Why do people oppose the health care reform?

by Alek Davis

In the Erron Morris’ documentary, “The Fog of War“, the former Secretary of Defense, Robert S. McNamara, describes a conversation with the former Foreign Minister of Vietnam:

There aren’t many examples in which you bring two former enemies together, at the highest levels, and discuss what might have been. I formed the hypothesis that each of us could have achieved our objectives without the terrible loss of life. And I wanted to test that by going to Vietnam.

The former Foreign Minister of Vietnam, a wonderful man named Thach said, “You’re totally wrong. We were fighting for our independence. You were fighting to enslave us.” We almost came to blows. That was noon on the first day.

“Do you mean to say it was not a tragedy for you, when you lost 3 million 4 hundred thousand Vietnamese killed, which on our population base is the equivalent of 27 million Americans? What did you accomplish? You didn’t get any more than we were willing to give you at the beginning of the war. You could have had the whole damn thing: independence, unification.”

“Mr. McNamara, You must never have read a history book. If you’d had, you’d know we weren’t pawns of the Chinese or the Russians. McNamara, didn’t you know that? Don’t you understand that we have been fighting the Chinese for 1000 years? We were fighting for our independence. And we would fight to the last man. And we were determined to do so. And no amount of bombing, no amount of U.S. pressure would ever have stopped us.”

McNamara implies that both sides misunderstood each others’ intentions: North Vietnamese assumed that the U.S.A. were planning to replace France as their new master, while Americans saw Vietnam as a proxy of Russia and China readying to spread Communism in Asia. McNamara suggests that understanding each others real intentions back then could’ve helped the two countries avoid the conflict and saved millions of lives.

I wonder if McNamara’s idea could be applied to the health care debate. Would it make the dialog between the opponents and the supporters of the health care reform more civilized and productive? Would it help if both sides of the debate made an effort to understand the motivations of the other side?

I read hundreds of articles, research papers, studies, watched and listened to many interviews, heard multiple personal stories, and have a couple of my own. Knowing what I know, I cannot understand how anyone can object the reform, but many of those who do are among my friends, co-workers, and neighbors, mostly intelligent people. Why don’t they see what I see? Can I understand their motivations? I want to give it a try.

From my liberal, pro-reform, and what some may call “biased” viewpoint, I see that the opponents of the health care reform represent different groups, each with its own motivation:

Profiteers include health care executives, investors betting on health care industry profits, and all those making insane amounts of money and who have most to lose. Of course, UnitedHealthcare CEO Stephen Hemsley does not want to shake the system that brings him $100,000 each waking hour. He and his buddies are fighting for their self-interests. I can understand that.

The richest 1.2% — although not all — obviously do not want the proposed 1%-1.5% surtax on the income amounts exceeding $280K/$350K per year (individual/family) to pay for poor people’s health care. If you make $1,280,000/year (individual), you rather spend the extra $10K (thank you, George W. Bush) on things better than someone else’s health care. Understood.

Beneficiaries are those who don’t make fortunes on the current system, but somehow directly or indirectly benefit from it, such as rank-and-file employees of health care companies, administrators handling insurance paperwork for health care providers, and so on. Although health care reform will probably bring more jobs (with more people having access to health care more medical professionals will be needed), some of the administrative and/or non-productive positions will be eliminated. While losing a job is not the end of the world (people lose jobs even without reforms), I can see this group’s perceived threat to its well-being, so I can understand its opposition, too.

Politicians are actually split between the two groups, but they both have the same goal: being re-elected. Non-conservative politicians opposing the reform most likely get significant campaign contributions from the insurance companies and other interest groups opposing the reform, so they want to continue the flow of contributions in future. Conservative politicians must please their base, which mostly opposes the reform, so they play along. Again, motives understood.

Hate media jockeys – Beck, Limbaugh, O’Reilly, Hannity, Savage, & Co. — would not say that they like anything about the policies or intentions of Democratic government (and President Obama in particular) even if they did (I’m stretching my imagination here). The more angry they sound, the more outrageous and preposterous claims they make, the higher their rating climb. This is how the entertainment/propaganda machine brings ratings/profits these days, so it would be stupid for them to move this machine into a different direction on the issue of health care, even if it contradicted their own opinion. Consider this one clear, too.

