I took me a while to comprehend that there are people who I will never agree with. We just have fundamental philosophical differences that we will never reconcile. I used to believe that goodwill and empathy eventually win out. That with enough exposure to alternate ideas and experiences with people who share those ideas, people will find middle ground or shift toward inclusiveness. Unfortunately, that isn't true.
In his book Don't Think of an Elephant, which discusses how liberals can effectively frame issues to present an inclusive, progressive moral vision for our country, George Lakoff writes:
"The . . . mistake is believing that, if only we could present facts about a certain reality in some effective way, then people would 'wake up' to that reality, change their personal opinion and start acting politically to change society . . . The reality is certain issues have to be ingrained in us – developed over time to create an accurate frame for our understanding."
Like the issue of health care.
Consider this excerpt from an interview with Iowa Rep. Steve King, who introduced the House bill to repeal the Affordable Care Act, on NPR's All Things Considered last night:
HOST ROBERT SIEGEL: Donald Trump's adviser Kellyanne Conway recently told an interviewer, we don't want anyone who currently has insurance to not have insurance. Would that be for you the test of a new law or the test of what happens after Obamacare is repealed - no one who's gotten health insurance through Obamacare losing it under its repeal and replacement?
KING: I think that's a fine and shining ideal, but it wouldn't be my standard. We have about 20 million people that they say would be pushed off of Obamacare if we just repealed it and did nothing. I look at the numbers on the 20 million. It's about 10.8 million that were pushed onto Medicaid, and so I don't really look at Medicaid as a health insurance policy that you own.
I would argue there is no constitutional - you have no right to a health insurance policy. Whatever our hearts tell us, we can provide those things, but there's not a right to them. The roughly 9.2 million people that are insured under Obamacare that would presumably lose their insurance if it were repealed - they're living under a subsidized premium, and that subsidized premium is paid for almost a hundred percent by the taxpayers.
"You have no right to a health insurance policy." That is simply an ideological position I fundamentally oppose.
Health care is a human right.
In our society, access to health care largely depends on access to health insurance because without health insurance, we tend to forgo health care, settle for haphazard remedies and neglect preventive care. Therefore, there is an implied right to a health insurance policy because that policy is a prerequisite for affordable, appropriate and necessary health care.
Lakoff chastises liberal leaders for failing to present the right to health care as a moral imperative and for not reaching enough people with their vision.
"Conservatives understood that politics is a matter of morality and decided to attack [the Affordable Care Act on moral grounds. They chose two moral domains: Freedom and Life. On Freedom, they attacked it as a "government takeover." On Life, they said it contained "death panels." And they repeated "government takeover" and "death panels" over and over, month after month. And every time the president said "It is not a government takeover" he used the words government takeover, which activated the idea of a government takeover, thus reinforcing the conservative attack."
"If the president had understood the conservative framing tactic, he could have undercut it in a simple way. He could have adopted the same two moral issues, Freedom and Life, from a progressive perspective."
"If you have cancer and you don't have health care, you are not free. You are probably going to die (a Life issue) . . . Even if you break your leg, do not have access to health care and cannot get it set, you are not free . . . Ill health enslaves you. Disease enslaves you."
Seven years later, is the rejection of the ACA still an issue of insufficient framing and presentation? Or is that rejection actually a GOP rallying cry, a piece of conservative canon, a repudiation of Obama and progressivism fueled by mythical individualism and infused by racism against the perceived undeserving recipients of Obamacare (poor people of color)?
I think commentators tend to overstate the framing argument. I think a certain segment of the population would reject anything Obama championed or achieved.
But with Trump and the GOP about to invalidate expanded health coverage, kick millions off health insurance and prevent millions more from obtaining affordable coverage, I constantly dwell on the threat to Life and Freedom, as Lakoff put it.
Poor people who lose or who are denied health insurance –– like those covered by the ACA Medicaid expansion or those who do not get coverage from their jobs but received access to subsidized health insurance through the ACA –– will suffer injuries and illnesses catastrophic to their health, their finances and their tenuous housing. Many people live paycheck to paycheck and spend a significant chunk of their income on rent or mortgage – often more than half their income. If they incur a medical expense - such as an ER visit or diagnosis of a chronic illness – and lack health insurance, they will owe thousands of dollars that they do not have. They can't pay the bill and their rent at the same time. The medical debt collectors will never let them off the hook. So they'll have to stop spending money on other things, like housing. In other words, they won't be able to afford rent or mortgage payments.
So health insurance preserves peoples' finances and enables them to afford housing. Coverage preserves their life and freedom. Conservatives either don't consider that position or don't care. Many of them will never change their minds. So we have to stand up for our convictions and outnumber them.