I found this article on the BBC website to be in equal measures interesting and depressing. It is called Why do people vote against their best interests? and is about the US healthcare issue, but really has lessons for the left over here too.From this side of the pond it looks like a no-brainer.  Here in West Sussex we have huge uproar over hospital issues. To put it in perspective, we have GP surgeries right across Horsham and Crawley that are free to everybody, we have hospitals in Horsham and Crawley that are free to everybody and can treat most conditions, at Crawley there is an urgent treatment centre that can treat most walk-in cases and quite a few ambulance cases too – all free to use – and to back it all up there are two major acute hospital within 20 miles of Horsham town centre, and all free at the point of use to everybody.
With all that, there are still protests and campaigns to have more hospitals and more services. Meanwhile in America, using the example of Texas from the BBC story, about a third of the population have no medical cover and a fifth of children have no medical cover. If they get sick or injured there is no guarantee of treatment and yet they seem to have even bigger protests because Obama wants them to have the sort of access to medical facilities that we have.  A rational person would expect them to be dying of envy for us, but instead they are fighting to remain deprived.
So here in the UK we find it hard to understand why Americans protest about the prospect of having what we protest about not having enough of – with the exception of the Dan Hannan tendency who would prefer us to move to the US model – but the BBC story, drawing from some recent books and theories tries to explain why that could be.
It seems to boil down to a basic human trait of paying more attention to narrative than to facts.
How I understand it is that, collectively, we act like contrary teenagers. If our parents tell us we should do something because it is better for us we are against it because it our parents telling us.  We have our own minds, how dare they have the arrogance to decide what would be better for us just because they know more? I think we have all been there, and probably found ourselves ten years later wishing we had listened, and ten years after that getting the same reactions from our own teenagers.
The worrying aspect of the story is that you can see it happening here to an extent. The recent fuss about ‘dodgy statistics’ on crime is a great example. On one side of the fence we have statistics gathered to show the drops in different types of crime. On the other hand we have the Tories with a catchphrase of ‘broken Britain’, backed up by anecdotal evidence and a distortion of the statistics. Guess what? Lots of people hear the ‘broken Britain’ catchphrase but don’t want to hear all the real statistics, whether that is because of a natural mistrust of official statistics, or anything official, or our famously reduced collective attention span or some other reason entirely doesn’t really matter: the bottom line is that the broken record wins over any reasoned argument.
Ironically, it is hardly necessary for the Tories to keep misrepresenting the crime figures, except as a hook to get the broken Britain message back on the front page of the Daily Mail – nobody is paying any more attention to their mendacious interpretation of the statistics than to the proper interpretation.
The reason why this is depressing is that, even knowing why Tories get their arguments across better (style having greater impact than substance, complicit media, etc.) does not help. There are certain character traits ingrained in the left that will not be overcome:
For Mr Westen, stories always trump statistics, which means the politician with the best stories is going to win: “One of the fallacies that politicians often have on the Left is that things are obvious, when they are not obvious.”
So true. But I can’t see us abandoning our facts for rhetoric. It just feels wrong, despite the Labour Party’s reputation as being masters of spin (if only that was true). I’m sure we will continue to counter emotive, baseless, but effective soundbites with reasoned argument that just turns the voters off, because at the end of the day we on the left are no more able to control our instincts than the poor Americans without healthcare who are voting to stay that way.
He [Thomas Frank] believes that the voters’ preference for emotional engagement over reasonable argument has allowed the Republican Party to blind them to their own real interests.
That is the challenge right there. How do we find a way to compete on emotional engagement without abandoning our quaint, self-destructive preference for reasonable argument?
Sorry about that rare diversion into dull theory. I’m sure I’ll be back to trivia again soon enough.
\” A rational person would expect them to be dying of envy for us\”
Thats only if you believe that the NHS is the envy of the world. The fact is that the overwhelming majority of Americans have healthcare that they are happy with – health care which is better than that provided by the NHS.