Seniors are a special case. They seem to like Medicare, yet they do not want government-run services to be extended to people without health insurance. Some seniors don’t realize that Medicare is a government-run program, but what about others? It seems to me that Medicare recipients opposing the reform are afraid that any change will negatively affect their services. What I do not understand about this attitude — besides the obvious selfishness — is that it should be clear that the Medicare system is more likely to be affected by spending cuts without the reform. With medical costs escalating, just wait for the next round of legislators to get the Republican majority and you will see the job Newt Gingrich started finished. Grandpa and grandma: GOP does not liked Medicare: never did and never will. How one cannot understand this, I do not understand.

Conservative Christians oppose the reform for several reasons, but only one of them is relevant to the Christian teaching: abortion. Although, FactCheck.org believes that the House bill would allow abortions to be covered by a federal plan and by federally subsidized private plans, other interpretations are less certain. I do not see even the FactCheck.org’s interpretation to be different from the current system where employee health care contributions can be used to cover abortions of other plan members. If you oppose the reform because of your position on abortion, what about your current health plan to which you make contributions? Does your current health plan cover abortions? If so, shouldn’t you cancel it? On a different note, it’s hard to imagine that extending health care to the uninsured will somehow result in explosion of abortions, but okay, I can understand the desire to protect the unborn. What I do not understand is: why the same people caring about the lives of the unborn do not care about the lives of the living. Shouldn’t both be protected? How can you advocate one and not the other? Being a Christian, Christians’ opposition to the health reform puzzles and upsets me the most. How can you spend Sundays preaching about the Good Samaritan, helping the poor, taking care of the needy, and healing the sick, while at the same time opposing the efforts of the society to do the very same things. I don’t think I can understand that.

Libertarians hate all things government (and especially Democratic government), including taxes, social programs, etc. Since health care is a sort of social program funded by taxes, libertarian opposition to the reform seems logical, at least more logical than Christian opposition. Yet the whole concept of libertarianism seems strange to me. I’m all for self-reliance and against bureaucracy and government waste, but I definitely do not want to live in a medieval society. Hey, I don’t like paying taxes either, but I like to drive on public roads and visit public parks. I expect police to to protect us from criminals and the army to defend against foreign aggression. I’m glad that public schools, colleges and universities offer free or affordable education. I don’t visit libraries that often, but it’s nice to know that they are open. And I want health care to be available to all: healthy and sick, young and old, rich and poor. It seems civil. So even thought there is no plan to raise taxes on 98.8% of the population, if I have to pay a bit more in taxes for someone’s medical care, it’s okay with me (it’s probably the best use of my tax money). Libertarians also tend to believe that government cannot do anything good, which again is not accurate, since the existing government-run health care programs (like Medicare and VA hospitals, which already cover about 28% of the population) are managed cheaper and get higher customer satisfaction than private insurance.  Even the most vocal opponent of the government-run health care admits that U.S. government-run health care is best. Puzzled? Me too!

Anti-entitlement groups oppose social programs intended to help disadvantaged. From their perspective, people are not entitled to anything including health care. If someone is sick, it’s his/her problem. If you don’t have health insurance, it’s your fault. If you had insurance, but your benefits were rescinded after you got sick, you must have done something wrong. We’re not gonna pay for you, period. I don’t understand this attitude on a number of level. First, it operates under a false assumption that all needy are bums, which is so Old Testament: poor=sinful, rich=righteous. Sure some people without health insurance are bums, but the majority is not. Second, it’s not civil. A civil society takes care of the vulnerable, and I want to live in a civil society. Third, people don’t like to think about bad things, but bad things happen. You may be healthy and well-to-do now, but what if you get cancer and can’t work? What if you exceed your lifetime benefit cap? Wouldn’t you want the society to take care of you?

