Emotionitis: A Political Malady

Today's political debates are extremely polarized and emotional. One person's charming, clever, and assertive is another's manipulative, cunning, and ruthless.

Consider the opposing perspectives on some of the most important issues:

  • Did the politician lie or merely misspeak?
  • Is the NSA perpetrating an obscene invasion of privacy or deploying a crucial tool against terrorism?
  • Is supporting voter identification laws resurrecting Jim Crow or ensuring legitimate votes are not diluted by fraudulent votes?
  • Do federal regulations stifle business and entrepreneurship or do they ensure Americans' safety?
  • Why is it racist to disagree with the policies of President Obama or Attorney General Holder, but reasonable to disagree with Condoleezza Rice or Clarence Thomas?
  • Why is interest in the possible long-term effects of Hillary Clinton's brain concussion intrusive, sexist, and unfair, but delving into Sarah Palin's medical records to determine if she had actually given birth to her new baby is manifestly valid? (I guess it's a political crime to be petite.)
  • Have you cornered the market on compassion if you believe Medicaid provides good health care, or are you a heartless subhuman if you believe Medicaid traps lower income individuals in a two-tiered health system?

Marcus Aurelius said, "Everything we see is perspective and not the truth." In 1880, William James, a Harvard physician, philosopher, and "father of psychology" observed, "As a rule we disbelieve all the facts and theories for which we have no use. A great many people think they are thinking when they are really rearranging their prejudices."

To analyze why we cement our beliefs in the face of contrary facts, psychologist Leon Festinger proposed the theory of cognitive dissonance: people seek consistency in their beliefs and perceptions because it is uncomfortable to have inconsistent ideas. For example, you like President Obama, so how can you dislike ObamaCare?

One unconscious mechanism we use to ignore facts is "motivated reasoning." Here, we process information such that the influence of our beliefs outweighs new facts in forming seemingly reasonable conclusions. In other words, our brain's goal is not accuracy, but defense of beliefs.

Adding to the difficulty in changing our minds, we tend toward "confirmation bias," i.e., listening only to those who confirm our preconceptions. Another psychological tool is post-purchase rationalization. Anyone who purchased a time-share or hot-off-the-shelf Betamax knows what that is.

Modern technology confirms Professor James's observation. An Emory University study analyzing functional magnetic resonance imaging (fMRI) found that the areas in the brain regulating emotion and conflict resolution light up when subjects were questioned about their political beliefs. The part of the brain most associated with reasoning was quiet.

Emotionitis and ideological divisiveness should never have been allowed to take over the healthcare reform debate. A good relationship with your doctor is just too important to health and peace of mind. And there are actually large areas of agreement. A mere 19 percent of Americans say that they trust Washington "to do what is right" just about always or most of the time according to Pew Research Center.

Yet, while we think the government is made of incompetent self-serving fools, we trusted it with our health care system. Perhaps enough first-hand experience with grossly higher premiums, deductibles, and co-pays and limits on patients' choice of physicians jolted people into reality. The support for the Affordable Care Act (ACA) is at an all time low of 26 percent according to the latest Associated Press poll.

There is also almost universal agreement that American medicine has serious problems. The right approach would have been to seek dispassionate analysis of the causes instead of leaping into the Affordable Care Act.

Our system relies heavily on public and private third party payers and muscles out the one-on-one relationship between patient and doctor. ACA just makes it worse. ACA's "health insurance" is not medical care-and it isn't insurance either.

Real insurance-unlike ACA and most of pre-ACA coverage also-is affordable because it is designed to financially protect against catastrophes, not routine necessities. Individualized affordable medical care can be achieved through expansion of health savings accounts, direct pay (which cuts out third-party overhead), charity care, and major medical insurance.

We need to overcome our emotional attachment to the false promise of security through third-party coverage.

Marilyn M. Singleton, MD, JD is a board-certified anesthesiologist and Association of American Physicians and Surgeons member. While working in the operating room, she attended UC Berkeley Law School, focusing on constitutional law and administrative law.