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Thursday, Aug. 10, 2017 12:17 am

Fear and loathing in health care

When politicians target our primitive brain

Why do voters support politicians whose clear policy goals indicate that they are likely to support measures that will adversely impact the very people who voted for them?

For example, the various iterations of the widely unpopular Republican American HealthCare Act  (AHCA) were based on a GOP policy document released June 22, 2016.  http://abetterway.speaker.gov/_assets/pdf/ABetterWay-HealthCare-PolicyPaper.pdf

You can read online about the hazards of cutting back Medicaid. This threatens low-income working adults whose jobs don’t provide health insurance and who otherwise cannot afford health insurance.

You can read about removing benefit mandates. In the recent legislation, this took the form of threatening mental health and substance abuse treatment coverage. This makes little sense given that depression is the number two cause of disability in the United States and we are in the midst of a massive opiate epidemic.

You can read about Republicans wanting to eventually change Medicare into a private insurance model. This would mutate the system on which seniors depend and result in premium increases that would impact already limited fixed incomes. And don’t forget that Medicaid helps seniors whose savings are depleted to access medical or nursing home care. That help was on the block as well.

I could go on but you get the idea of why the AHCA had only a 17 percent approval rating. So why did people vote for individuals like U.S. Reps Darin LaHood and Rodney Davis, who ran on this platform and spent most of this spring singing the praises of the AHCA? I suggest that it is due to politicians’ use of fear and anger to cloud rational thought.

When most people think of the brain, they think of this organ with ridges and valleys on the surface. What they see is the cortex, the area that is involved in perception, organization of perception and hopefully rational thought.

However, deep inside the brain are much more primitive structures involved with pleasure and emotions (including fear and anger) that link these drives with memory.

The greater the potential threat to life, limb and family, the more fear and anger drive our responses – while higher level cognitive issues take a back seat.  

This tactic was used when the Affordable Care Act (ACA) was initially passed. Remember Republicans’ false claims about death panels?

Fear and anger were the focus of the Republican national campaign in 2016.  The message basically was “be afraid for your safety and angry about your economic future because foreign countries are stealing jobs, immigrants are coming here and taking jobs – or being criminals or terrorists–, and climate change agreements are killing jobs,” among other claims.

In such an environment, reasoned discussion of the details regarding how to fix the ACA versus the content of any Republican health care replacement bill was largely absent. Only after the election, when health care policy was front and center without all the emotion-laden distracters, could people begin to focus on what the Republican plan would do to Joe Average American.

So where do we go from here on health care? Sen. John McCain said it best: “It is now time to return to regular order with input from all of our members – Republicans and Democrats – and bring a bill to the floor of the senate for amendment and debate.”

In other words, take the fear and anger out of the discussion and focus rationally on a bipartisan solution to fix the ACA. But how do we get folks like Reps LaHood and Davis on board?

Remember that there is one thing politicians generally fear – not getting re-elected. Write them and let them know that you expect them to push for bipartisan efforts to fix the ACA and that you will remember any failure to do so in 2018. Then in 2018, remember what they did or didn’t do.

Finally, remember to ask yourself the next time you hear a politician using inflammatory statements to induce feelings of fear and anger: From which real issues are they trying to distract me?

Dr. Stephen Soltys is a retired professor emeritus who still teaches at SIU School of Medicine on a volunteer basis.


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