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

-- 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 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, and a number of other television personalities and elected officials, would go on to draw parallels between the Obama administration and the Nazi and Soviet regimes countless times. Many posters at rallies 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.”

Where Did Reform Advocates Go Wrong, And How Did Their Opponents Succeed?

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. The party in power would go on to pay a heavy political price in the mid-term elections of 2010. 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.” 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.

While it’s true that Obama didn’t sell the legislation perfectly, much of the backlash was inevitable. “When new types of social organizations are required, respectable, well-thought-of, and conservative people are unable to take part in them,” says Arnold. “Their moral and economic prejudices… compel them to oppose any form of organization which does not fit into the picture of society as they have known it in the past.” Those who benefit from the existing order come to see it as morally perfect. They do not choose their creed; they become bound by their loyalties and enthusiasms toward existing organizations.

The great success of conservative politicians and media outlets was that they provided the words and parables necessary to express the distrust that people already felt. They laid out a consistent narrative in which a vaguely foreign demagogue used his oratorical powers to convince people to give up their freedoms and become more dependent upon an out-of-control federal government. Ironically, one of the lessons that the Obama administration took from the Clinton administration’s failed attempt at reform was the need to appeal to insured Americans by explaining how they would stand to benefit from proposed reform. Unfortunately for Obama, it is much easier for people to see what they already have (and fear its loss) than to imagine what they might gain.

What Was Gained.

Supporters of reform often focus on missteps and what might have been, but it’s important to remember that in the end a rather significant piece of legislation was passed. Obama avoided a number of the pitfalls that sank reform efforts in Clinton's first term. He involved Congress in the drafting of the legislation, worked with the insurance industry rather than against it (including the group that financed the Clinton-era Harry & Louise ads), and most importantly, he did manage to pass a bill. While the Democratic Party suffered short term political disaster in the 2010 midterm elections, there was a potentially greater political cost to investing so much time and capital and coming away empty handed.

The PPACA isn’t all that supporters hoped it might be, but its provisions are destined to become existing government organizations and to amend our mythology of government. The political cost of reform can be mitigated by arguments that place reform within the framework of accepted principles and organizations, but there will always be a cost, and there will always be those who resist new organizations until they become existing organizations to which they may stubbornly cling.

Eben, I'd like to continue to edit this during the summer based on your comments. Thanks.