Free market economists use models that assume that people are given complete information and make rational decisions. How absurd. No one has complete information, most people have terribly unreliable information, and people make stupid decisions all the time. Witness the election of George W. Bush in 2004.
But people usually are not alone in their beliefs. If anything, people often seek the comfort of a group of like-minded people. They find them in their neighborhoods and through their social and religious activities, and increasingly, they find them by virtue of the sources of information that they choose (Daily Show:Fox News::Oil:Water). It's uncommon for people to survey the breadth of ideological offerings on a given political issue. They go, and stay, where they are comfortable.
The insurance industry is massively funding the campaign against health care reform, especially reform that includes an option for publicly administered insurance. They want to keep making a lot of money, so they prefer to keep things the way they are. The industry is abetted by its mouthpieces on Fox News, talk radio, and in the op-ed pages of the Wall Street Journal. Their teams of strategists are rolling out some rabid crusaders to try to stop the conversation, apparently encouraging them to use tactics as close to brute force as the law will allow (and then some).
This illogical outrage and outrageous behavior obviously didn't spring up overnight, it's been cultivated for years by political strategists and interest groups on the right. The rabid dogs know what they're doing--they know their role, even if they can't control themselves. If you sat these birthers and screamers and Glenn Beck fans down and asked them to explain how the universe is put together, the story you heard would be scary and wrong, but they would believe every word of it.
While it rests uneasily on an old foundation of philosophical principles, the right's current 'platform' on health care is a twisted-up mess of distortions and opportunity-driven sound bites. It makes very little sense for an ordinary working person to adopt a stance against public health insurance--what exactly is so great about private health insurance?--but rational decision-making has nothing to do with this. People are committed to being on a team, and they will fight for the team.
It will take a long time, if it ever happens, to shift perspectives in a way that will allow people to stop viewing politics as an intense and bitter rivalry between two teams. This raises an important practical question: can we introduce an element of choice to the health care discussion, reflecting the chasm between the two sides, that doesn't undermine the bargaining power of a public option?
While every community has people of all persuasions, we all know of predictable differences in 'the sense of a community' spread across different geographies. In general, urban centers are socially libertarian and supportive of spending on public services, while rural areas tend to be socially conservative and anti-tax. The suburbs are the swing districts for the most part, in terms of D or R, but they have their own cohesiveness as well.
The current debate in DC has focused on 1) a national public option for everyone or 2) state-by-state decisions on whether a public option is available. Neither of these approaches successfully take into account the reality that people are bitterly divided on the issue, and will stay that way. One answer to the dilemma might be to create a national public health insurance option, but give local communities the choice to opt in or out. Union County can vote in or out. Multnomah County, same choice. Equity can be ensured via the tax code.
It's a foregone conclusion that the major urban areas will all opt in. Both coasts will be in. In parts of the country where the political divide is intense, communities will have their say; e.g. rural Georgia will probably be out, and Atlanta will opt in. With most cities in, the population base will be plenty large enough to ensure maximum bargaining power. And the conservative communities that are whipped into a frenzy can sit this one out.
If we're right, in a few years they will be clamoring to be included. If we're wrong, they can say they told us so.