The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Health Care Reform: Fear and Loathing

Posted by Alan on August 10, 2009

Health care is personal, important, confusing and expensive. No wonder so many people are upset at attempts to reform America’s health care system. The status quo may be broken, but the devil known is more welcome than the devil coming to town.

It’s especially scary for conservatives who look at the folks doing the reforming and are terrified. When they see President Barack Obama, Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi they see liberals – actually they see LIBERALS. The kind their parents warned about. These aren’t fellow Americans with whom they happen to disagree, they’re “the others,” the socialists, the government building, boogie men of talk radio and a certain 24 hour news station. (And yes, this being America, there’s a 24 hour news station boosting fear of conservative boogie men, too).

It takes a giant leap to think that elected leaders in America are plotting to create a system with death panels that will impose euthanasia on seniors, make virtually every health care decision in the country, murder millions of children and much more. Yet those are the accusations made by former Governor Sarah Palin, Cal Thomas, Representative Virginia Foxx, and Representative John Shadegg. And many on the right take are predisposed to take these accusations seriously.

Then there are more legitimate controversies that health care reform impacts. For example, should health plans health plans be required to cover abortions? That’s a legitimate public policy issue although it’s often weighed down by political rhetoric that obscures the real issues.

All of this makes it easy for liberals to dismiss these concerns. They see the need for a public health insurance plan to increase competition, not drive private carriers out of business. Evaluating the cost and effectiveness of care makes common sense and sound economics. It has nothing to do with being intrusive. There’s nothing sinister about this approach, but conservatives view such claims with fear and loathing.

What we have here are two groups of people looking into the same room from different windows. What they see is colored by where they stand and the prejudices they bring to the view. Where one sees conspiracy and death panels the other sees common sense and prudent regulation.

This is more than just a fascinating glimpse into the human psyche and how it plays out in the public policy arena. It underscores the challenge facing those seeking change. They need to not just fashion a workable system, but they have to deal with the fears and suspicions of those who instinctively oppose them – fears and suspicions that are stoked for self-aggrandizement and profit by the Glenn Becks and Michael Moores of the world.

Then there’s the political element of this dynamic. Liberals can comfortably ignore the concerns of conservatives regarding health care reform. All they need to do is bring enough moderates along to build the majorities needed to pass their legislation.

But in American politics the pendulum swings. In 2001 the President was George W. Bush, the Senate Majority Leader was Trent Lott and the House Speaker was Dennis Hastert (just two years earlier it had been Newt Gingrich). Their view of how a public health plan should work – what it covers and who it benefits – varies considerably from the Obama/Reid/Pelosi view. Yet the greater the role liberals give the government over health care, the more control over issues like abortion conservatives like Bush/Lott/Hastert will have when they take power again – and eventually, they will.

Fear and suspicion, anger and foolishness knows no ideology. The left and right are equally susceptible to assuming and perceiving the worst in the actions and words of the other side. Both have paid cheerleaders to make stoke their worst predilections.

As lawmakers consider the impact of health care reform they should keep in mind the American political wheel turns. Eventually all of us watch our elected leaders with fear and loathing. And the greater the influence government has on health care the more vitriolic the suspicion, anger – and the danger.


21 Responses to “Health Care Reform: Fear and Loathing”

  1. Spencer Lehmann said

    “A memo obtained by the Huffington Post confirms that the White House and the pharmaceutical lobby secretly agreed to precisely the sort of wide-ranging deal that both parties have been denying over the past week.”

    Click on link to read:

    The only chance of meaningful Insurance Reform being put into law in the near future will depend in large part in it being introduced as a free-standing bill with no relationship to a Health Care Reform bill, in my opinion.

    This leaked memo regarding the White House and Big Pharma (PhRMA) cutting a deal behind closed doors, and others like it may kill any chance of any Health Care Reform passing into law for many years. When the public is stung by this kind of disingenuous and dishonest behaviour displayed by those segments of the debate that are linked to rising health care costs and the “primary leader” of the debate, the current occupant of the White House, the public will experience great fear and evidence that fear in a loathing of the issue at hand that may put Health Care Reform on hold for another 20 years.

    There should never have been even a whisper of wrong doing on the part of the Administration. What say you now, President Obama? Who has been minding your store, Sir?