Given that most are happy with what they have already it is hardly surprising that they are reluctant to give that up for some politicians promise of a healthcare nirvana – especially as the present government run healthcare services are inefficient and almost bankrupt.
Many americans are deeply concerned at the cost of this proposed change and their confidence has not been helped by the lies that have come out in support of it – first they were told it wouldn\’t cost any more (coverage for another 50 million people wouldn\’t cost anything?), that they could keep their present doctor, that they could keep their present plan etc. etc.
Yes the US needs to expand coverage, but to get widespread support you need to offer the majority something better than they have now – this has not been done.
And just loved the \”cant see \’us\’ abandoning facts for rhetoric\” – classic. Are you hoping to win the comedy vote in Horsham?
If there is a big comedy vote in Horsham I’ll happily chase it 🙂
“The fact is that the overwhelming majority of Americans have healthcare that they are happy with – health care which is better than that provided by the NHS” – Ash
Ash, dear, have you seen Michael Moor’e’s “Sicko” ?
Obviously not.
When you have, try writing that comment again.
Richard, if you get your views of America from Michael Moore then you will be very ill educated.
This should educate you a bit better than Michael Moore:
“More than eight in 10 Americans questioned in a CNN/Opinion Research Corp. survey released Thursday said they’re satisfied with the quality of health care they receive.”
http://edition.cnn.com/2009/POLITICS/03/19/health.care.poll/index.html
Ash. Well, yes, I can understand that 80% of Americans are happy. The other 20% are uninsured and not covered by Medicare.
What is the comparable figure in the UK (I think in most countries it’s about 90%)?
And as for the costs – they are already paying it. Whether it’s in hospitals that give up chasing bills, or cases that get left until they turn into emergencies, or lost days work, high levels of personal bankruptcy. It all adds to a drain on the economy.
On top of that, the US pays about double per person what *any* nation does for healthcare, and is ranked about 38th in the world for quality. The UK is about 18th. While they may not want to follow us there are plenty of other countries that get better value for money and better quality of care that anyone can access.
You are missing the point Danivon – it doesn’t matter what the comparable figure in the UK is or that the UK is better ‘value’.
For someone in the US with insurance and that is by far the majority, they are in receipt of excellent healthcare (better than the UK) and are understandably unsure about restrictions on that care and extra taxes to pay for those that, in many cases, choose not to be insured.
I have never met any American with insurance (and I have spent an awful lot of time in the US) who looks at the UK with ‘envy’ – yes if you have no insurance then any other system that provides ‘free’ healthcare would be attractive. But that is the choice of the desperate, not the choice of those with good provision.
>I have never met any American with insurance (and I have spent an awful lot of time in the US) who looks at the UK with ‘envy’
Of course not. Americans are pumped full of nationalist propaganda, and could never think another country is in any way better than they are at anything. I think they should envy the Swiss system – it’s pretty similar to what the Healthcare Bill would have delivered and in line with their economic outlook, and yet is far better in terms of outcomes.
My point was that in the US, people with provision may well be happy (of course, with the phenomenon of losing cover over pre-existing conditions, and at the loss of a job, they may not continue to be so), but millions are not in that position.
And as you say, they are desperate. But hey, we know that capitalism and conservatism are not about helping the people at the bottom, they are about blaming them for their own problems, aren’t they?
Well you can make all the childish comments about Conservatism and capitalism you like if it makes you feel better, but the fact remains that a majority of Americans are not willing to forego the quality of care they have for a system that will cost more and in many cases provide less.
Until you come up with a system that improves on what the majority already have I doubt that there will be much appetite for change.
I pointed at one- Switzerland’s system. It has better outcomes, costs less, and everyone is covered.
It is odd though. Before actual reforms are proposed, most Americans want change. When they think they may have to *pay* for it, they run screaming. If they think the ‘undeserving’ poor might get something out of it, they call it communism.
