Cognitive Dissonance: Health Care & Taxes
October 4, 2017 -Steve Hays
We hear a lot now about cognitive dissonance. That’s not bad if it means we’re noticing inconsistencies that all of us notice in our lives from time to time and, ideally, resolve in a way we feel good about. Seems like the country is doing that these days.
Cognitive dissonance (CD) seems to be big part of the debates we hear on taxes and health care. Some of those “opposing” realities are worth looking at because we don’t hear much about them; and since resolving CDs involves how we feel about where we end up—ideally, a more humane place where we can identify what is (and what isn’t) worth debating.
Thinking about the “that will never work” or “there’s no money for that” conversations, I ran across what a 70-year-old man said as he was stuck in a Houston shelter with people fleeing Harvey. A proud Texan, he said that half the problems Harvey caused could be solved in six months by Texans. A proud American too, he knew that our great new president would solve the other half of the problems in six more months. In fact, he said, he usually wore a button on his cap that read, “Proud American” and he’d be wearing it then, but “the Blacks in the shelter keep knocking it off.”
Yes, we are a diverse society with more ways than one to view reality. Reinforcing a CD is to think doubling down and ignoring other views works better than getting creative or co-creating, but is that democratic?
Isn’t the beginning CD issue often that there is no way we can do or afford something? Or is it that we are an ingenious, creative and enterprising people who can overcome obstacles and challenges and to resolve problems? Maybe it’s time we embrace the latter.
If we are creative and want to explore approaches, can’t we give up pointing out the UK health care system does x, y and z all wrong; or that the Canadian system won’t work because of a, b and c?
Don’t we want our own system? We want to notice what works and take the best from other systems, don’t we? Isn’t it a distraction to think we have to adopt another country’s system and faithfully stick with it? Politicians love distracting us, planting seeds of fear when we let them. Seeing the horrors of other systems helps us avoid the same problems. That’s good. Let’s find our own way—how can we not?—and give up the tired “reality”—we can’t.
Another CD to resolve is that our representatives will have the perfect answer in advance of applying it. Are all our decisions irreversible?
Sometimes in life don’t we start over with our work choices, relationships, residence locations, and even beliefs? Life does offer us some flexibility. We can change our minds and feelings, or else we couldn’t explore, discover, learn, fall in love, or forgive.
Isn’t thinking we have to know in advance an unworkable reality? We all know we can’t know exactly what we are getting into, but most of us try to figure it out anyway. We do our best, then adjust, adapt and get more creative.
Isn’t another pattern that we want to give up the one that plants seeds of fear, instead of possibilities, when someone isn’t getting their way? A little childish, isn’t it? But terrorists, in and out of government, use that technique all the time.
Following the money, instead of the OMGs, might be more useful. Fortunately we are hearing more about money’s influence in the news these days.
A distraction for me is the argument that health care is a right. It may be a right, or not. We may want the government involved or not, but the Bill of Rights doesn’t mention it as a right. Why argue it is when whether we can do it, legally and Constitutionally, is what’s important?
Drones, nuclear weapons and the Internet are not in the Constitution either. But we know the government can promote the general welfare, insure domestic tranquility and provide for the common defense. If you live in San Diego or regularly go downtown as I do, you know we need public sanitation as a defense from hepatitis and other diseases. Sixteen people have died, and since November 444 hepatitis A cases have been reported. More than New York, Texas and California combined, in all of 2015.
People aren’t calling insurance companies or businesses to fix it. They don’t clean the ocean and polluted air either. While public health care may not be specifically mentioned in the constitution, what has been established by law and upheld in the courts, is this: “The Emergency Medical and Treatment Labor Act (EMTLA)passed by Congress in 1986 forbids the denial of care to indigent or uninsured patients based on a lack of ability to pay.” (From freeadvice.com). The law applies to hospitals that take Medicare or Medicaid, and “emergent” conditions only—not to private practice doctors and urgent care centers.
So we have crowded emergency rooms that raise everyone’s insurance rates. Congress’ solution: get rid of Medicare and Medicaid. This means people can then be turned away. Simple and cost effective, right? And somehow they sleep at night.
Isn’t this cognitive dissonance with several realities and lots of emotional consequences tied to the choices we make? Do we watch the problems, such as we have in San Diego, get worse and more abundant with no obligation on the medical community to provide treatment to those who may be spreading disease?
Can we afford not to have the government involved in health care? No health system in the world relies entirely on insurance companies. In most countries with national health care, insurance companies provide more premium coverage options.
That we don’t have the money is a topic I hoped to address more last minute changes cut this space short. But it’s worth remembering that the US government collects $1.1 T a year in taxes that goes toward discretionary spending and spends more than that. Yet tax deductions ($ not collected) worth another $1.1 T are not collected—the majority of that benefits the top 1%. What people in the US pay in insurance premiums is $3.35 T, or about $10,000 per person. The idea that we don’t have money is a good example of cognitive dissonance.
What’s missing is the will to change. The criteria for a solution is what allows us to sleep at night..