Would-be reformers, take note

Ezra writes:

Among the many reasons I'd prefer not to be a politician, navigating the remarkable confusion of your constituents as to their opinions on public policy issues ranks high up there. They're for abortion, for abortion restrictions; for lax immigration laws, in favor of draconian enforcement; for going through the UN, enamored with acting unilaterally; for tax cuts, for spending increases; and on and on it goes. The phrase "mutually exclusive" is absent from America's political vocabulary, as is the concept of a "tradeoff."

He's right on the mark. That's why we have a war that, if there was a draft, no one would want to fight, a war without any tax increases. This logic extends to health care reform and our quest to fix the system.

Just look at my post from yesterday, where I discussed the ramifications of Gov. Romney vetoing the employer assessment. 

When I attended the National Health Policy conference in February, an entire presentation was devoted to the idiosyncrasies of health policy polling. Sure, the vast, vast majority of Americans are in favor of reform, and a majority will even support a "modest tax increase". But if you name any specific dollar amount of that tax increase, the foundation of support crumbles.

I wish I could say, "This is a cultural problem; let's try and fix it." But the truth is that this is a symptom of democracies -- when you're insulated from making the calls, it's easy to support or protest them. A change in perspective, where people bring themselves to support reform with trade-offs, only occurs in the face of substantial problems and hardship (like premiums reaching $20,000/family in today's dollars).

In the meantime, we should keep talking about all the things that are wrong with the U.S. health system, and all the ways other countries succeed where we fail. That way, when it's time for reform, the foundational message and education will have been laid, and coupled with the public's willingness (if not desperation) to act, efforts will hold strong.   

Comments

[opit]

I've been "hanging out" on the comments thread at Washington Monthly (Kevin Drum's Political Animal - Calpundit) for some time now.
Realizing that it does not sound credible on first blush, I suggest that the dysfunctional government programs were part of a deliberate pattern of sabotage covering every government department if the flurry of conflicting - often obscene to hysterical -posts there can be trusted to illuminate the situation. Or check with Ezra.
Regardless, you may need to "get out" more.
I feel safe in saying that was the basis of Stephan's comment about "feature, not a bug".

[Steve Beller, PhD]

>> I wish I could say, "This is a cultural problem; let's try and fix it." But the truth is that this is a symptom of democracies

Actually, I think the state of current day democracies is a symptom of the negative side of human nature.