Mark Schmitt says the health-care reform's benefits go beyond expanding coverage and lowering costs. The legislation should also help bring peace of mind to an increasingly anxious citizenry.
Some years ago, while working on a doomed presidential campaign that staked too much on a detailed, flawed health reform proposal, I organized a meeting of the policy and communications staff tasked with explaining the plan. The hardest thing for young, healthy, insured policy wonks like us to keep in mind, I recall saying, is that the place in our brain where we think about health and security is close to the brain's locus of anxiety. And the voters most interested in health policy are also most likely to be anxious about their health, or insurance coverage. And so, as frustrated as these voters may be with their current health insurance of lack thereof, they will be the least receptive to wonky explanations about how a complicated health proposal will improve the system for everyone.
A standard lesson of behavioral economics is that people weigh the risk of losing something they have more heavily than the chance of gaining something better. That's even before coming to any question of trust in government or Democrats or liberals. Getting over the hurdle of convincing people that a complicated change will be for the better must always overcome that basic psychology. Overcoming that obstacle, whether in the minds of voters or politicians, is the basic story of the yearlong journey toward health reform's passage. Democrats were aware of that challenge as early as the 2008 campaign, which, remarkably, forged a shared approach to health reform, rather than a half-dozen incompatible alternatives. Hillary Clinton and then Barack Obama tried to buy anti-anxiety insurance with the promise that "if you like the coverage you have, nothing will change." While this strategic maneuver represented a lesson learned from the overblown promises of 1993, it created a perception that the legislation would benefit only the uninsured, and offered nothing but costs for those of us with insurance.