(and yes, I know Americans too, most of whom are covered and who oppose change)
But Obama was not offering the Swiss system.
Likewise the Singapore system offers better outcomes, costs less and everyone is covered than the NHS but it simply is not on the table – so there is no real point looking at them is there?
Ash, if I were happy, as you appear to be, to know that the most affluent 80% of my country were selfish enough not to care that the other 20% (who in some cases will be colleagues, friends and relations of the affluent) could not afford to seek treatment for even common ailments and injuries I would be ashamed to be ill. And choosing to eat rather than pay for healthcare is not a fair choice….
It is also worth remembering that there will be communities in the States where the percentages are reversed (a minority will be able to afford insurance) – those communities deserve a chance to have a healthy, productive workforce in order to increase the prosperity of the entire community.
Well for a start many of those not insured are illegal immigrants, and Obamacare will not offer coverage to them – and many choose not to have coverage.
A major problem with the US system is that it is voluntary – many young people choose not to pay for insurance or only pay for catastrophic cover – they choose to pay for general health care out of their own pocket as they go along.
Forcing everyone else to pay for these people that choose to have little or no coverage is not that attractive to everyone else.
Ah yes, choice.
They can’t afford it usually, and have the idea that being young means they can do without. If healthcare-related bankruptcies were not a major issue (even before the recession), then you may have a point.
And your last point is indeed the problem. If everyone pays, then the effect would be minimal (and the young would end up subsidising the old, perhaps even reducing their premiums).
Well as Obamacare did nothing about reducing the cost of health care I dont think we need to worry about premiums going down.
But you seem unwilling to admit that unless you can come up with a plan that either improves the healthcare of the vast majority who already have coverage they are happy with or reduces the cost for them, any reform is going to be unpopular with the general public.
What makes the Public NHS the “envy of the world” is in its wonderful vision – especially during the “1945 Revolution” – a book co-written by Pound Hill’s Peter Young.
It was post-war ‘consensus of care’ in action – with the vision of health (& education) for ALL – not just those who could pay for it.
There was a vision also of making the Government-led, Public-controlled NHS (& State Education) so good that no-one in their right mind would want to go back to Privately-controlled Health & Education service.
The US, at the time, saw this democratic Socialism as a form of Communism – and they went down the Private route.
That vision is now lost, because the ‘social consensus of care’ has disappeared (thanks mainly to Thatcherites & Reaganites)…and we’ve lost the moral plot.
I we don’t somehow regain our moral senses, and start caring again, we can kiss goodbye to our humanity & future.
Perhaps the Crawley Labour Party should centre their election campaign around this book, “The 1945 Revolution”, co-written by Crawley’s Peter Young :
http://catalogue.nla.gov.au/Record/2516218
Perhaps then, after their decisive election victory in May, Peter may be persuaded to write a follow-up : “The 2010 Revolution” 😉
Ash (I’ll reply to both threads at ones).
1) The Senate Bill was pretty close to the Swiss system: Mandatory insurance, private provision (no ‘public option’), support for people who are unable to afford premiums…
2) Your maths on cost is based on assumptions. If the overall cost rises, but at the same time more people are paying premiums, that means that the premium level per person could go down. Additionally, if the costs of publicly-funded or written off care were reduced because more people were covered by insurance, then the system would be more efficient.
3) The American public are not a homogeneous lump, but they do appear to be a little confused over the past year or so. They elected a man who campaigned for ‘Change’, and who said he would reform healthcare in the direction of extending coverage. And having done that, they now seem to be saying “Oh, actually, we don’t want much of that change at all, now we come to think of it”.
One fundamental thing about democracy is that the people should ‘own’ their democratic decisions. Otherwise, what’s the point?
4) You like the Singaporean system? Yeah, I’m sure it works in a compact city-state with a virtual one-party (originally a socialist party) monopoly, whose economic success is based on state planning, and where the government owns vast swathes of the economy. I’m not sure how much of their healthcare system can transfer to the UK without the other parts and at the same scale.
