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Opinions and Emotions

August 17, 2009

“An opinion should be the result of thought, not a substitute for it.” — Jef Mallett

The heated exchanges accompanying the health care reform debate illustrate some of the pitfalls of the sound-bite approach to public policy that has come to dominate public debate in recent years.  Advocates of the most extreme positions have become masters at using hot-button issues to stimulate emotional responses that often have little or no basis in fact.

Now, I would be among the first to argue that we should not rely solely on rational analysis to resolve policy problems, especially those that rightly stimulate strong emotions.  But by the same token we must recognize that not all emotions help us engage issues constructively.

Anger and fear are among the least constructive emotions.  Substantial research from the field of behavioral economics demonstrates the tendency of people to over-estimate losses and under-estimate gains.  Risk aversion in the face of anger and fear can lead us to conclusions contrary to our own best interests.

What exactly do we have to fear from health care reform?  No one has yet suggested restricting provider choice.  No one has yet suggested rationing beyond that already experienced under private insurance plans.  No one has yet suggested abandoning the principle of informed consent.  And no one has proposed withholding care from the terminally ill or requiring abortions in cases where antenatal tests indicate a fetus has serious birth defects.

Concerns about rising costs accompany all available options, including the status quo.  If we do nothing, rising public and private costs threaten individual businesses and our economy as a whole.  If we adopt reforms that do not generate significant efficiencies, we will increase the budget deficit, which may require tax increases and could also undermine our economy.

But of these choices — reform or status quo — only one seeks to expand access to health care among the 47 million uninsured while preserving access to health care and health insurance among those already covered should they lose a job, change jobs, or exhaust their existing benefits.

When you stop and think about it, the emotional appeal of doing something, even if it’s wrong, seems pretty compelling.

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