talking about the health care forums and civil discourse

This morning, I was on “Radio Times” with Marty Moss-Coane. That’s a call-in program of WHYY-FM in Pennsylania. The MP3 file is here, for those who like to listen online or download podcasts.

My fellow guest was Martin Carcasson from Colorado State, a great proponent and practitioner of deliberative democracy at the grassroots level. I think we agreed that the protesters are exercising free speech, expressing views that belong in the political debate, and should be treated respectfully as citizens (not as robots operated remotely by special interests). On the other hand, a format for discussion that encourages angry individual speeches is pretty alienating for most citizens and is a poor source of information or enlightenment. We could do better–although both Martin and I noted that the political and media environment work against deliberative politics; and even good forums might be vulnerable to hostile takeovers.

One great model is Oregon Health Decisions, an elaborate series of public discussions that created the Oregon Health Plan. Citizens were able to make difficult tradeoffs–for example, between preventive and palliative care–and produce a durable policy. The question is whether that would be possible under the harsh and competitive conditions of national politics today.

After the show, we got a long email response from a listener who wanted to document (with 17 links to stories on TPM and Huffington Post, among other sources), that “these disruptive and anti-democratic tactics were designed and spread by right wing organizations and vested industry and Republican interests.” I think some angry speakers have been mobilized by interest groups. (By the way, mobilization is a legitimate democratic technique, as is the technique of arguing that one’s opponents have been manipulated.) At the same time, I believe that deep and broad skepticism about government is another major cause of these protests. It isn’t all manufactured, even if some of it is. We progressives ignore that skepticism at our peril.

3 thoughts on “talking about the health care forums and civil discourse

  1. ACarroll

    Let’s be fair. Out of 15 links to references (I counted them 3 times; 2 were merely a comment about web sites I trust), only 3 were to TPM and ONE was to a Huffpost article; e.g., roughly 30% were to sources with a left perspective, and roughly 70%(!) were to ALL others (insurance industry sources=2, media watchdogs [no ideology, just research and fact checking]=3, sourcewatch [no ideology, just research on front groups, right, left and center]=3, Health Beat [market-oriented, straight down the middle party line Democrat]=2, local media outlet [description of town hall meeting in Chambersburg,PA]=1. Pretty biased, eh?

    In addition, out of 11 paragraphs in which I made a MULTI-PRONGED argument hypothesizing that these town hall meetings are not about healthcare public policy or authentic conservative concerns about it (which I addressed), but rather about right-wing anti-Obama fervor by interests who are working hard to reverse the last election, only 3 paragraphs were devoted to the argument that these are really Astroturf groups fronted by the extreme right wing. What about the rest of my arguments???

    AND in addition, as I explained in the email and I want to point out again, there has been a reporting dearth on the issues by the mainstream media, as documented by FAIR even since that cite from March, 2009. So if you want to find out what is REALLY going on, almost the only place to go is to the outlets that are providing information on events.

    As far as “mobilization” goes: as an advocate of several causes and groups, I have been and am frequently “mobilized,” and I mobilize others as well (since the 60’s, in fact). But not all “mobilizations” are equal. I always know the provenance of the funding and activism of the groups I work with, and their mission, and there is complete transparency; these mobilizations by front groups are just dishonest, to the people who participate in them as well as to the public at large. Hence the fact that these participants are not amenable to facts, information, or sunlight. It’s like when I canvassed in Brooklyn for Gene McCarthy in the early 70’s; we were told, “Some of these people will think you’re talking about Joe McCarthy and they’ll vote for him. Don’t enlighten them–a vote for McCarthy is a vote for McCarthy.” To invalidate my argument, you would have to show that there is evidence (polls, surveys) that people who are “mobilized” by these groups also voted for Obama. (I don’t believe there is any such evidence).