Which is why I compare Switzerland to the USA. Both are Federal democracies with high levels of local and state/cantonal autocracy. Both are more market oriented than most of Europe. Both are very keen on personal liberty – for natives at least – in he forms of gun ownership, direct democracy. Of course the major difference in in size.
In answer to your points.
1: Obama never said at any point in the whole process that he didn’t want a Public Option, in fact he continually said the opposite – so the comparison with Switzerland is not valid.
2: One of the major reasons that Obama has lost trust is that he has continually lied about Health Reform – and his biggest lie was that insuring an extra 40 million people wouldn’t cost any extra. The CBO shot that down in flames and he hasn’t really recovered since.
3: To be fair to the voters, they voted for Health Reform based on what Obama had said – as more and more has proven to be untrue they obviously lost confidence.
4: I do agree that the Singapore system has no chance of being introduced here – mainly because there is too much vested interest in keeping the NHS as it is.
I’m not sure that the Swiss/US comparison is actually valid – Switzerland has a very clear system of direct democracy where ultimate power lies with the people, the US is basically a corporate society where power lies with big business.
“The US is basically a corporate society, where power lies with big business”.
I agree with you, Ash, on that one – and that is the main reason why we should avoid imitating the US :
It’s not a Democracy (of, by & for ALL people). It is a Plutocracy (of, by & for POWERFUL people).
It is therefore essentially a tyranny run by tyrants.
Is that what we want here in the UK ?
If so, vote for that Tory – Henry ‘Wannabe MP’
Smith.
An interesting discussion, but I think that it misses the original point, while simultaneously acting as a great example of it.
Outside the rather limited pool of people actively interested in politics and political theory all of the arguments one way or the other would be blown out of the water by a convincing soundbite catchphrase.
Vast numbers of voters on both sides of the Atlantic would switch off within a few words of any of the fact-laden arguments – and not because they are stupid, just because it is the way we are now.
Our best chance of progress lies with the parties who have the best stories also having the best policies because one without the other isn’t enough any more.
Our own fault, but the media are complicit. Even the supposed flagship politics show, Question Time, is little more than a circus now, where getting a round of applause is more important than being right.
“Vast numbers of voters on both sides of the Atlantic would switch off within a few words of any of the fact-laden arguments – and not because they are stupid, just because it is the way we are now” (Skuds)
People “switch off” because they no longer feel able to trust the politicians who represent them (or want to); because they are angry at the bullshit & lies which masquarade as truth & sincerity; because they are confused by the obfuscation in the media.
People can think for themselves (& act accordingly). People can understand for themselves the complexities of political theory. People do have an attention span greater than a goldfish….
But what people find difficult is to think CLEARLY.
Why ?
Answer that question, and people won’t “switch off”.
Oddly, a lot of the bullshit and lies is media based rather than something people hear first-hand from politicians. Some people do have non-goldfish attention spans – even soaps last half an hour ata a time – but they save their attention for stuff they care about. The problem seems to be making people care and the media have no interest in that. Partly because it is hard to do without appearing partisan and partly because they fear it would send us running to other media outlets that are not trying to make us care. I don’t know what the solution is but watching the people who do care about politics (mostly the politicians themselves) telling us what everyone else is doing wrong rather than coming up with ideas of their own is not working….
“The problem seems to be making people care and the media have no interest in that”
I agree SS – but I believe we need to understand the bigger problem to find the solution :
“Media” is the primary medium for communicaton
– especially for politicians – but this Mainstream Media is Corporate-based & Corporate-controlled – working within. State Capitalist System.
This System – which we all work under – survives & thrives only on competition & selfishness – not cooperation & care.
So, the corporate Media within our present system
is not designed to care – just as a shark is not designed to care.
Somehow, We the People, have to rise above ‘the system’ – and if a politician can help us in that endless quest, people will listen…and care…and vote accordingly.