Paternalism is a dangerous thing. Someone in power thinks he knows what is best for his people more than they do. Making decisions for others is often emotional. Often the response to paternalism is a passionate outpouring and a violent reaction to the feelings of being trapped, ignored or powerless.
On Sept. 30, National Public Radio, the Kaiser Family Foundation and the Harvard School of Public Health released a study that illustrates that Americans feel the same way about health-care reform.
The survey, which was developed to study the role of health-care interest groups, was telling. The study asked respondents about how well members of Congress are listening to different groups. Seventy-one percent of respondents marked that Congress is not listening to “people like you.” In addition, 61 percent felt that Congress was not listening to people on Medicare enough, and 56 percent felt that they were not listening to the uninsured enough.
Fifty-six percent did not even feel that Congress was listening to the ubiquitous public opinion poll. In addition to being asked about what the public thinks is influencing Congress, respondents were asked, “Do you think there is any group in Washington today that represents your own view on what’s best for the country when it comes to health care, or not?” Fifty-three percent of respondents said, “No.”
These numbers should not come as a surprise. How would the general population know what Congress was planning with regard to health-care reform? The current bills are mammoth tombs that exceed 1,000 pages. Professional policymakers are acting more like playground bullies or Chicken Little screaming that the sky is falling. We have abandoned reasoned debate for ignorance and innuendo. The end result is that the public is losing faith.
Even the return of reasoned debate might not help us find safe passage. For many have lost faith in the federal government or even hold them responsible for the crisis.
Bob Blendon, professor at Harvard School of Public Health, argued during an interview on NPR’s “Morning Edition” on Sept. 30 that the public and the government do not even agree on the cause of our current crisis.
He says, “In our poll, when you say who’s responsible for the current problems they see in health care, it’s insurance companies, pharmaceuticals and the federal government. It’s not focused at all on the way the system currently operates in terms of delivery.”
The problem may be more than a disagreement about who is responsible. The public may have lost trust in the government to fix a problem that they hold it responsible for creating. In July, Time released a poll that illustrated Americans’ growing distrust of reform. The study found that 62 percent believe that reform will raise health care costs, 65 percent think it will make health care more complicated, and 56 percent see reform as providing less patient freedom.
No wonder we have seen passionate protest and even violent outburst in public forums. People feel our lawmakers are treating us like children. They know what we need and they will give us what they think we need.
Many are in support of health-care reform, but they feel that the public’s concerns or needs are being ignored by those with the power to create a new health-care system. Others are in support of health-care reform, but they lack an understanding of the proposed solutions. Still others do not trust Congress to solve the problem it may have created in the first place.
With all of this in mind, how do we move forward? What must we do? We need to return the power of voice to the voiceless. We need to have open, calm and reasoned debate about what is being proposed.
First, we need to set aside our emotive arguments, ad hominem statements and fear tactics. Next, Congress, political action committees and ethics groups need to focus upon the public and re-establish trust. The easiest way to do this is to take responsibility for our past failures and listen to the public’s desire for the future.
We need honest discussion, not pie-in-the-sky promises. The public knows that the system is broken or needs major renovation. They also know more of the same will only give us more of the same.
Monty M. Self is the instructor of spirituality at Baptist Health Schools-Little Rock and the Oncology Chaplain for the Baptist Health Medical Center-Little Rock.
Senior Staff Chaplain and Clinical Ethicist at the Baptist Health Medical Center in Little Rock, Arkansas.
