Health-Care Reform and the “Culture Wars”

Friday, Politico.com editor Fred Barbash posed this question to “Arena” contributors: “Does the ongoing debate about healthcare reform reflect a :”kind of culture war” that can be traced to a “fundamental difference in world views?”

Barbash then pointed to a thought-provoking piece by Bill Bishop, titled “Health Debate Runs Along Familiar Lines” which was published on Politico.com in March.  Bishop, who  is the co-author of “The Big Sort: Why the Clustering of Like-Minded America Is Tearing Us Apart,” argues that “The health care discussion reveals that the country is still divided along lines drawn more than 100 years ago. . . divisions in the country were never about specific issues . . .. They were about ways of looking at this world (and the next), and those century-old differences are now shaping the health care discussion.”

Bishop frames the age-old religious debate this way: “Do you get to heaven by your good works, by what you do for your brothers and sisters on Earth? Or do you find salvation by your individual relationship with God? Does the world get better through public acts or private ones?“When Sen. Jim DeMint (R-S.C.) said recently that ‘this health care issue s D-Day for freedom in America’ he was talking from one side of this division. President Barack Obama says,  ‘I am my brother’s keeper.’ That’s the view from the other bank. “This isn’t a policy issue or a disagreement about strategy,” Bishop adds. “It is a fundamental difference in worldview. It’s a division in what people expect out of life, and it’s been part of this country for more than 100 years.”

He points out that “Religious historian Martin Marty described the late 19th-century split between what he called private and public Protestants. Private Protestants promoted individual salvation and personal morality.By contrast, Bishop exatplains that “Public Protestants saw riots by workers [fighting for unions]  as a failure of society. Pubic Protestants promoted the minimum wage and  the 8-hour days . .  . Public Protestants believed that either the needs of people would be met, or the kingdom of God [on earth] would never arrive. ‘Either society confronted social injustice or society would fall,’ wrote one prominent public Protestant. ‘It is either a revival of social religion or the deluge.’”

There were “two types of Christianity” alive in the country, Bishop adds, “Congregationalist minister Josiah Strong wrote in 1913. ‘Their difference is one of spirit, aim, point of view, comprehensiveness. The one is individualist; the other is social.’”In my response, I  tried to connect the dots between Private vs. Public Protestants and today’s progressives and conservatives.Regular readers may not find many surprises in my comment on healthcare reform, but I suspect many would enjoy Bishop Paul Moore’s spectacular analysis (which I quote in the second paragraph of my comment), explaining where former president George W. Bush fits in the Private vs. Public  Protestant debate.

Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, her work has appeared in the New York Times, Barron’s and Institutional Investor. She is the author of  “Money-Driven Medicine: The Real Reason Why Healthcare Costs So Much,” an examination of the economic forces driving the health care system. A fellow at the Century Foundation, Maggie is also the author the increasingly influential HealthBeat blog, one of our favorite health care reads, where this piece first appeared.

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13 replies »

  1. I agree that the debate on health care reform is really about differences not only in groups of people with vastly different religious values, but differences in education and intellectual curiosity. I am a Protestant and believe in health care reform. I understand that Medicare ia a government fund. Many of the opposition to healthcare reform have a misunderstanding, or rather an educational deficiency in how Medicare operates and so are “against government” involvement. If you ask them if they wanted to give up medicare, they would be in an uproar. In my church the people who are for health care reform are the professionals, highly educated, with jobs connected to health care or education. The opponents are generally those are less educated, skilled workers working for others, less well read and yet they all think medicare if wonderful. But then they argue about government interference.

  2. i have read the house bill and find it very difficult to follow. i think every one of the points or counterpoints/ denials made by both sides have some interpretive validity in the text of the bill and for me that IS the problem. if we cant understand what it says then it says whatever they say it does. having the lives of my family or myself “open to interpretation” is a very disturbing thought. clean it up, make it comprehensable to a high school graduate, and vote on it. we as a people are very generous when we are “asked”, not so much when we are “told”. stand your ground but demand simplicity.

  3. Interesting perspective and one I would agree with however today we have two world views which could not be further apart. On one hand the secularists who would remove anything having to do with God from the public square and on the other hand we have those with a Biblical world view, of whom I am one. These opposing views are not going to come together over anything having to do with adding more government into our lives and so true health reform, which needs to happen and should happen, will pass away and we’ll miss an opportunity to do something great.

  4. “President Barack Obama says, ‘I am my brother’s keeper.’”
    So he lies to his brother and tricks him into turning over all his money with false promises of benefits to come. The only thing he keeps is his brother poor and suffering. Didn’t the Democrats claim to be their brothers keeper when they institued public housing? That kept 5-6 generations of his brothers in poverty.
    Who ends up in Healven the person that teaches you to fish or the taxman who takes all your money with the promise of daily fish rations they never deliver?

  5. “The horror stories about being refused medical attention, or having to wait for hours, days, weeks, month for treatment is simply not true.”
    Yes the thousands of first hand accounts are all lies, Frank says so! And those liberal pro socialized medicine papers and journalist that report those stories are also in on the lie.
    “But perhaps the biggest misleading fact regarding health care is the cost per capita.”
    ? Before you cut and paste spam maybe read it and understand it? What is the fact you reference and what is misleading?
    “On top of that you still have to pay for your own health insurance”
    Idiot, What premiums are there for Medicaid, SCHIP, VA? Paying $100 in premium bad, paying $120 in taxes to cover $100 in premium good? That is why Europe will always be the red headed step child to US success, they can’t even do basic math.
    “Perhaps that is why less than 40% of Americans are satisfied with the current health care system”
    Speaking of lies, 80%+ of Americans are happy with their insurance, nice try.

