By Dena T. Smith
Health care reform is in the foreground of the American political landscape. Politicians in favor of transformation face staunch opposition and must convince the public and their fellow representatives in congress of both the imminent need and potential effectiveness of a major overhaul.  Classical studies on altruistic behavior inform us that actions aimed at helping others, such as supporting health care reform, are more likely when we experience empathy for the person(s) in need. Estimates as to how many Americans are uninsured usually fall between 30 and 40 million and even those with insurance coverage are likely overwhelmed by deductibles or denials of coverage, so it should not be too hard for many to put themselves in the shoes of the under or un-insured. However, the piece of the altruism puzzle that is more complex is that seeing individuals who are in obvious need of help may not be enough to lead us to act in assistance (clearly we do not act EVERY time someone is in need); altruistic behavior is more likely when the rewards of said action are greater than the costs. It is a combination of feeling a need to act and the assessment that the cost of helping will be small and the rewards will be large that make someone more likely to act altruistically. In short, in order to motivate the American public and congressional leaders, those in favor of reform will have to show  that it will be more beneficial than costly to the American public.

Proposals are making their way to the senate floor and press conferences headed by Speaker Pelosi, as well as prime-time addresses by President Obama are clearly meant to remind us of the narratives to which we were exposed during the 2008 primary; these usually include facing astronomical prescription and hospitalization bills. This social problem is also intimately tied to others, such as home foreclosure, poverty and further illness. Health care reform and certainly support for or against a universal program are politically charged issues with republicans and democrats fighting it out on a daily basis in formal forums as well as in nightly news segments and between friends and family members at dinner tables and in break-rooms. So, what will it take to convince people of the need for change? The benefits of helping behavior must evoke our sympathies for those suffering and outweigh the pragmatic, often fiscally-oriented parts of ourselves that fear the costs of helping may outweigh the benefits.  Following Nancy Pelosi’s July 22nd press conference, one CNN reporter framed the event with the following question: “what would you give up to get meaningful health care reform?” Similarly, David Leonhardt of the New York Times (see the link below) summarizes the issue with the question, “What’s in it for me?” How we weigh the costs and benefits of changing the system will determine the final outcome, which begs the question of whether health care reform is really at all about altruism – perhaps it is, in the end, much more about self-interest.

Placing emphasis on the costs to the American public seems to be an increasingly pervasive trend. Advertisements and many right-wing politicians lead us to ask questions such as: Do Canadians really have access to effective and efficient health care? Will this have economic ramifications that our grandchildren will be forced to live with? Is there an efficient way to transform our system? Does President Obama really have a reasonable plan given the state of the economy? What will we have to give up in order to restructure the current system? On the other side of the debate lie questions such as :  How can Americans possibly continue to pay costly premiums for substandard coverage? How can we not do something about the unequal distribution of care?  Isn’t our government responsible for taking care of its citizens’ health? This perspective turns our attention to questions of the sustainability and effectiveness of the current system. Ultimately, the question is whether enough members of congress and the American public can be convinced that the benefits of health care reform outweigh the costs – or vice versa.

square-eyeChallenge to Health Bill: Selling Reform

Obama Explains Rush for Health Care OverhaulThe Blackwell Encyclopedia of Social Psychology: Altruism