I have spent the last 3 years educating and advocating for the Affordable Care Act with much of that being one-on-one, street-level encounters. Nearly everyone I meet either pro or con ACA needs some educating. The ACA is a mind bogglingly complicated piece of legislation and I don’t blame anyone for being confused. Opponents of the law need lots of educating and, in my experience; I can have a reasonable conversation with 90 percent of them even though I may not change their mind on the wisdom of the reforms.
As committed as I am to educating, I don’t want to waste any of my precious time talking to the ideologically fixed and inflexible who are not open to fact or reason. So I try to size-up my audience within a 1 minute period to see if there is room for education. This is where 30 years of experience as a physician is invaluable; I am a pro in evaluating a person’s mindset rapidly and accurately. When I meet those relatively rare intransigent fools, I wish them a good day and move on. This approach has worked well for me. My educating and advocating sessions with folks never deteriorate into mean spirited arguments.
But last week I let a situation get out of hand which proved the wisdom of my usual approach. A close friend of mind, who works for an aerospace company, is applying for security credentials. This required 6 people who know him well to be interviewed, in person, by a contracted security investigator and I offered to help out. The investigator interviewed me at my home and a colorful character he was. A retired FBI agent, in-between questions about my friend he regaled me with fascinating stories about his flight combat experience in Vietnam and years of fighting organized crime in Las Vegas. I quite enjoyed our conversation and after 45 minutes walked him to my porch and we shook hands. There the friendly encountered ended.
Knowing that I was a physician, the investigator asked me what I thought about Obamacare. He didn’t like my answer and then launched into a classic tirade of misinformation. After a couple of counters to his ideas it became obvious I was dealing with a complete fool and would normally have wished him well and left the scene. But he was now on my porch, going no where, and although a few inches taller than me, getting in my face. No avoidance or retreat today.
I tried my best to respectfully challenge his notions but to no avail. One point where we went round-and-round was his certainty that Congress had recently exempted itself from the ACA. In a nut shell, a section of the ACA requires most members of Congress, and their staffs, to use the new online insurance marketplaces to purchase their personal health insurance. Last week, the Obama administration promulgated rules that would allow Congress and staff to receive the funds that have in the past gone towards their health care benefits, to allow them to purchase individual plans. Conservative media has jumped all over this and claimed Congress has cut a special deal for itself so it can avoid onerous Obamacare Fox News and talk radio have very effectively made it sound like Congress passed a special exemption for itself from the law. The reality is that yes, Congress has created an exemption for itself, but it is an exemption to participate in Obamacare. I’ll admit, like much of the ACA, it is a bit complicated and nuanced. And opponents of the law have taken advantage of every confusing announcement to hopelessly muddy the waters and further inflame passions. So there was no convincing my antagonist that he had it backwards and he bluntly cut me off by stating “I know a 100,000 people who say it is so and you are the only one who says otherwise.”
The conversation got worse as my investigator, now inquisitor, went on to attack President Obama, then his cabinet, and he summed up by stating “the entire country is going to hell.” After 20 minutes he finally got in his car and I wished him a safe drive back to the very conservative county he inhabits, one of the most conservative in the nation, where he can enjoy a life of nearly complete ignorance.
What's going on here? Unfortunately, our golden age of the unlimited access to information has produced information silos, which each of us tend to inhabit, and which reinforce any distorted notions we may have latched onto. Some have become so incased in their silo that they are hopelessly isolated to any contrary ideas.
Each of us needs to be careful to let some fresh air and light into our own information silos. For me that involves listening to a lot of conservative talk-radio in the care, reading some Wall Street Journal op-eds, and minimizing my exposure to MSNBC. But everyone needs a different technique; otherwise we risk the sad fate of my “friend” the investigator.