What's fair?
The Talk

My week with Ralph

Stick figure at computerI recently got myself involved in an email discussion of the Affordable Care Act.  

Maybe I was channeling an unconscious desire to participate in the Supreme Court debate. Maybe I was just venting. Whatever.

In any case, I decided to see how long it would take to get frustrated discussing the issue with someone who openly admitted he had never read the Act, but had loads of opinions about it.

My correspondent was not someone I know. He is a friend of a friend. Let's call him "Ralph."

I only became aware of Ralph's existence when he responded to an email my friend had sent out recommending a Washington Post story listing "five myths about the Act." 

I responded to Ralph's reaction (which I can summarize as "what a lot of hooey") and a vigorous email exchange followed.

I'll spare you the details. Let's just say that Ralph presented the Act as "socialized" or "quasi-socialized" medicine, and I countered with provisions from the Act itself and studies by the Congressional Budget Office on its financial impact.

It all ended when Ralph presented his final argument: Obama was born in Kenya, the Act is a stalking horse for a single-payer system, it is designed to put private insurance out of business so the government can take over, let's discuss it again in four years when all this comes true.

To which, I am inclined to say, "Amen."

But if I truly aspire to be OtherWise, I can't leave it there. I need to understand why Ralph feels so strongly that the Affordable Care Act is a socialist plot.

I know little about him, except that he is a Cuban immigrant, male, in his 60s or 70s, has a business background, and lives in Miami.

Much of Ralph's opposition to the Affordable Care Act is tied up with his suspicion of President Obama himself. Ralph believes Obama has no legitimacy, was born in Kenya, and is among the most divisive presidents we've ever had.

"Obama’s style and speech have systematically pitted various groups against one another," he wrote, "which accounts for much of the social and political divisiveness we have today."

Furthermore, Ralph believes that Obama's real intention is to impose a single-payer system on us.  The Affordable Care Act is just a way-station to that end.

"The only way to 'save money' while bringing 45 million more people into the game," he wrote, "is by either lowering product quality, or rationing services  … which can only happen under a government mandated monopoly."

What's really going on here? There is plenty in the Affordable Care Act not to like. And Ralph mentioned some of it -- a lack of real tort reform, no competition across state lines, etc. 

Ralph's opposition could also be an entirely rational belief that there is a better way. A way that will unleash competitive forces strong enough to bring the cost of healthcare down to a level that everyone can afford.

But I'm convinced that the actual provisions of the Act are incidental to Ralph's opposition. His basic problem is a deep-seated suspicion of the government and especially of this president.

Perhaps his experience in Cuba colors his perception of politicians who seem to get by on oratory. In that sense, another friend has observed that many Cubans consider Obama a "carbon copy" of Fidel.

Perhaps, he conflates the effort to extend health insurance to the poor with Fidel's pandering to the Cuban underclass. 

Perhaps, like many Cubans, he thinks Democrats are soft on Communism, as demonstrated in Kennedy's "betrayal" of the Bay of Pigs invasion and by Clinton's "betrayal" of Elián González.

Perhaps Ralph's disdain for Obama reflects unconscious racism. Skin complexion is considered a sign of class in some Hispanic communities. People with African or indiginous backgrounds rank lower on the social scale than those with "pure" Spanish bloodlines.

Perhaps Ralph's opposition to the Act reflects a belief that it is intended to redistribute wealth from those who work hard to those who don't. 

My money is on the latter point, which makes this a moral discussion, where "facts" carry less weight. 

But that doesn't mean the task is hopeless. On the contrary, it means that instead of emphasizing the benefits to the uninsured of expanding coverage, we should emphasize the benefits to the already insured. 

If everyone has to have coverage, healthy people will help fund insurance for the uninsured, which will help pay for their emergency room visits (or keep them out of emergency rooms in the first place). Ultimately, that will lower everyone's costs.

I plan to present that argument when I resume this discussion with Ralph. As he suggested, in four years.







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