until you recall that he was beheaded.
2. Invite the opposition to a Red Wedding
3. Call up your elected representative and say "Hodor!"
4. Call up your elected representative and hear him or her say "Hodor!"