  2. Spencer Lehmann said

    Alan, interesting site.

    Had anyone in the Agent Community attempted to “push through” as poorly thought out a “Plan” as that being pushed by the Congress and Administration, it would have failed long ago. Thus far we have been presented with little more than a concept, no substance regarding benefits and a clear attempt to avoid delineating a funding source that will pay the $1 Trillion price tag.

    However, the Administration and the Congress has now made clear that they would like to see $600 Billion cut from Medicare. That represents over half of the estimated cost. It also seems to be an adherence to the phrase, “throwing those [over 65] under the bus”.

    [A quick qualification: I am not a member of either party, finding them both to be equally corrupt.] While those on both sides of the aisle, Democrats and Republicans, are highly organized to fight for their own concerns (the Democrats concerned that they won’t be able to shove a concept through the process before anyone can truly examine its up and downsides, just “Push, push, push” that concept through, get it done and then ask questions; the Republicans demanding answers to those questions before law is made so that bad law doesn’t become the all too common result (as was HIPAA, an exercise in the destruction of another rainforest simply to allow for some to see their names in lights; redundancy and waste), much of the anger and disruption we are seeing could have been easily avoided had the Obama Administration simply acted with a higher sense of responsibility, explained a fully researched plan, benefits, costs, funding sources, exclusions, and the “fine print” as must every single agent and broker in the United States if they are to effect a quality pairing of a client with an insurance company with the goal of creating an “Everybody Wins” scenario, instead of viewing this issue in the same light in which insurance companies view the agent community and our clients using the “Us against Them” philosophy of doing business. Sadly, that same “light” seems to shine upon the Democratic Administration and Congress, who seem hell-bent on explaining nothing while attempting to pass everything related to and called “Reform”, excluding Tort, of course.

    Among those campaign concerns I heard expressed by the Obama Camp were those regarding “transparency” and “disclosure”. A lot more “walking the walk” may have negated the need for so much “talk”. Regardless of the item being “sold”, the public has a right to “Full Disclosure”.

  3. Marcus said

    Bottom line is health care cost are crippling our economy…it’s past time to do something and instead of people out here spreading hateful lies and scaring people, they should realize that something needs to be done and help come up with an equitable solution. No one knows what will happened to the bill once its printed (amendments are made daily) and to say what you “think” what will happen because of bad interpretation is not smart.

    Everyone that doesn’t agree with President Obama’s proposals, rather sit back and do nothing (could it be because they already have it good and don’t need the help?) Let’s try interviewing the single mothers that (because of whatever reason) can’t afford health care and works hard every day or the man that’s trying to support his family on a part-time job that can’t afford health care. Let’s interview the people that can’t afford to storm town hall meetings following something Rush Limbaugh said, because they are at work. Those are the people that will benefit from Health care reform. Now, will there be people out there that will abuse the system, of course, but name one program out there that isn’t being abused by someone…..none…..we have to take the good with the bad and no matter what anyone syas Health Care reform will do more good than harm.

    A critic is now gonna ask “how do we pay for it”? Well if you don’t know it by now, I will tell you….taxes are gonna go up…after what the Bush Administration did, they have no other choice but to go up FOR EVERYONE (poor, middle and rich)…it’s not realistic to believe that with all the spending that took place after 9/11 that the taxes weren’t gonna go up, I actually applaud the Bush administration for pushing it out as long as they did.

    • Dave Wood said

      Heya Marcus, great post, but you ask what the opposition of Obama care advocates? The conservatives adamantly claim that more choice and more competition will bring down costs and increase quality, FOR EVERYTHING!

      They are consistent in that mantra, even health insurance and services. But Obama is ignoring them, and the chances for the public option are ZERO.

      Obama care is no solution to our mess. Consider that COST is our main problem. We currently pay DOUBLE per capita compared to Europe, and have more illness, higher mortality on many fronts, and patchy quality.

      So the big question is HOW to reduce costs. ANSWER is two fold……1. reform the overly fragmented, inefficient, and wasteful system itself. Either with a single payer system, or through a TOTAL and pure private insurance based choice system with subsidys. (currently we have the worst of both worlds where we get little benefits from an insurance market where one insurer typically rules the market ( wellpoint blue cross blue shield) and we get the waste, and inept management of big govt. programs, and massive fraud. Back to the cost issue……..2. we need to seriously and effectively advocate to our fat and lazy people the true costs of lack of exercise, poor diets, smoking, and other hazardous lifesytles. Then follow up that education process with a real person to person outreach system to baby people through their quest to drop the weight, stop smoking, and manage their chronic diseases.