  6. DeMint was referring to the fact that, once HC becomes a gov’t monopoly, the citizen becomes the supplicant rather than the other way around. In authoritarian societies, the subjects beseech the ruler, beg for help or favors. And so, such would be the case under single-payer. It is, effectively, the end of republican democracy, and the start of the sort of soft authoritarianism we see in Europe today. That’s why people are so scared. Get it, Maggie?

  7. The two basic worldviews is an old idea (for instance, Thomas Sowell’s “Conflict of Visions”, etc., etc.). The conservative view sees human nature as more dangerous, the world as inherently adversarial, thus supports more “defense” spending, etc., the liberal view sees human nature as more cooperative, and reaches different conclusions, etc.
    So this has been understood well for a while, and I even include this in a chapter in my coming book (which is about broader issues).
    I’m not saying restating this in a new way isn’t worthwhile. But it’s good to read what’s already been done.

  8. The current ongoing debate surrounding the much needed proposed reform of the US Health care system is beyond logic to me. Having grown up with “Socialized” or “Government” controlled/provided health care and having spent the better part of my adult life in this country with a private “for profit” health care system I am somewhat qualified to speak on the subject. First the “myths” or downright lies that certain political groups are attempting to spread regarding Socialized medicine is simply just that. The horror stories about being refused medical attention, or having to wait for hours, days, weeks, month for treatment is simply not true. You receive prompt medical care when needed, as a matter of fact doctors in Denmark still makes house calls! You complete freedom to choose which ever Doctor and Hospital you desire. I could go on but I encourage all to educate themselves beyond just listening to the various “talking heads”.
    But perhaps the biggest misleading fact regarding health care is the cost per capita. US rank the highest in the world and are spending almost twice that of Denmark…on the current health care system. On top of that you still have to pay for your own health insurance, co-pay, deductibles, etc, etc not to mention the constant fight with the insurance companies. In Denmark (read Socialized medicine), no cost, no fight, no hassle! Perhaps that is why less than 40% of Americans are satisfied with the current health care system while 91% of Danes are satisfied with theirs.
    BTW, as you will see from the enclosed links the health care system in Denmark is administered by the “Ministry of Health AND PREVENTION”…what a novel concept, prevention! but that is a natural byproduct of a “not for profit” health care system. Since there is no money in treating people it is in your interest to prevent having to in the first place, makes sense right. In a “for profit” system your interest lies in the treatment, not the cure and certainly not the prevention. Come on people wake up!!!

  9. Most Americans are aware that what is good for the health care system as a whole often looks very different when it’s their own health at stake or the health of someone in their family. Do we Americans view health care as a communal resource that should benefit everyone or do we view it mainly from the standpoint of “what’s in it for me”? Do they view themselves as citizens working together for a “greater good,” or as patients and consumers of health care, worried about retaining access to all that medicine has to offer? The longer we delay, the higher health care costs rise, while more and more Americans lose their health insurance. In the meantime, you’ll continue to have a corporate bureaucrat between you and your doctor.

  10. The Government Loses Over $200 Billion A year To Medicare/Medicaid Fraud!!!!
    Should they be taxing us more to grow their control of the system??? Isn’t it a bottomless pit???
    The federal Health Care Financing Administration, which oversees Medicare & Medicaid (the parts of the healthcare system which are run by the government), estimates that the government loses 30 cents to every dollar from fraudulent practices in the medical community. This is a huge problem that must not be ignored; especially when you consider that the combined total spending that is projected in 2010 for Medicare & Medicaid is $675 billion! That is over $200 billion of taxpayer’s money that is being wasted in the current government run healthcare system!

  11. I don’t think anyone disagrees that we do need health care reform. But I think many are truly concerned about the cost of a completely new system versus fixing the problems in the system we have. Also many believe when the USA became a free country it embraced an ideology of free market enterprise and small government.
    At the time the constitution was written the damage that can be caused by letting a government become too big and too powerful was all too apparent. I think this is a valid concern today. In government the most powerful senators are the ones that control the largest budgets. Obviously healthcare is huge! Management systems in Washington work in reverse of the free market system. In Washington budgets are reduced if they are not spent in the previous year, so the emphasis is to grow your budget. Larger budgets equate to more power and control for that department. In the free market system CEO’s are rewarded for reducing costs and saving money, while continuing to maintain a health budget for research and development. Free market system is more efficient and more likely to achieve the results we need in our healthcare system.

  12. one problem for all is that whatever is healthy this week will kill you the next and vice versa.
    also with different countries having different rules and methods of health care you get medical migrants who travel to get what they want somewhere else.cheaper ops for example or ones not alowed in their country

  13. I believe that this “world view” argument is clearly at the core of the healthcare debate, as it is with many of our other social and political debates. It is also about the redistribution of power in ways that make many uncomfortable, despite the fact that the train has long since left the station, not only in the U.S., but increasingly everywhere you look around the globe. Enabling digital technologies are playing a central role as well, but that is a comment for another day.