Open letter to Doug Usher of Politico.com in response to a forwarded column of his.
Thanks for the email. By the way I would use an email system that sends messages out with the recipient in the TO: field even if it is being sent to others.
It is sad that the debate is about health care reform as the word "reform" both is inadequate and allows the conversation never get serious about the real issue. Perhaps it is impossible for Americans who have not lived in other countries to grasp what the issue is about.
So let me give you an analogy that might help and would then explain why Americans back off support when pressed on the "details."
Imagine that America did not have a comprehensive fire department system. People would only get service for their burning house if they paid immediately by credit card when they called 911 for the fire department or if they were on the list of privately paid fire dousing insurance. And in addition, insurance companies would deny coverage if they found that a smoker had visited the house or if children below the age of 10 lived there.
The conversation would be whether we should have a single payer fire insurance system or continue to have the best fire department system for those who could afford it (unless they were retroactively denied coverage). There might be an effort to make sure children living in a house might not be considered a reason to deny coverage (of course, restricting the cost of such premiums would be considered price controls). Or to reform the system with a single payer system (note that our current system is not single payer). Or to come up with vouchers for people living in rowhouses (imagine living on a street with 90% coverage because one family saved money by not paying for fire coverage even with a voucher system).
Then go and poll the inhabitants of this land. They might not want to subsidize "those people" living in rough sections of town. Instinctually, they might know that their system was broken, but trying to fix it involves helping those who haven't made an adequate contribution to society. Harry and Louise ads would explain that you as an individual would be forced into a system that would mean that fire trucks might go first to the three alarm fire rather than your home; that the equipment would be second rate like in Cuba.
Then we living outside of this swiftian vision of America could step back and talk about the real issues that hold us back from a more humane society. Surely we can provide fire dousing to every house on fire. How it gets paid for is immaterial. We could better understand the funding issue as purely one that has allowed us to get mired in unimportant details. We might ask better questions if we we could stand outside and look in. Right now the arguments of the "liberals" to help the uninsured look like a handout system to poor and "brown and black" people. The arguments of the "left" for single payer look like anti-profit and anti- US economy. The arguments of the "reform-minded" conservatives look like attempts to mitigate the current system. To people outside the system all three look silly, because they see it as we would see the society of pay for fire dousing: either we save lives of others in our community or we don't.
This is the reason that the movie both fails as people cannot see the real issue of the film and believe it is about health care reform and succeeds as people are moved closer to seeing their system from the viewpoint of those outside of it. Just like the Britains who laughed at the absurdity of not providing care to those who need it, we need to stand outside and look in.
I do not envy you trying to observe the issues from within the confines of the current understanding of the issue here in the US. Even if you could step back and get a better grasp of what is going on and then get pollsters to ask insightful questions, it might be nearly impossible to convey it to your readers who believe they understand the issue.
P.S. I will add a link from my blog to Politico with a copy of this as a post. Don't worry no one reads or understands my blog postings.