      Obama care does very little to address these two main drivers of high cost and we will surely redo this sorry debate in the next decade when costs will be even higher.

    • Doug said

      A key part of the Hippocratic oath is “Do No Harm”. The current health care proposals are holding to this principle. Current proposals regulate private health insurance within an inch of their life. The federal government will muscle folks not on the public plan into highly regulated managed care plans. These same principles have been practiced in certain states like New York, Massachusetts, and California. Those states have higher insurance cost.

      We can control cost with a combination of different approaches like high deductible insurance with health savings accounts that roll over, allow insurance companies to sell policies across state lines, giving companies to incentivize preventative health choices, and equalizing the tax treatment for all citizens that pay for health insurance.

      We can make a difference however putting a velvet cover over the sleigh hammer of the public plan will not work.

      • Spencer Lehmann said


        We will need to agree to disagree. I do not think that the current health care proposals (and No Plan yet exists…Congress is being asked to vote through a concept, not a “Plan”) “do no harm”. They have not only done a great deal of harm; in not being specific, in not outlining any true benefits, in not outlining what amount of funding will be required and then not outlining how that funding will occur, until HR 3200 was just introduced, causing immense dissension and question among the populous about the specifics of the “Plan”, questions not answered by Obama because he had no answers, just a concept (Imagine! Congress being rushed to pass a “concept into law”?!), and now Congressional delegations being asked the tough questions at Town Hall Meetings where they have no answers because they do not have a clue about how the “Plan” works. Further, HR 3200 is NOT a Health Care Reform bill; it is an Insurance Reform bill with added benefits for the IRS. Read Sections 162, 163, and 246, and ask yourself, honestly, if the idiots who wrote this junk thought any of it through, including the Section on Illegal Aliens. This so-called bill asks that every taxpaying citizen reveal to different agencies every cent of all income, assets, and real property, and if you sell your real property then you must report same to the Health Care Reform Agency as well.

        Click on this link to read:

        I live in Seattle, Washington, that state often left out of the list of those who have passed serious insurance reform and law, and do not understand how The State, that passed “Hillary Care” into law, put ground glass into that law, just to make then Governor Lowery look like a big shot when he flew to WA, DC for photo ops with the Clintons, leaving our state to become a magnet state for all who had serious illness throughout the country on which to descend for GI, no questions asked or allowed to be asked, resulting in WA State not having a single individual policy for sale for over two years! We are still ranked one of the toughest states in the US in which to do business by insurance companies.

        None of this “Health Care Reform” needed to happen if the Feds had the guts to adopt in law what some states had already set forth. Further, none of the harm that has been done needed to occur had President Obama and those in his “ether” been willing to forgo having their names in lights, and I most definitely am including Obama.

        Why wasn’t an excellent program like Medicare expanded to cover all ages, which could have been done for a fraction of the cost, and by beefing up the Medicare Trust Fund so that it could stand on its own, making those who receive more than $150K per year in income (a hell of a lot of money) pay their fair share?

        Greed is why; the greed born of having such major egos that nothing short of being thought of as heroes will satisfy those huge egos.

        No harm has been done? What about the harm done to the public who have lost faith in their leaders as never before, who will now need to fund the incredible mega billions of dollars it has cost so far for this foolish experiment, and for the 47 million uninsured Americans who will remain uninsured because none of this Utopian fantasy land Marxist/Leninist nonsense will be passed by any Congress wanting to be reelected in 2010 or 2012.

        Think of all of the good that money could have helped to fund.

  4. Arjelia said

    Although, I do agree that the shouting will give the “Liberals” the excuse to close their ears to the arguments of the opposition, one cannot ignore the argument. People are upset and angry that their hard-earned money (taxes) is being used without their permission in other areas and they are expressing it, I realize it may not have to do with healthcare alone. Some have a problem with this passion being displayed and want people to behave with civility, I completely agree with that; however, maybe, these people would behave that way, if they believed they were being heard. Being called names doesn’t reassure them that they are.

