[This post was written by UCSD Sociology Graduate Student Jeff Lundy. Previously, Jeff posted here about Why Everyone Younger Than You Is Spoiled, drawing on his insights into the problems of amateur accounting for inflation and cultural and technological change. Today's post is about the current debate on healthcare and the role of expertise and skepticism in public debates. For a related point, check out this recent Daily Show clip on the media's disastrous role in the current healthcare debate.]
The Paradox of American Skepticism
The current healthcare debate is, without a doubt, a source of ire for many liberals. The White House finally has a savvy, liberal President. Democrats finally have a strong, filibuster-proof majority in Congress. The need for healthcare reform is pressing and has been for quite some time. Before the election, many Americans seemed extremely interested in the plans of candidate Obama. And yet, with all forces seemingly faced in the right direction, the irritating question remains: why is there so much trouble in making this healthcare reform happen?
I have to admit I was surprised by the depth of resistance that emerged against reforming our health system. Protesters were taking to the streets and town halls before there was even a definitive plan to rail against. (On a side note, isn’t it weird to think of conservative protesters? It seems like an oxymoron. I guess we live in strange times). Clearly, selling healthcare reform is much harder than I (and probably many other liberals) had previously thought; and this is a very irritating fact.
Now, there are one-million things I could say about the healthcare debate. I’ve read CBO reports, CDC reports, not-for-profit non-partisan reports, etc. However, this resistance to healthcare so surprised me that it got me thinking about something deeper than the debate about healthcare and the battle between liberals and conservatives. I thought to myself: why is it that Americans would resist changing a system that is so patently bad? Furthermore, why are so many Americans immediately apprehensive about changing the system? And what’s more: if they are so apprehensive about changing the system, why don’t these same Americans do any kind of research to figure out the facts on the matter?
These final thoughts brought me to a paradox about the American public. On the one hand, a large number of Americans are extremely skeptical of government policies, when one considers “skepticism” in the conventional sense – i.e. automatically mistrusting any plan that is proposed. On the other hand, however, Americans also seem extremely un-skeptical when one considers skepticism in the “scientific” sense – i.e. demanding empiricism and well-reasoned thought be applied to any proposition.
That I think this is a paradox probably has to do with me being an ivory-tower academic. And yet, I know that for myself (and many of my friends), my first impulse is to do research whenever I hear some heated debate that I don’t know much about. I take this to extremes sometimes (I recently did a semi-extensive literature search on college football); but yet, the impulse is fundamental. I need to know the facts on the matter. However, I don’t sense this impulse is fundamental for most of my fellow citizens.
And this leads me to a great concern. My impulse to research facts has led me to recognize that almost everyone talking about an important issue is grossly wrong. Even your common “experts” and “pundits” generally seem to know only about 50% of the facts about any pressing matter. The healthcare debate is no exception.
For instance, I’ve heard from liberals that the current state of healthcare could be fixed by removing company profits. However, the best estimates of company profits reveal that they are likely ~1% of the total GDP spent on healthcare. This estimation process is really complicated, and there are lots of counterarguments that could be raised, but the main point remains: profits are nowhere near the main source of our problem (at least in a straightforward sense). The same troubled reasoning goes for the conservatives’ favorite argument about “tort reform.” If we enacted these “reforms,” we would only reduce our health expenditures by at most 2%. And you only get that number if you take the most grossly unrealistic estimate of the impact of tort reform (i.e. if we strip consumers of every right to good treatment they currently enjoy). Numbers can be backed up with CBO reports, if you want to double-check.
The real source of the growth in healthcare spending is not one of these easy, naïve answers. It probably has a lot to do with the current state of medicine, which is centered on complicated treatments, instead of preventions or cures. The problem is multiplied by our society’s increasing insistence that everyone live as long as they can, while being given the absolute best treatment (a noble goal – but one which I think most people haven’t truly thought through to its fullest consequences).
However, I digress. The point of this post is not to disseminate the best thoughts on the healthcare debate; the more fundamental question I hope to ask is: why don’t most people realize how far off they are from understanding the sum total of this problem? Why don’t people know how much they don’t know (and how much “science” as a whole doesn’t know) about healthcare, and other important topics? How can we get more people to do some research whenever they feel the impulse to be angry about something?
This is an honest question. I honestly don’t understand this situation; but if we could figure out why this is happening I believe we’d open up the possibility for some major changes. For instance, I believe that most of the healthcare debate would be solved if everyone just understood the best facts we have on the matter.
I imagine some of this lack of inquisitiveness comes from people mis-estimating the amount of information needed to form a strong opinion. Maybe some of this lack of curiosity is caused by our education system focusing on facts and less on processing information. There are certainly many contributing factors.
I don’t think that the answer to why people aren’t more “scientifically” skeptical is that they are too stupid. People far less informed than current-day Americans have been tough-minded and inquisitive when facing challenges. I also don’t think it’s simply that people don’t have time to think through matters, or that they don’t have the necessary skills to evaluate the complex information needed to have a strong opinion. These may be reasons for why people are lacking in a strong opinion, but they can’t explain why so many people hold bad opinions.
So now I end this post with an appeal to anyone who finds him- or herself reading it: Fill me in. Let me know every idea you have on this subject. Set an ivory-tower intellectual straight and put his feet on the ground. Tell me your thoughts on why people can be so angry, misinformed, and also undesirous of better information, all at the same time.