Health Care: Americans Want Change While Keeping Status Quo

By Michael Kinsley
Friday, August 28, 2009

The reason Americans have turned against health-care reform, after electing President Obama in part for promising it, is simple: Despite protestations to the contrary, Americans don't like change. You wouldn't know it, of course, if you listen to politicians in high-pander mode, or to talk radio hosts of the right or TV pundits of the left. Or, for that matter, if you listened to the president of the United States. You would think that while we might disagree about what kind of change we want, Americans are in total agreement that the current situation is intolerable in all areas and that change -- big, immediate change -- is essential. Americans do agree about this -- in the abstract. But as soon as it seems that change might actually happen -- as soon as we leave the abstract for the particular -- we panic. We suddenly develop nostalgia for the comforts of the status quo. Sure, we want change -- as long as everything can stay just as it is.

Yes, of course, the opposition party has gotten away with some grotesque misrepresentations. But that will always be true as you move from the abstract to the particular. There will always be a Betsy McCaughey sharpening her pencils and cackling as she underlines promising sub-clauses. And she will always find something. Obama thought he could avoid this by not supplying the document. He thought -- hell, we all thought -- that Hillary Clinton's big mistake in the 1990s was too much detail. Obama said he would leave all that up to Congress. But at some point, you've got to show your hand. All Obama seems to have achieved in the end was a shift in timing -- and not an advantageous one. Instead of being in trouble almost from the beginning, his reform remained popular until it was time for Congress to vote.

The similarities to the last time we tried health-care reform are striking. Bill Clinton had campaigned on a call for change in general and health-care reform in particular. Rising costs and increasing numbers of uninsured made the system seem intolerable. There were deep disagreements about what change was needed, but whether change was needed appeared beyond dispute. Afraid of being tagged the party that prevented change, Republicans were about to give up and compromise. Then GOP apparatchik extraordinaire Bill Kristol blew the whistle. He said, better to be thought of as against all change than to be tarred as in favor of any particular change. It seemed like a lunatic idea at first, but Kristol turned out to be right -- politically. He was wrong about the actual substance of the issue. As a result, in the 14 years since, millions more are uninsured, and here we are trying reform again. I'd like to think that if it goes down this time -- when even the insurance companies are on board, promising to eliminate their odious policies about preexisting conditions -- Republicans will pay for having killed it, if indeed they do kill it. But they didn't pay the last time.

All this is similar to those polls about attitudes toward Congress that show that most people find Congress absolutely loathsome, yet are extremely fond of their own representative. Once again it's the difference between the abstract and the particular. Congress in the abstract is greedy, stupid and corrupt. It will do anything to get reelected. Your own representative, though, is Congress in the particular. And he or she is not so bad, even though he or she actually does get reelected.

Why does this happen? Some people (including me) say the voters are immature. Politicians (and those talk radio fellows again) are always telling them that they are wise and those folks in Washington are fools. Pollsters seek and validate their opinions on subjects they haven't bothered to learn anything about. Politicians drown them in benefits with no thought of how the bills will be paid. No wonder that citizens turn out like spoiled children. But "immature" is a label, not an explanation. It's just a guess, but my own suspicion is that the raucous town hall meetings that blindsided pols and press alike reflect the voters' true feelings -- misinformed, perhaps, but sincere -- and their previous passionate demands for what they now passionately oppose -- in a word, "change" -- were empty ritual. Discontent verging on anger is almost the price of admission to our political culture these days. You're nobody if you're not furious at Congress and/or the media and/or your health care and/or the president. To believe in your country's institutions is virtually unpatriotic.

This is only as long as your discontent can remain abstract, of course. When you are asked to approve of even moderate but genuine change, the status quo starts to look pretty good.

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