No question. But it has come as something of a shock for me to realize that, in many areas where I thought I was seeing a big, sweeping problem, like climate change, there has actually been a very small but perceptible shift to a more conservative position over the last ten or fifteen years. And this really surprises me because I am not a political scientist or a sociologist or a public-policy expert. I had expected that there would be some ideological shift over time as a result of these policies. Not so much, thankfully.
Why is this happening? That is a complicated question, and I don’t want to get into all the details. One big story seems to be a shift in attitudes that are not all necessarily good, but some will get you out of this economic mess a lot more quickly than others. There’s been a really dramatic shift on the role of the state in relation to social policy, particularly health care, for example. Now, there is an enormous cost to all sides of all of these issues.
That’s a more personal story than we’re going to get into here, but let’s just say that you look at the number of uninsured people in the United States and you realize that the burden is really just falling on the people who can least afford it at a time of such high financial burden. What do you think the reason for this might be?
I think that it might have less to do with politics and more to do with the economics of health care that has just shifted beyond the reach of most people.
The main point is that it is becoming harder for low-income families to maintain any level of coverage or any level of coverage for the long term, and this is in part because of the collapse of the individual insurance market and what’s called the “grand bargain” between the Obama and the Republican proposals.
What are the implications for policy? Are those going to get worse, or are they going to remain stable?
I don’t really know the answer to your question. My impression is that the trend is going to be stable. The issue now is how long this will last because the individual insurance market has collapsed, and now everyone has to buy into a larger system. It’s difficult if not impossible to get anyone to buy into an entirely new program that you don’t have to pay for yourself.
There’s going to be a lot of people who end up worse off, and the people who are likely to pay most of the bill