Which would you choose- a big buffet dinner that your entire neighborhood is attending, or a private dinner that costs twice as much and tastes awful? If you're like most Americans, you might lean towards the private meal of ramen noodles and leftover chicken nuggets. Why, you might ask would we be that stupid? I would submit that this markedly American behavior is an outgrowth of the Ikea effect, an import from that socialist mecca, Sweden.
The Ikea effect has been written about by psychologists to explain the unusual attachment people have towards things they make, design, or build themselves. Ikea furniture is unique in that it has to be assembled by the consumer. This act of creation is so powerful that it makes the furniture much more valuable to the one building it. We value things like this so strongly that we become blind to flaws and completely lose our objectivity. The Ikea effect explains why we think our children are all above average, our houses are better than the market says they are, and our representatives in Washington are great while the rest of congress are crooks.
In looking at the ongoing healthcare debate, it's clear that the Ikea effect is at work there as well. Our healthcare system is demonstrably inferior to most other industrialized countries- with sky-high costs and poorer results. Yet because at some level we chose our doctors, pharmacies, and drugs, we overvalue them and refuse to consider any better alternatives. The medical industrial complex (hospitals, big pharma, and insurance companies) knows that, and is exploiting it with their "Partnership for America's Healthcare Future," a sophisticated campaign to scare Americans that government will take away their crappy healthcare.
Big medicine rails against single-payer systems such as are found in Canada, Europe and Japan as "one size fits all systems". They push the Ikea mythology that your healthcare has to be special and unique because you get to choose it. (Most people are stuck with one size fits all plans that their employers choose, so that argument is phony) What they neglect to tell you is that most of those countries also allow private insurance on top of the public insurance for those who can afford it, so even in the most socialist of countries there are ways to tailor your choices.
The entire healthcare debate- public option vs. Medicare for all vs. Obamacare vs. every man for himself- is couched in scary terms of what you can lose instead of what you could gain. Once we have put together our wobbly, overpriced healthcare, we cling to it because it's ours that we made ourselves. The overpaid middlemen who run our system want us to keep thinking that. Could taxes go up? Of course- but the net effect would be positive if we can get more affordable and better healthcare to offset the higher taxes. Might we have to change our doctors, drug stores, or dentists? Maybe. Maybe not. If the end result is better, as it seems to be all over the world, it's worth trying.
I recently finished the book Code Blue by Dr. Mike Magee, and it goes into great depth about the state of American health care. While things are much better than they were 100 years ago, they suck in comparison to how other countries handle health care today. Why should we pay $320 for insulin while just across the border in Canada they can get it for $30? With our talent and technology, why can't we lead the world in life expectancy and infant survival rates instead of medical bankruptcies and uninsured populations?
The Ikea effect, because it's so personal and emotional, is extremely hard to overcome. Aided by well-established companies protecting their healthcare turf, it becomes nearly impossible. The only path away from cognitive biases is to step back and see them for what they are. We need to go to our most trusted health providers, doctors and nurses, and get their honest assessment about what's gone wrong with American healthcare.
There's something very wrong when over 50% of doctors don't recommend their profession to young people and nearly 50% of nurses report being seriously burned out or disengaged in their jobs. They are caught in the hot center of this dysfunctional system, and most of the problems are not their fault. We need more doctors and nurses to run for public office, and more of them to speak out about what needs to be fixed in medicine today. Dr. Magee was a hospital administrator and Pfizer executive and he spoke out plenty in his book.
In the meantime, we all need to follow the healthcare debate with an open mind, and vote in 2020 for candidates who don't cynically exploit fear and ignorance to threaten us. We need to let go of the shit that is holding us back and find better ways to be healthier. We deserve better and we can do better.
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