The Healthcare Bill and the Automatic Brain

The tools of conquest do not necessarily come with bombs, and explosions, and fallout. There are weapons that are simply thoughts, ideas, prejudices, to be found only in the minds of men. For the record, prejudices can kill and suspicion can destroy. A thoughtless, frightened search for a scapegoat has a fallout all its own for the children yet unborn…

Rod Serling (from the Twilight Zone)

Does anyone really know what that healthcare debate was all about? I mean, really know? Most Democrats have been for it and most, if not all, Republicans against it. So, if you’re a Democrat and support healthcare reform, your tendency is to believe that those against it are selfish, maybe wealthier than you, and less compassionate toward others than you. If you are Republican, you no doubt feel that those in favor of the bill are looking to impose burdensome taxes and replace freedom of choice with government-run healthcare.

I am not going to take sides in the debate over this bill. Instead, what I’d like to do is pass along this story that a friend shared with me a few days ago:

Joe was the very image of a mountain man—deep-set brown eyes, wavy sandy hair, chiseled square chin, and muscles defined by years of hard work on his father’s farm and now keeping his own place in order. One day, after working hard in the yard, Joe returned to his shed to put away his tools and wrap it up for the day. After storing all the tools in their proper positions, he unbuckled his tool belt and laid it down on the table that he used for his power saw. As he turned toward the door to leave, the mountain man froze in his tracks.

Now, Joe has never been a man to display much emotion, and rarely gets nervous about things that might affect others. But now, the blood left his face, his breath became rapid and shallow, his pulse quickened, and beads of sweat appeared on his brow. He could not move. In front of him, on the floor of the shed, he saw coiled up a large green snake. At some point in his life, Joe developed a phobia for snakes. He could not recall a precise incident; all he knew was that his fear was paralyzing.

His brain began to race: “If I try to run out the door, the snake will bite me as I run by! But if I stay in the shed, I’m a sitting duck and it will get me anyway! If I throw something at it, it will become scared and strike me!” Joe’s automatic brain (AB) was doing what it’s designed to do: set up the response of fight or flight, along with the tactics to deal with the danger. Time seemed to stand still as the adrenaline surged through his veins, and the thoughts generated by his AB clouded his vision. Slowly, the cloud lifted and he began to see things more clearly. He noticed that the snake’s skin was smooth, not scaly. Its color was uniform, not varied. And the snake had no head. In fact, what he saw had fallen off the wall next to the door - it was an old garden hose.

So what does this have to do with the healthcare bill? Actually, it has everything to do with the bill and with one of my primary messages. All of us, politicians included, behave and react to perceived dangers, threats, and vulnerabilities, as though they were real. Please don’t read anything into that statement about my personal political beliefs—I’m not saying that the Republicans are acting out of an irrational fear of the President’s programs, or that the Democrats as playing the “compassion” card and invoking schadenfreude toward the opposition in an effort to appear superior.

These politicians make decisions that do affect our lives. I am concerned about their ability to point to a garden hose and call it a snake—in other words, to instill fear. When President Obama campaigned about overhauling healthcare, he flung arrows at doctors (e.g., the charge that some doctors perform unnecessary tonsillectomies just to bring in more money). He has also vowed to “unleash an army of auditors” to go after insurance companies and doctors who defraud the system.

To me, this is a sign that the Administration is creating a snake. (Make no mistake, I am no fan of how medical insurance companies invade decision-making. Just last month, a company denied payment for one of my patient’s hospitalizations. If I hadn’t admitted the patient to the hospital, I would have violated good medical practice and been negligent.) In my view, our leaders, the President included, are being ruled by their AB. They’re driven to take an unyielding position, regardless of whether it is right or not, because it is the party line. That line is what defines them; it brings them support from their respective parties; they feel that it sustains their life and insulates them from the dreaded dangers, threats, and vulnerabilities that exist in the political jungle; indeed, they’re convinced that their stubborn adherence to one point of view is what gives them power.

A hallmark of the AB’s thought process is the creation of a scapegoat (or the snake in the above story). Some blame minorities and the poor for the ills of our society, while others blame rich CEOs, the insurance industry, investment bankers, hedge fund managers, and “greedy” doctors. Setting up a scapegoat is a device for manipulation, seduction, and lies, all used by our primitive AB to fight or flee perceived danger (see chapter 11 of Brain Drain). Blaming the insurance industry or doctors or any one person or group won’t solve our problems or make us safer. No course of action derived from the automatic brain will leave you better off.

I would like our leaders to show true leadership. I hope they can strive to come up with creative ideas and not just tired slogans that play on their own fears or those of their constituents. With this healthcare bill, the Obama Administration seems committed to carve a place in history. As Congress and the President deal with other weighty issues in the future, they need to make sure they don’t try to tell us that a garden hose is a snake. They need to put aside their AB and work on coming up with creative solutions. Are they capable of doing this? I am not so sure. The history of creative, flexible, mind-based dialog in Washington (and Albany) does not inspire optimism. Our leaders must never forget who they work for: They work for every one of us.