walkitout (walkitout) wrote,

a modest insight

I was having a conversation with my stepfather-in-law on Wednesday regarding health insurance reform and he remarked that change happens when doing nothing is worse than doing something. I observed that a little more was required: doing nothing had to be perceived as unacceptable. My sister-in-law then popped in with, aren't those the same.

We didn't get into it in any great detail at the time, and I revisited it with R. today, and after about a half hour of trying to figure out which aspect of this Mattered To Me, it turns out that R. views my addition as a subset of "costs" and trivially obvious: yes, you always have to take those into consideration. We harbor a suspicion that that was not was his sister had in mind, but we didn't ask her so we don't know. I was actually making a comment based in behavioral economics: the natural human tendency is more towards not doing anything, or at any rate, not changing anything.

The policy debate on health insurance reform has been prodded recently by a variety of progressive talking points, one of which my stepfather-in-law repeated. Another is referring to the people who don't want to do anything collectively as the status-quo lobby (and believe me, that does not have a good connotation in this context). People like my friend W.M. are a tad mystified by all this, because he doesn't necessarily believe that the status-quo is All That Bad, calling into question other talking points like premature birth (a highly problematic statistic that should probably not be used to "prove" anything, and which should be replaced by either a well-defined perinatal mortality number and/or death before age 5, depending on what your goals are).

It turns out when I say, doing nothing has to be perceived as unacceptable, I'm trying to articulate a very central belief. You could mock it: call it "change is bad" or "don't fix it if it ain't broke" or being conservative, but none of these are quite right, at least not to me. I think it's a hell of a lot closer to old-school Stoicism, because it ties into a lot of my ideas about remembering how much is enough, and having some standard that doesn't constantly escalate lifestyle and/or expectations, and reminds me to ask what exactly am I putting on the line to get some increment of something.

Also, I don't like being carrotted right off a cliff.

ETA: In case previous posts haven't made it brutally obvious, despite the sausage-y nature of the process and the product, I'm still pro-health insurance reform. Even if it costs us a bundle just to get rid of pre-existing conditions (which is to say, you are guaranteed they will offer you a policy, even if it is 2x or 3x or even more than it would be without that pre-existing condition), and even if the affordability bits are totally inadequate and blah, blah, bleeping, blah, I think just requiring health insurance companies to write policies for all comers is worth a helluva lot.

For one thing, once that requirement is in place and we see what the premiums look like down the road a piece, we can mangle things further if/when we collectively decide it is worth the hassle.
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