There's a lot of polling that Californians support the new federal health reform law, and when they know more details--including the costs and the benefits, the arguments against and the arguments for--they support it even more.
That said, there is a challenge, which is that many don't believe the benefits will actually materialize for them. People have become so distrustful of politics and government that they are disinclined to believe that things can get better, that a problem--like people being denied for pre-existing conditions, or patients going broke due to medical bills--can be solved. So there is a disbelief and discounting of promises of progress, not just when a bill is pending and the skepticism is understandable, but even after the law is signed.
It seems that health reformers were not fighting conservatism, but cynicism. There may be conservative solutions or progressive solutions to health care and other issues. Many would argue that the health reform included both. But if people don't feel that any solutions are possible, then that's profoundly disempowering.
Cynicism also has a policy impact: Cynicism engenders a small-c conservative impulse: that any change will inevitably be bad; that the most logical impulse is to turn inward; in health reform, it leads people to be very protective of the coverage they have, even if they have all sorts of problems with it, rather than take any risk. It leads to "your on your own" policies and against the community solutions that are actually the most effective and efficient.
Reformers and progressives sometimes feed into cynicism with our critiques of policy and politics. Those critiques are not wrong, whether about the influence of money in politics, the barriers of supermajority requirements, or the lack of leadership by specific elected officials. But if we don't show where there is possibility for hope, then this worldview leads to an obvious conclusion: is the political process is that bad, then anything that can come from it will be bad as well. Instead, we should be realistic about the barriers to progress while also being clear about the strategy to surmount them.
I was reminded of the corrosive nature of cynicism from an unlikely source: Conan O'Brien, whose comedy tour came through Sacramento this past week. It was a good show, but it also recalled for me the last part of his farewell speech from the Tonight Show. For his fans who felt he was treated unfairly, he made a striking statement against cynicism (starting at about the 3:20 mark):
"All I ask of you is one thing: please don't be cynical. I hate cynicism -- it's my least favorite quality and it doesn't lead anywhere. Nobody in life gets exactly what they thought they were going to get. But if you work really hard and you're kind, amazing things will happen."
It was striking that the comedian took such pains to make the point, but it's real: cynicism gets us nowhere, not inn our personal or professional lives, and not in politics or policy.
At a similar time earlier this year, President Obama said as much in his state of the union, understanding why there is so much cynicism, but making a case against it:
Unfortunately, too many of our citizens have lost faith that our biggest institutions – our corporations, our media, and yes, our government – still reflect these same values. Each of these institutions are full of honorable men and women doing important work that helps our country prosper. But each time a CEO rewards himself for failure, or a banker puts the rest of us at risk for his own selfish gain, people's doubts grow. Each time lobbyists game the system or politicians tear each other down instead of lifting this country up, we lose faith. The more that TV pundits reduce serious debates into silly arguments, and big issues into sound bites, our citizens turn away.
No wonder there's so much cynicism out there. No wonder there's so much disappointment.
I campaigned on the promise of change – change we can believe in, the slogan went. And right now, I know there are many Americans who aren't sure if they still believe we can change – or at least, that I can deliver it.
But remember this – I never suggested that change would be easy, or that I can do it alone. Democracy in a nation of three hundred million people can be noisy and messy and complicated. And when you try to do big things and make big changes, it stirs passions and controversy. That's just how it is.
Those of us in public office can respond to this reality by playing it safe and avoid telling hard truths. We can do what's necessary to keep our poll numbers high, and get through the next election instead of doing what's best for the next generation.
But I also know this: if people had made that decision fifty years ago or one hundred years ago or two hundred years ago, we wouldn't be here tonight. The only reason we are is because generations of Americans were unafraid to do what was hard; to do what was needed even when success was uncertain; to do what it took to keep the dream of this nation alive for their children and grandchildren.
Why do I bring this up?
Because the challenge of health reform is not just to educate people about the law, or even to implement or improve on it.
I firmly believe that health reform will improve millions of people's lives: people who get care that wouldn't otherwise, and prevent people from going bankrupt when they get sick who otherwise would. Many more will get some financial help in affording the care and coverage they need, and all of us will have a more stable, secure and affordable coverage than we would otherwise.
But health reform can, implemented right, do even more. A well-implemented and improved reform can promote the idea that big problems facing our nation are solvable. It can rekindle the American"can-do" spirit of optimism and hope and progress, to make additional progress on health issues and other issues. So those are the stakes: health reform cannot only reduce the number of uninsured, or the cost of care, it can help reduce cynicism itself.