Government, the Thinking Man, and the Patient Protection and Affordable Care Act

-- By JamesCrowley - 16 Feb 2012

Introduction

In the introductory chapter of The Folklore of Capitalism, Thurman Arnold describes a political culture in which practical solutions to recognized problems frequently become the objects of vigorous opposition. Writing in the 1930’s, Arnold saw a country in which the “pressing problems of waste of labor and national resources” necessitated new organizations for which there were no places in the existing mythology of government. “The social needs were felt by everyone,” he says, “but the slogans which the new organizations used had a queer sound.” Law, morals and economics were therefore arrayed against them.

In modern day politics this pattern is perhaps seen nowhere more clearly than in the debate over health care reform that dominated political discourse in this country throughout most of 2009 and early 2010. At the time it was universally acknowledged that the United States spent more on health care relative to GDP than any country on the planet only to lag behind most developed nations in many key indicators of public health. It was also well known that many citizens were regularly denied access to necessary care because of their inability to pay. Against this backdrop the party in power introduced legislation based heavily on past conservative proposals only to see it denounced as socialism and strenuously opposed at every turn.

A Devil Found and a Hell Invented

“All arguments against heresy follow the same pattern,” says Arnold, “A devil must be found who is leading the people astray. A Hell must be invented which illustrates what happens to those who listen to the Devil. Then the age-old story is told. Russia and Germany listened to the Devil. They are therefore in Hell.” Those opposed to health care reform found their Devil readily in Barack Obama. Somewhat oddly and anachronistically they found their Hell, like Roosevelt’s opponents some seventy-five years earlier, in Russia and Germany.

Prior even to Obama’s election Glenn Beck created a promotional video in which he described Obama as “the path to the new socialist motherland” to the tune of the Soviet anthem. He would go on to draw parallels between the Obama administration and the Nazi and Soviet regimes countless times on his television and radio shows. He was joined in these comparisons by other television personalities and elected officials. Many posters at rallies held in opposition to the proposed reform depicted President Obama sporting a Hitler mustache, while many others associated the reform and its proponents with the swastika or the hammer and sickle.

“Men do not actually search history to avoid the mistakes of the past,” says Arnold, “they seek convenient analogies to show the dangers in failing to adopt the creed which they advocate.” It was effective to draw extremely tenuous connections between the Obama administration and Hitler’s Germany and let imagination fill in the rest. Making more realistic comparisons to the health care systems of modern European social democracies wouldn’t have the same effect. While terms like communism and fascism were thrown around as readily in 2009 as in 1932, then as now “it was only important that these words be used to surround new organizations in America with a vague atmosphere of disorder.”

Comforting Obstructions, Then and Now

In the 1930’s those who saw Roosevelt’s New Deal legislation as a threat to the capitalist order rather than a set of practical solutions to recognized problems were “offered spiritual comfort” by a Supreme Court that “had been confusing and delaying every exercise of national power to solve national problems.” Those fearing change in 2009 were likewise offered comfort by legislators who made use of all available tactics in avoiding a vote on the proposed legislation. Many individual legislators fueled the hysteria by refusing to debunk clearly erroneous claims, including the supposed possibility of government “death panels.”

What Went Wrong?

When the dust settled supporters of health care reform were left to wonder what had gone wrong. They had championed seemingly moderate reform in an effort to ameliorate a recognized problem and had managed only to pass a watered down bill after a year of fighting. Many wondered if Obama had relied too heavily on “the conception of a group of thinking men in society to whom rational appeals can be made, who are willing to accept right principles when they are logically explained.” After all, much opposition was based on ridiculous concerns over things like death panels, concerns that didn’t fade no matter how often the underlying myths were debunked.

Obama may have been guilty at least in part of believing too readily in that “highly idealized portrait of an individual which flatters him and makes him proud.” Still, there is evidence that he was never so naïve as to think that he could win support for his proposal exclusively through advertising its practical benefits. Throughout the national debate, and with increasing frequency as it dragged on, he made efforts to place health care reform within the framework of accepted American principles, tracing a line from turn of the century progressives to the New Deal reforms of Arthur’s era, to Johnson’s Great Society and straight through to today. These previous reform movements made great strides, amending American folklore and creating accepted places in the American mythology for new organizations.

Conclusion

Perhaps fierce opposition in the face of a perceived threat to the established order was inevitable. Perhaps the greatest legacy of the Affordable Care Act will prove not to be any specific provision it contains or immediate effect it has on health care in the United States, but instead its role in the development of the set of principles and mythology necessary for a new health care regime to rise in an atmosphere of religious devotion to the established regime.

This draft is capably written and assembled. The effort to dovetail Arnold's rhetoric with the superficial narrative of recent events is mostly successful, partly because you deal so much with the absurdities and so little with the substance of the situation.

But it's really shooting fish in a barrel. You take the opportunity to make the obvious comparisons. You don't teach much to the reader about how Obama succeeded and how Obama failed. You don't explain how his executive branch staff and the Congressional leadership interpreted the problems the last Democratic Administration had in dealing with the cost and access issues. You don't describe either the White House approach nor the efforts of the Democratic majorities in Congress. Nor do you explain precisely how the public uproar generated by the Republican Party, Rupert Murdoch's outlets, and the other sources of counter-publicity succeeded so massively that the legislative triumph became a short-term political disaster. All of these matters would have interested Arnold, and received from him a trenchant (and quite predictable) analytic description. Another draft that adds attention to these elements (at the expense of your conclusory editorial rhetoric, which is not so serviceable, and dependent upon tightening up the portions which are now a little blowsy) would be a significant improvement. Even better would be a draft embodying an idea of yours rather than one of his.