    Interesting thing about this is that if it were a Republican President presenting this bill, the “Liberals” would be screaming as well. So, don’t let who is presently screaming about something distract you from the facts; facts are stubborn things, to quote John Adams, educate yourself, read history, read the bill (most politicians haven’t, they just look for the initial before the name of the author to know whether they should agree), and think for yourself…most decisions just take common sense, not emotions—we see emotions on both sides of this argument. Many of us have already experienced negative consequences from decisions that we have made based on emotions.

    Hawaii is a perfect example of the possible “success” of universal healthcare (

    At the core of this argument, is that we NEED the government because the private sector (individuals) cannot do this for themselves; we NEED the government to protect us and yes, but from terrorists. “Oh, but look at the mess WE have already made of things when WE are left to fend for ourselves,” you may think/say, hmm, have WE? Or was it government intrusion ( Remember, we don’t always see the consequences of our actions immediately, it sometimes takes years and years, look at the mess we have made of our social security system; there are hospitals closing due to the lack of funding because Medi-Cal and Medi-Care pay pennies on the dollar, which then puts pressure on neighboring hospitals, which means that they may close down as well (vicious cycle). Government intrusion is the problem (regulation), this is history folks, and we can learn much from it. This is Destructive competition (

    I believe that people need to be careful with this and make sure that they educate themselves and look at all sides of the argument with an open mind and always think about the consequences to come. We teach our children to be independent, to think for themselves, and work hard for what you want, be responsible for your own actions and make no excuses…so, we should lead by example because they will end paying for this; it is a serious issue that should be debated. Disruptions do help because it’s bringing attention to those who otherwise may not have been heard.

  5. Maybe they could get the American people behind this bill a little more if they actually read the bill. I just saw a segment where only 7% of senators even agreed to read it. How can you get the people behind something that they don’t even understand.

  6. Nosedoc said

    “Fear and suspicion, anger and foolishness knows no ideology. The left and right are equally susceptible to assuming and perceiving the worst in the actions and words of the other side. Both have paid cheerleaders to make stoke their worst predilections.”

    Alan, you are on the money. Why anyone would put their full faith in either one of these characters is incomprehensible. The half-truths and distortions abound on both sides.

  7. Ron Masters said

    Of great interest to me is why liberals find it necessary to paint conservatives with the broad brush as members some organized group, incapable of independent thought and action, while at the same time their truly organized groups of ACORN and SEIU are working for their agenda while they cast themselves as the only group with a thoughtful and reasoned approach.
    The American people, including R’s, D’s and I’s are not in favor of what currently is before Congress in the form of health care reform. I know none of them is a bill yet but Kennedy’s offering and the previous drafts show the direction.
    In this debate, those who consider themselves conservative do not have any one person speaking for them. Not Palin, Limbaugh, Hannity, Steele or (fill in the blank). I for one, have yet to find one who is a leader and further is worthy of my trust, at least on this issue. And while I haven’t personally taken a poll of all conservative folks, but I feel relatively safe in stating that conservatives see the wisdom in health care reform, just not those offered so far. So “painting” conservatives or R’s all as the party of no, no way. Just not these reforms.
    And I am one conservative that is insulted in being cast as in a group that only “sees conspiracy and death panels” in the current majority party legislative initiatives merely because I disagree with the reforms as they now stand. As as conservative, I am most capable of viewing anything that is plausible with “common sense and prudent regulation”. Regulation that penalizes the most heinous behavior while not stifling free market inventiveness.

    • Alan said

      Ron: I think the problem is that the debate is too often hijacked by the extremes on both sides. As a mainstream conservative you have no one prominent speaking on your behalf — certainly not Governor Sarah Palin nor entertainer Glenn Beck. Nor do mainstream liberals are in the same boat. Speaker Nancy Pelosi and entertainer Keith Olberman fail to give them voice.

      Fortunately, there are moderates in both parties who are trying to find common language and common ground. While I have problems with some of the ideas they are putting forward (the “Exchange-as-Salvation” concept, for one), at least I recognize they are trying to get to a workable improvement to the status quo. I suppose we shouldn’t complain that they do their work silently — at least they are doing their work. In the meantime, conservatives risk being lumped in with FreedomWorks and liberals with ACORN.