Fiscal conservatives, who fear that the reform will add to the budget deficit, would’ve made sense had they been consistent in their strive for balanced budget. Had they opposed the Iraq War, which costs more than the health care reform would, or Bush Tax cuts, which over 10 years will cost 2.5 times more than the health care plan, then their opposition would’ve made sense, but thus far, it does not go beyond hypocrisy. Beside, one of the goals of the reform is to contain the ever escalating cost of health care (which is already highest in the world), so if done right, in the long run it will actually help balance the budget.

Anti-immigrant league, which blames the evils of society on illegal (and sometimes legal) immigrants, is afraid that it will have to pay for the new wave of illegal immigrants seeking “free” health care. Being an immigrant myself, I do not appreciate the bigotry directed at newcomers (both legal and illegal). After all, the forefathers did not get the permission from Native Americans to land here, so directly or indirectly we’re all in this country illegally. Most of the anti-immigrant rhetoric is based on false assumptions and wrong facts (even the Cato Institute — a libertarian think tank — concluded that the legalization of undocumented workers would be beneficial for the native-born). And regardless what Rep. Joe Wilson (R-SC) thinks, the health care bill does not ensure access to health care to illegal immigrants, which is a shame because doing so would make more sense. So I understand the anti-immigrant rhetoric, but it is not supported by facts.

Obamaphobs don’t like the President, and this seems to be a sufficient reason to oppose the President’s policies. “We’re afraid of Obama,” people say. I’m not sure what exactly they fear: they seem to be in no imminent danger, and most are doing quite well. I guess, for some it’s a racial issue, for others it’s a Democrat-is-a-President issue, and for others it’s a mental problem that could be treated with therapy and/or medication (I’m not trying to be sarcastic here). So the “bad Obama=bad reform” logic is simple, but it sure is weird… and unhealthy.

Neo-McCartyists see communist conspiracies everywhere, even in such well-meaning projects as health care expansion. Ronald Reagan made the very same arguments when he warned about the dangers of Medicare in 1961, so it’s not new, but equally baseless. The whole logic is flawed: communist/socialist countries have public health care, therefore if the U.S. adopts public health care it will turn into a communist country. By the same assumption we can say that the U.S. is already a communist country since it has public schools.

Conspiracy theorists see health care reform as yet another government plot against them. This is the group that believes in the concept “death panels”, “Obama will kill your grandma”, “universal health care=slavery”, and other equally stupid concepts. I do not even try to understand this.

Misinformed is the group made of people who take the common myths about health care at their face values. They claim that the U.S. health care is the best in the world, although they probably haven’t experienced health care in France, Canada, U.K., Germany, or any other industrial country (and they probably did not have a serious encounter with U.S. health insurance either). They assume that the escalating health care costs are driven by malpractice law suites and illegal immigrants. They believe that you can get a cancer drug at Walmart for $10, that free county and city hospitals are open to people without health insurance, that special programs and sponsors are ready to pick up your bill for emergency treatment. People from this group have at least three things in common:

  1. They get their news from Beck, Limbaugh, O’Reilly, Hannity, Savage, and other Fox pundits.
  2. They either (a) have health insurance (most likely via employer) or (b) are healthy.
  3. They did not experience major health problems, especially when holding individual health insurance policy or without insurance.
  4. They do not consider a possibility of losing health care coverage (people do not ask themselves: what if I get laid off? what if my working spouse loses job?).

I know it’s possible to hold onto these assumptions and live in a knowledge shell until something bad happens to you (then you’ll find first-hand whether these assumptions were right or wrong), but come on: have some intellectual curiosity. How do you know that U.S. health care is the best? How do you know that health care in Canada is worse? Dow you know how much malpractice law suites contribute to rising health care costs? Have you actually tried to find a free clinic? There are answers to these and many other common questions available online. Google is your friend (or you can start with my own Everything you need to know about U.S. health care reform post, which addresses many questions).

I’m not sure if any attempts to understand the opposition will do any good or lead to a more constructive dialog, but I wonder what the opposition thinks about the pro-reformers. If you are against the reform, do you really think that Obama has a secret plan to kill your grandma and turn the country into the Soviet Union? Seriously, what do you think about the motivations driving the reform supporters? I’d really like to know.