    In fact, the latest NY Times/CBS News poll shows numbers IN SUPPORT OF “healthcare reform” that are far higher than the so-called “widespread citizen displeasure” that is being reported in the mainstream media in these town hall meetings: :”49 percent said they supported fundamental changes, and 33 percent said the health care system needed to be completely rebuilt.” (their methodology is available at this link). And even these numbers are lower than an earlier poll from June. Fully 52% agreed with the statement “The US needs to fix its health care system now as part of fixing the overall economy.” Earlier polls showed that “the public” wants government to guarantee health care coverage for all. In other words, this is a phony campaign and it is being reported in the mainstream media as if were authentic, and the “scepticism about government” is neither as deep nor as broad as we are told it is. As the NY Times poll shows, there IS a lot of confusion and lack of information on the part of “the public,” and the Democrats are doing a lousy job of clarifying the issues and setting out the debatable options.

    Finally, I wonder whether you would have made the (misleading and unfair) observation about “17 links to stories on TPM and Huffington Post, among other sources” (and no other comments or evaluation about the rest of my argument) if I hadn’t first disclosed my political position and my support for a single payer financing system. I believe this is a clear case of “confirmation bias.” Did you read the sources at the links or just count them?

    Posted by at August 14, 2009 2:01 PM

  2. Peter Levine

    I acknowledged privately and will say again here that my original comment was unfair in that I assumed the writer’s sources were biased. I’m glad to have her comment here because it contributes a valid perspective to the debate. I hope she is correct. If most of the opposition to the Democrats’ health bill is “astroturf” (driven by well-funded special interests) or ignorant, it should be possible to turn the tide. The well-funded pro-reform advertising now underway should help. I hope it does, because I strongly support the House bill both on its merits and because this is a crucial moment for the administration.

    But I’m not so confident. In the Times poll, 44% say that we cannot afford to fix the health system right now, 38% say it is not the government’s responsibility to guarantee health insurance for all Americans, and 41% are very concerned (and another 28% somewhat concerned) that the quality of their own health care will get worse if the government guarantees health care for all. Those groups represent more than one hundred million skeptical Americans.

    Perhaps more pertinently, a narrow majority in the latest Rasmussen poll thinks that the quality of health care will get worse if reform passes; 26% think it will improve. CNN had 50% in favor of the Democratic bill and 45% against, on July 31-August 30. In the same poll, 40% said they would like government to make difficult decisions about what to cover; just as many chose insurance companies.

    Of the opponents, some are individuals described in news reports who have been sent by right-wing groups like FreedomWorks to disrupt public conversations. I am angry about their behavior. But if 45%-51% of the public are against the bill and many are against its core principles, I doubt that this is all manufactured dissent. News reports (whether in TPM or in more neutral sources) are anecdotal. The anecdotes should be taken seriously but also read in the context of national data.

    Finally, I think an under-appreciated aspect of the current debate is the fact that an effort to expand health coverage (modestly) follows massive federal bailouts of banks and automotive manufacturers. Those bailouts were probably unavoidable but they certainly left a bad taste. In the latest Pew survey, 48% say the government is handling economic problems badly; 31% are favorable. That is a tough context in which to try to expand the role of government.

  3. Peter Levine

    ps, the writer notes that she made a “multi-pronged argument,” most of which I overlooked. For example, she wrote:

      There’s little evidence that the people who identify themselves as “conservatives” in the “town hall meetings” (I agree that these are just PR opportunities for the Democrats to push their legislation as a fait accompli) are really conservatives when it comes to public policy. If they were real conservatives, they would support policies that save money (both public and private), that allow American businesses to compete with the rest of the world by freeing them from the responsibility for providing healthcare benefits, and that allow workers to be free to switch jobs or start their own businesses without being tied to a dead-end job because they “need the health benefits.” These are all policy goals that the House bill in its final form claims to achieve, while saving money overall.

    I think this perspective neglects genuine (if perhaps mistaken) conservative concerns about expanding the government’s role. It is one thing for the Democrats to claim that their bill will save money and help business; it is another question whether it will work. At the heart of modern conservatism is deep skepticism about the efficacy of complex governmental interventions–quite apart from their intentions. I don’t share that skepticism in the case of health care, but I can understand and respect it.

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