      Not a pretty picture, but if you think about it, it has worked for over 200 years.

      • Dave Wood said

        Heya Alan, another problem with this debate is that health care is truly a very very complex issue. It really is a LOCAL issue, with states, countys, and the feds involved. Very fragmented and complicated since our health is a very private issue and everybody has a perspective and ax to grind in this debate.

        I have personally spoken to a couple dozen senators and congressman and usually they dont have a real grasp of the big picture. Even their aids often have holes in their grasp of this issue.

        So how in the world can this abomination we call American health care be reformed when even our elected leaders dont really understand the ins and outs of this mess?

        Another issue is that as more and more Americans pay attention to Obama care, they see the same thing I see, that is that Obama care really only TINKERS with the flawed, wasteful, and unfair system. So why tinker with it if it works for most Americans? Why risk change, and increase taxes to pay for this new scheme?

        The Bush years have proven that we really CANNOT trust the federal govt. with effectively managing ANYTHING. Obama care only gives more power, more management of the system to the federal govt., and that scares the American people, left and right.

        The answer is the two bill solution where congress would write two bills, one written by the Dems called the spa program (single payer authority) and the second bill written by the republicans called the TAC program (total choice- private insurance based)……THEN let the states opt into either program on a voluntary basis through a local election.

        • J Williams said

          I agree with giving a choice to people.
          Give people a choice of single payer (gov’t run) or what we have now, private insurance (mafia care).
          It wouldn’t be long until these republicans were sneeking into the gov’t program.

  8. Bob said

    Thanks again Alan for rising above the politics to provide insight and perspective. This is why I read this blog regularly.

  9. Rick said

    “They see the need for a public health insurance plan to increase competition not drive private carriers out of business”

    Alan, I saw and heard Obama on YouTube, while a Senator in 2003 and while President in 2007, and Congressman Frank on TV, say the goal over time is to eliminate health insurance through employers and implement a single payer system. How do you reconcile what I heard them say with what you feel is there goal?

    • Bob said

      Link? I’ve seen Obama say that if we were “starting from scratch” a single-payer system would be the best approach. CBO analyses over the years have backed up that assessment. However, pragmatically, politically, and economically, there’s no way to get there from here. Thus single-payer has never really been on the table.

      • Rick said

        I don’t know how to do a link. However just go to and search Obama single payer

        • Spencer Lehmann said

          In order to link, go to UTube (my spelling, it always works), copy the URL, and post it here as in “Click Here”: I’m not endorsing Ron Paul or his message (Nope!), just presenting an example of posting a link.

          There may be a method of posting a “Tiny URL”, in which only the “subject shows” while the actual URL is hidden, but I don’t know how to do that here, and only know UBB and HTML embedded code.

          Perhaps Alan can clarify.

    • Rick said

      Correction: The dates were 2007 & 2009 – sorry

  10. Meg McComb said

    The 24 hour news station that conservatives (those Americans filled with fear and loathing) look to for answers may be more objective than Alan paints in this latest blog. For exanmple, Mike Huckabee ran a special over the weekend that included interviews with people from both sides of the aisle–those in favor of a public option, and those vehemently opposed to it. He concluded with this message, “I don’t trust insurance companies, nor do I trust the government, to make my health care decisions. I believe each American is responsible for his/her health care choices. Don’t take anyone’s word as to what’s in your best interest. Health Savings Accounts are one smart way to be in charge of your health care savings. Right down your questions, and contact your government representatives to find out what they really think on the issues. Make up your own mind.”
    Now those are words than even a Liberal could see has common sense and prudent regulation behind them!

    • J Williams said

      Republicans believe in the gov’t when it comes to the military, being told when to go to war. I think law enforcement is gov’t?
      I believe in capitalism in a sence that people are naturally greedy and should be allowed to fulfil that drive. I believe in the “invisable hand” to a certain extent.
      But I believe there has to be some regulation by gov’t or we get CEOs that make $100,000/hour. Good gig if you can get it, bad for those that die because there private insuance thinks there lives are not worth the price! I don’t believe life and death decisions should be made by a for profit company.
      Congressman Weiner has the answer!

Sorry, the comment form is closed at this time.

%d bloggers like this: