• Did Obama fail to justify health reform? Ctd.

    The questions I posed in a post earlier this week generated some interesting discussion in the comments and on Twitter, which Paul Kelleher notes in his post at Bill Gardner’s place. Paul works himself around to a defense of wonkery. Who can argue with that? It’s worth a read. See also this RWJF summary of related work by Julia Lynch and Sarah Gollust.

    The bottom line for me, personally, is that I am well aware that in the minds of many, many people Obama did indeed fail in whatever attempt at a moral argument for universal coverage he might have attempted. Yet, he did not fail me, but that is only because I had the luxury and motivation to pay close attention to what he said and what others said for him. However, if an argument penetrates only the uber-wonks who are obsessed with reading every blog post pertaining to health reform, then it is indeed tempting to conclude that it isn’t an argument well made or made forcefully enough.

    The trouble is, it is not a simple argument. It could be a simple one if we had a different health system, one that doesn’t already benefit the majority of Americans through subsidized coverage. How does one overcome the strong status quo bias and vested interests, particularly in an aggressively partisan political debate?

    I’m just not convinced the moral argument can succeed against those odds. Are we sure we’re witnessing a failure of effort or just a failure? Did Obama not shout loudly enough or was he shouting into a tornado-strength wind? Or, in seeing the tornado, did he rationally conclude that saving his voice for other arguments was the best he could do?

    • I certainly did not hear every statement the President or his surrogates made about health reform, but I heard many of them and I don’t remember anything saying something to the effect that over the next 10 years ______ (number) will die needlessly, ______ will be disabled needlessly and _____ will be hospitalized needlessly. Even with all the caveats that would have been needed about methodological limitations and margins of error, and conflicting research, , I still think we should have heard statements like that more often.

    • I suspect that anyone reading this blog is pretty well invested in health care issues, so it may be difficult to answer this question. I do think that Obama spent more time on the details of making the plan work. However, I also seem to remember the right getting upset when it was claimed that people were dying due to lack of health insurance. If you deny the moral argument, you may be more prone to thinking that it was never made.


    • I’m just an anonymous American citizen who has no standing in the wonkish discussions of economics either of finance or medical care. However, I took part in lobbying efforts at the Congressional level in the run-up to the votes on health care reform and I followed the public debate in mainstream media to some extent. I also worked for the Obama GOTV efforts as a volunteer. I supported and continue to support a single-payer, national health care system.

      I think complexity is not an excuse for failure to inform a concerned public about the details of our system of insurance and care and the problems of increasing costs and decreasing coverage. Yes, this story is complicated, but it can be told carefully and clearly. As can the stories of other societies’ systems of dealing with these same matters. But we very rarely see such reporting and explanation in the mainstream media. Similarly, in the great furor over the debt ceiling, the deficit, and the budget, we see almost no careful explanations of, say, tax structure, the history of tax rates, graphs showing the growth of the deficit and the relation to the recession and tax cuts, etc etc etc.

      The public struggles to be informed on the urgent matters of the day and they are extremely ill-served. It is very distressing to me to know that real and valuable information on public matters can be found and studied, but then to turn to mainstream media such as the Washington Post or the NYT and see almost nothing within those pages that provides facts, figures, data, and a coherent, continuing use of those in reporting the ongoing debate. What I find most odd about these media is the apparent partitioning between their online and ‘print’ personas. The NYT blog edition contains Krugman’s blog and occasional posts by Uwe Reinhardt, for example. These are deeply informative, but they seem to have almost no effect on the ‘news’ content of the paper.

      I don’t think the problem is a failure to make a moral versus a wonkish argument. The problem is a failure to provide sufficient fact and detail about the realities of our system, coupled with accurate comparisions to other existing systems. To do this would require well-informed reporters, however. And these reporters would be dedicated to following the debate and their editors would have to be similarly dedicated to running regular reports, even when there was no political fireworks to use as a hook. In short, the issue would have to be treated like the serious matter it is.

      • See my post next week about Paul Starr’s forthcoming book. The US is really in a different place with respect to health reform than other nations and it really does complicate things. It’s not an excuse. It’s a fact. And it matters, as we can plainly tell by the nature of the debate.

        I think this is under-appreciated, and it is a reason to read Starr’s book (due out in October).

    • I’m not sure if you’re addressing my comment or not. I am in no way denying the complications of any public debate on matters of real concern in this country. I do not, however, think that health care reform is unique in this respect.