I’ve seen conservatives circulating this YouTube clip, in which Andrea Mitchell, discussing polling numbers showing low support for Obama’s health care reforms, notes in an aside that opponents “may not know what’s good for them.” This incredibly tone-deaf choice of words, naturally, prompts cries of “elitism” and “arrogance.” Insofar as “elitism” has recently been used primarily as a bludgeon against anyone who thinks knowledge or education are good, I’m certainly much happier to see it deployed as a surrogate for “paternalism.” But I’m also not quite sure it fits the bill. After all, if you disapprove of Obamacare, what’s your opinion of all the people who favor it? Presumably that they’re mistaken about what would be good for them. Maybe it’s only elitist when the people you disagree with are (barely) in the majority or plurality?
Now, someone might object that if health care reform will have winners and losers, you could believe that the people who think it will be better for them and the ones who think it will be worse are both likely to be correct. And maybe many of them are. But I suspect that for a lot of people, their view of whether reform will be good or bad for them is pretty tightly bound up with what they think the system will look like on the whole. If you’re totally without coverage now, you can guess that almost any reform has a good chance of being an improvement, and if you’re extremely happy with your current coverage and cost, you might reasonably expect that tinkering is more likely to muck things up than to result in still further improvement. If you’re somewhere in the middle, though, your opinion probably turns on which of a range of general scenarios you find most plausible. That is, it’s not so much anything specific to do with you, but rather how you answer broad questions about the systemic effects of the policy: Will costs be controlled? Will rationing be severe? Will patients have more or less control over the course of their care? Will innovation be encouraged?
To the extent people’s predictions turn on those sorts of questions, “knowing what’s good for you” just amounts to “knowing whether the policy is good.” And while we should expect people to routinely be in the best position to know what’s good for them—to know what their own values and priorities are, what their specific options and constraints are, and how to trade off between them—there’s not much reason to expect that expertise to translate to national-level policies, even when those policies will naturally have some effect on the welfare of each individual. Insofar as there’s sharp disagreement, it’s practically a tautology that large numbers of people will turn out to be wrong about “what’s good for them” in this sense.
I mention all this, by the way, not because I have any interest in defending Obama’s health proposals, but because I’m loath to see anti-paternalist rhetoric conscripted in service of crude majoritarianism.
9 responses so far ↓
1 Dan // Aug 7, 2009 at 3:56 pm
I always thought Elitist was used to mean snobbishness more than anything.
2 Patrick // Aug 7, 2009 at 4:35 pm
For a while I actually tried formulating an opposite theory, that people’s ideological states effect how people view their own status. That if you’re a liberal you’re more likely to see your own ability to mitigate financial risk from health related problems as significantly worse then it actually is.
I’m pretty sure there’s no data to back this up though, and in fact is probably not true..
You’re actually quite wrong though. It actually isn’t about what’s best for themselves. While being ‘mugged by the insurance industry’ may turn you progressive, on a whole people in a democracy don’t vote on their best interest for themselves. Rather, and this is from a study last year, people are more then willing to advocate policy changes that do nothing for themselves or a burden, if they perceive it to be good for the rest of their neighborhood or country. This explains why people consistently tend to vote in ways that aren’t in their best interest, such as poor people voting for tax cuts, and rich people voting for tax hikes, amongst other policy inversions.
One interesting idea from this is that the politics of perception, and symbology becomes even that much more important. A problem that effects 4% of the population, like 12 million people uninsured, can be given the perception of a large overwhelming problem that requires massive system reform. Being able to contort people’s ideological perceptions of themselves and engage in politics of symbols can convince people to look for issues and ideas outside of their narrow scope, such as by convincing poorer families that they are middle class and their fellow middle-classers are suffering a burden of government.
3 Julian Sanchez // Aug 7, 2009 at 4:41 pm
I don’t remember the exact wording of the poll — I think I was just rolling with Mitchell’s premise that people’s responses reflected their assessment of how reform would affect their own situations. If people are just answering on the basis of their view of the net effect of the policy on the country as a whole, then that just strengthens the case against seeing it as paternalistic to say either group is wrong.
4 kevin // Aug 7, 2009 at 6:21 pm
“if you disapprove of Obamacare, what’s your opinion of all the people who favor it? ”
From what I’ve been reading this week, it would appear that the most frequently deployed characterization is “Nazi.”
5 Greg N. // Aug 8, 2009 at 11:14 am
There is a distinction between the two types of elitism here. Obamacare supporters say, “They don’t know what’s best for them,” and add, “but we do.”
Opponents of the plan say, “They may not know what’s best for them,” but add, “we don’t either, so it’s probably best to let everyone just choose for herself.” Doesn’t seem like the same level of elitism, at least.
6 UserGoogol // Aug 9, 2009 at 5:46 am
Greg N: That’s kind of misrepresenting what the proposals are, though. It’s not about forcing people to do what’s good for them, but forcing people to do what’s good for others. Taxing people isn’t doing what’s good for them, regulating insurance companies isn’t doing what’s good for them, even the individual health insurance mandate is largely justified as preventing free riders and increasing risk pooling.
When the people being forced and the people being served are largely different groups people, “letting everyone just choose for themselves” might possibly be a good policy idea, but it’s hard to say it makes you any less elitist.
7 Stones Cry Out - If they keep silent… » Things Heard: e80v1 // Aug 10, 2009 at 10:04 am
[…] This notion on healthcare that everyone without insurance wants it that way is problematic. […]
8 John Faber // Nov 12, 2009 at 7:22 pm
You’re right, Dan. That’s exactly what “elitist” means.
No, the word “elitism” isn’t used as a bludgeon against anyone who thinks that knowledge or education are good. You aren’t listening. It’s used to criticize those who believe that they are either better than others, and therefore entitled to be heeded even when they speak nonsense, or that their education or other credentials trump superior arguments in debate.
It’s a phenomenon fairly common on the Left, especially among folk who see themselves as egalitarian when in fact they’
9 John Faber // Nov 12, 2009 at 7:22 pm
You’re right, Dan. That’s exactly what “elitist” means.
No, the word “elitism” isn’t used as a bludgeon against anyone who thinks that knowledge or education are good. You aren’t listening. It’s used to criticize those who believe that they are either better than others, and therefore entitled to be heeded even when they speak nonsense, or that their education or other credentials trump superior arguments in debate.
It’s a phenomenon fairly common on the Left, especially among folk who see themselves as egalitarian when in fact they’re anything but.