Healthcare Choice: I want to give them less and make them think it’s more

earlier in this hour we heard the
results of a detailed survey done with
working-class voters in Ohio
obviously a swing state obviously an
important state on the issues that
mattered to them and what we heard was
that about a third of them can’t be
moved because they’re just rock hard
right winter is racist whatever and we
heard that there are at least a third of
them who definitely can be moved
including some former Trump voters as
well as a working-class voters of other
kinds and we learned that these movable
voters are not only unafraid of big
ideas they love big ideas now they’re
not deep into the policy details but
they love the idea of a green new deal
they love the idea of Medicare for all
and so on so the question is how do we
reach these reachable voters and why
would be.we be afraid of the ideas they
embrace but we have an entire
politically political industry that
includes the Republican Party and large
chunks of the Democratic designed to
make them afraid of big ideas and that
is what we need to fight I’m gonna
suggest here’s one way to fight it by
telling them simple plain truths about
policies like Medicare for all and like
the green new deal and I want to talk a
little bit about Medicare for all for a
very specific reason I used to work and
some of you may know in the health
insurance field and related fields
and I used survives large corporations
worked for large corporations I’m not
proud of it but I guess the information
it’s useful now I’m not ashamed of it
either it’s just in what I what I was
aware of at the time and then an
anecdote came to mind recently which I
talked about at a Tedder of speech I
gave the other day and I want to share
it with you now because I was asked to
come in and advise in the 1990s one of
the most powerful CEOs in the country
ran an entire insurance Empire himself
and he
called in his advisors of which I was
considered one and he had all these
ideas for the employee health plan and
benefit plan cafeteria plans and flex
plans these were all buzzwords that were
around then and choices and options and
lists and and the group of people around
him many of whom were human resource
professionals didn’t even know what he
was driving at with all of this except
that he was using the terms so as the
then young and sort of brash person in
the room I said excuse me what exactly
are you trying to accomplish with the
employees here with all of this and he
said I want to give them less and make
them think it’s more
now that phrase is
always stuck with me and I wanted to
stick with you if you’re willing I want
to give them less and make them think
it’s more choice is a game that is often
used to give us less and make us think
it’s more
what should we have when it
comes to medical care we should have the
treatment we need when we need it by the
doctor we want at the facility that’s
best for us with the medication we need
we don’t need quote unquote choice of
insurance companies to see if they can
provide us any of those things and we
can’t use that information because we
most of the time don’t have any idea
what our upcoming health needs are gonna
be it’s a game they want to give you
less and make you think it’s more so if
nothing else fine part nothing else to
you from all of this
I want please when you hear a candidate
say as people to judge says I don’t
support Medicare for all I support
Medicare for all who want it I want you
to hear he wants to give me less and
make me think it’s more when a candidate
tells you that Medicare for all is too
expensive when despite saving lives it
would cost less I want you to hear they
want to give me less
make me think it’s more and when a
candidate is asked do you support
Medicare for all and they answer I
support a lot of plans I want you to
hear that candidate wants to give me
less and make me think it’s more now why
would we want that why would we not want
to have what we need and know in advance
what it is there is no reason in this
world not to support Medicare for all
and every reason to support it now there
is one ideological reason I have to be
perfectly honest which is that Medicare
for all gives Democratic control to a
large segment of the economy that has
been operating in secret largely for the
private enrichment of a few now if
ideologically you believe that’s the way
the world ought to work if you’re a
libertarian if you think the private
executives somewhere should have the
right to make life-and-death decisions
about you and your family yes by all
means you should support Medicare for
all everybody else I mean he should
oppose Medicare for all everybody else
of course should support it

Our Elites Still Don’t Get It

The big social movements of the past half century were about maximizing freedom of choice.

  • Right-wingers wanted to maximize economic choice and
  • left-wingers lifestyle choice.

Anything that smacked of restraint came to seem like a bad thing to be eliminated.

We’ll call this worldview — which is all freedom and no covenant — naked liberalism (liberalism in the classic Lockean sense, not the modern progressive sense). The problem with naked liberalism is that it relies on individuals it cannot create.

Naked liberals of right and left assume that if you give people freedom they will use it to care for their neighbors, to have civil conversations, to form opinions after examining the evidence.

But if you weaken family, faith, community and any sense of national obligation, where is that social, emotional and moral formation supposed to come from? How will the virtuous habits form?

.. Freedom without covenant becomes selfishness. And that’s what we see at the top of society, in our politics and the financial crisis. Freedom without connection becomes alienation. And that’s what we see at the bottom of society — frayed communities, broken families, opiate addiction. Freedom without a unifying national narrative becomes distrust, polarization and permanent political war.

  1. .. Moreover, if you rob people of their good covenantal attachments, they will grab bad ones. First, they will identify themselves according to race. They will become the racial essentialists you see on left and right: The only people who can really know me are in my race. Life is a zero-sum contest between my race and your race, so get out.
  2. Then they resort to tribalism. This is what Donald Trump provides. As Mark S. Weiner writes on the Niskanen Center’s blog, Trump is constantly making friend/enemy distinctions, exploiting liberalism’s thin conception of community and creating toxic communities based on in-group/out-group rivalry.

Trump offers people cultural solutions to their alienation problem. As history clearly demonstrates, people will prefer fascism to isolation, authoritarianism to moral anarchy.

If we are going to have a decent society we’re going to have to save liberalism from itself. We’re going to have to restore and re-enchant the covenantal relationships that are the foundation for the whole deal. The crucial battleground is cultural and prepolitical.

In my experience, most people under 40 get this.

.. To address it, we’re going to need to confront it with another broad social movement

.. Many people my age and above seem clueless. Our elected leaders were raised in the heyday of naked liberalism and still talk as if it were 1994.

  • .. Congressional Republicans think a successful tax bill will thwart populism.
  • Mainstream Democrats think the alienation problem will go away if we redistribute the crumbs a bit more widely.