Cognitive Dissonance And Health Insurance Reform
Obama recently promised to move forward with reform of the health insurance industry, which is very risky for his party's re-election prospects. However, he may be giving the nation what it wants--even if it doesn't know it yet. While that sounds like a condescending statement from liberal elites, other poll numbers bear it out. The rise of conservative "Tea Party" activists and their protests make this hard to believe, but an recent analysis from the respected New England Journal of Medicine shows that over 80% of the American population approves of some form of individual health insurance reform. This support, unfortunately for the Obama administration, evaporates when the public learns the specifics about any particular plan.
According to experts, the psychological phemomenon of cognitive dissonance is to blame. When a person holds two contradictory ideas at once, anger and anxiety result. Cognitive dissonance is not uniquely American, but journalist Abigail Trafford claims that healthcare reform is a perfect example of the American mindset. After all, this nation was born of pioneers seeking freedom from the tyranny of the British government. The image of the rugged individualist is enduringly popular for a reason: Americans still hold those values dear. Many of them also desire their lives and businesses to be free of their own government's intervention--hence the libertarian movement. Increased regulation of health insurance companies is against what they stand for, and threatens further encroachment of Big Brother.
On the other hand, the United States is not controlled by anarchy. Although pro-independence and individual sentiment is extremely popular in America, the public would never stand for a complete lack of laws. Despite their political and ideological views, most Americans want at least some degree of law and order. Personal responsibility is important; but few people have seriously suggested that, for example, public fire departments be dismantled in favor of people either hiring private firms to put out the fire or having property and lives destroyed. Even those who steadily call for significant government tax cuts do not propose doing away with taxes; to them, certain (albeit limited) government services are worth some encroachment of their personal income.
The average American wants some form of social safety net, although many may not realize it. People have differing opinions on how wide and deep that safety net should be, but still believe it should exist. None other than small-government proponent President Ronald Reagan signed a law that requires hospitals and ambulances to provide emergency medical services, whether or not a person has the medical insurance or the ability to pay. However, they do not want laws that seek to prevent them from going to the hospital in the first place. Experts liken this mentality to crashing motorcyclists: the motorcycle rider (or American resident) may resent government intervention that mandates that he or she wears a helmet (or buys health insurance), but he or she would like the government to provide him or her with emergency care after the crash (or other health event). Europeans, by contrast, are more honest with themselves: in generally collectivist societies, they have chosen slightly less independence for a stronger social safety net, and pay higher taxes to live in a nation that provides it.
How does this relate to the current healthcare reform debate? Psychologists have found that cognitive dissonance, left unresolved, causes people to become angrier and more defensive in order to justify their positions to themselves. This would explain a portion of the vitrol that has come from both sides. These days, the Medicare insurance program for senior citizens is popular, despite similar initial controversy. Cognitive dissonance causes older Americans who oppose medical insurance reform to demand that the federal government "take their hands off [their] Medicare", while failing to understand the irony of that statement. Unfortunately for supporters of individual health insurance reform, many Americans have not been effectively convinced of what's in it for them.