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The Germ Theory of Health Care Reform August 14, 2009

Posted by judylobo in Photography, Politics, Zoos.

reformMy good friend, Bumper Sticker Ruth has written a thoughtful piece on the current debate (or shouting match) over Health Care Reform.  Ruth does not have a blog (but should) and asked if I would post it on my Lobo Rants blog. Well worth your reading time. Please comment on the blog so everyone can see your thoughts too. The photo to the left is mine and added because I like to always use my photos to ‘soften’ the language of any piece I write and generally people like pretty photos of animals.

The Germ Theory of Health Care Reform

Change is not easy. Getting people to even accept why change is needed can be a long and difficult process. The more fundamental the change is to the person’s lifestyle or worldview, the more difficult it is to accept the need for change – even when the person can substantially benefit from the change.

I believe that a good number of the people who are acting out and being dismissed as “crazies” or
“racists” in the Health Care debate are finding it very difficult to deal with the change embodied by
Health Care reform.

It’s not any of the details of a Health Care proposal that they’re having difficulty with, it’s the need to change their worldview that government intervention is always bad and open business enterprise is always good. This good vs evil view comes out in forms like the “death panel” allegory. Is there anything remotely resembling “death panels” being discussed as part of the legislation? No. Will you be able to get the anti-Health Care Reform movement to stop talking about “death panels” even by going through every word of proposed legislation with them and seeing that there’s no such thing in the legislation? Probably not. Whether it’s literally correct is not as important as the fact that it represents their worldview. It is, in effect, an allegory that lets them express that view and connect with others who have the same perspective. (Once again, Sarah Palin knows how to connect with her base – even while the rest of us think she’s talking herself into oblivion).

Even educated, well meaning people have difficulty dealing with change when it conflicts with basic
aspects of their lifestyle or perception. There’s an excellent example in a paper called the “Germ Theory of Management”. (Tribus, Myron (1992). The Germ Theory of Management. SPC Press, Inc. ISBN 0- 945320-33-7.) The example describes the reaction of the medical community to Pasteur’s discoveries in the 1860’s about germs, their role in spreading disease, and sterilization methods to prevent the spread of disease and infection. Rather than embrace these discoveries, many in the medical community reacted against it. It meant that doctors had to accept the fact that they had been unwittingly spreading disease and infection from patient to patient.

The paper asks you to imagine that you’ve just read about the work of Pasteur and have been invited to speak to an audience of these physicians “many of them having come to fame for their heroic service as surgeons during the American Civil war. What you now understand from your readings is that these famous physicians are actually killing their patients. Your assignment is to persuade them to forget most of what they have been taught, to abandon much of the wisdom they have accumulated over their distinguished careers and to rebuild their understanding of the practice of
medicine around the new theory of germs… Do you think you could convince them? Do you think they will be glad to hear you?”

The paper then asks “Suppose, instead of being the speaker, you are a member of the audience. You are one of the good doctors who have earned respect and prestige in your village…How will you feel if someone starts spreading the word that your treatments are a menace, that the theories you hold are bunk and that your habit of moving from one patient to another, laying unwashed hands on each, guarantees the spread of disease to all who are so unfortunate as to become your patients?… How would you be likely to greet the messenger?” Can you imagine greeting the messenger by
trying to shout him down?

I think this example provides some perspective on what’s happening today. At the surface level, there’s much benefit that can be derived from Health Care Reform. At the underlying level, accepting this change means that Conservatives would need to make a fundamental change in their worldview of private enterprise “good”, government intervention “bad”. Do I think they should all be branded “racists” or “crazies” because they are not willing to accept this change? Absolutely not. Change is not easy.

OK. So, given this perspective, what’s next?

– Do I believe that most Conservatives will change their worldview any time soon? Don’t think so.

– Do I believe it’s productive to continue to try to compromise with Conservatives on Health Reform Legislation? No.  Given the Conservative perspective of “government intervention is bad”, I don’t think it’s possible to compromise in the short term and come up with meaningful Health Care Reform.

– Do I believe Heath Care Reform is needed and should be pushed through? Absolutely, even if it needs to be passed using the Reconciliation process. There are too many individual horror stories about health care coverage in this country – not just the problems encountered by people without health care, but also the increasing number of problems encountered by people who have health care coverage: the skyrocketing costs, the denial of care when people most need it, the deceptive insurance practices, and the lack of accountability.

– How do we continue to promote the need for Health Care Reform? By having people tell their
individual stories about the problems encountered under the current health care insurance system – in effect, countering the Conservative worldview that open business enterprise is always good. The Health Care Insurance industry is not a competitive open market business – it’s controlled by a few large companies without free market forces that address consumer interests.

– What kinds of individual stories would be effective to hear from people at town halls and in the
media? When Conservatives talk about the theoretical “death panels” (which aren’t in the legislation), it’s important to hear from people, or their relatives, who’ve been denied coverage for needed care – either with or without insurance coverage. These are situations that are difficult to talk about and difficult to hear about, but they need to be shared. We already have health insurance “death panels” – but it’s not coming from the government. The sad fact is that we are already suffering healthcare nightmare scenarios under the “open market business worldview” favored by Conservatives. These are the circumstances when we need government to step in and adjust the balance of power on behave of the people. We need to hear the stories to remind us of that.

So, bottom line, I think we need to keep working to get meaningful Healthcare Reform enacted. I think people need to be out there, telling their stories to keep the focus on why we need the reform. I think the Conservative worldview of the free enterprise system needs to be adjusted by the reality that when the market is dominated by a few businesses, free enterprise falls apart and government intervention is needed to shift the balance of power back to the people.

Twenty years from now, I envision people looking back on this time and thinking – how could anyone ever have been against Health Care reform? Same as 20 years after Pasteur discovered the germ theory, people looked back on the use of sanitary practices in health care and thought – how could anyone ever have been against that? It happens.



1. jimmyboi2 - August 14, 2009

I agree with the writer in that she correctly assesses their– shall we say– well-grounded refusal to change their worldview, whether it is due to fear, stubbornness, resentment, or a lack of curiosity. I did however sense a sort of sea-change in the last election; unless my perceptions are totally wrong, I think a lot of who would have been called “crazies” and “racists” actually shifter their thinking patterns into more rational channels.
Education and dialogue, not Palin-esque, divisive mob-pandering, will hopefully bring us all together on this. Who doesn’t want a healthy population? Ignore the health needs of the people– especially the middle classes, who labor to support the rich and the poor– and the whole system will collapse.
Education and dialogue. And those on BOTH sides of this debate who can’t keep their traps shut during town hall meetings should legally be marched out to the parking lot and sent home.

2. Erica - August 14, 2009

I am one of those who refer to the conservative mobs at town hall meetings as “crazy racists”, so, thank you for reminding me that they are struggling with the idea of change. And, though it’s really hard for me, I will try to change, too.

As someone who is currently without health insurance (but, even when I had it ended up paying $400.00 for just a physical) I am for health care reform and hope this administration and Congress find a way to push it through despite the resistance.

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