... by Eduardo Porter, who acknowledges what would seem to be a crushing formula for the destruction of the private insurance business: If everyone can buy insurance at the same price whenever they want, people won't buy until they've got expenses that insurance will cover and that go beyond the price of the insurance, and this will cause the price of the insurance to spiral upward and fewer and fewer people will buy. It makes no sense. But Porter has an idea. Maybe that
won't happen.
Yet the portrayal of Americans as pure profit-seeking machines relentlessly on the lookout for a bargain is not entirely accurate....
[T]here is plenty of evidence that other motivations influence our decisions: altruism, for instance. We like to believe we are fair and worthy. And we are willing to sacrifice some gain to fit the norms of society....
Nice generalities, but you're talking about making millions of people apportion a huge chunk of their income to pay for something that they are not getting any benefit from. (They can keep their money, pay their own health-care expenses, and start buying insurance only at the point where the benefit outweighs the cost... which is the standard way we make decision about what to buy: Does the benefit outweigh the cost?)
Social norms explain why we tip a cabdriver we will never see again, why cheaters blush when caught or why people go to the polls despite knowing their individual vote will make no difference. Government programs to help underwater homeowners have been held back for years over fear that they will encourage families who were still current with their mortgage payments to default. However, the evidence so far is that most people who can pay their mortgage do, even if they would profit from walking away.
Social norms can provide a much more powerful incentive than money. A few years ago, a handful of day care centers in Israel tried to get parents to pick up their children on time by imposing a fine for tardiness. Much to their surprise, tardiness mushroomed. The fine had somehow made it acceptable, erasing the shame parents used to feel when they were late. The fine, by contrast, was cheap.
Advocates of health reform argue that the individual mandate will create a social norm that will hold everything together. Without it, people merely have a subsidy to induce them to buy insurance. The mandate turns buying health insurance into the rule of the land, like paying taxes....
None of these examples involve getting people to suddenly start following a
new norm. In the Israeli day care situation, parents were given a way to
buy out of the
old norm, and they did. It was worth it. (And the old norm was weak anyway.) How would you get to a
new norm, especially one that expects people to ignore huge new expenses? Especially when the norm is about something a
majority of the people have been trying to avoid and that comes from
government norm-imposers?
Tipping the taxi driver isn't a new idea, and it doesn't come from the government. It bubbled up through the culture over a long period of time. We don't know why we feel we're supposed to do it and that feeling is enough to get us to let go of a little money. But many — not all — of us do.
How do you "create a social norm"? Surely, it takes more than passing a statute — especially a statute that barely squeaks through the legislature and that is widely denounced for years as unconstitutional. The government
tried to require it, that violated our deeply treasured fundamental law, but, yeah, now I'm going to internalize the now-not-required requirement and do it by force of psychological urge to follow norms! That makes no sense.
And yet... for social norms to work, they probably need to be perceived as legitimate.
Yeah,
probably.... Actually, I don't even see how something gets to be
called a "social norm" until it's been internalized psychically, which takes a lot more than perceiving it as legitimate. And what we have here is something that's perceived as illegitimate. And this is
before any announcement from the Supreme Court saying the government overreached its powers.
Making the mandate work requires convincing Americans that the new health care law is not a plot to destroy the nation. Americans would have to embrace universal coverage as a desirable goal for a rich industrial society.... The Supreme Court’s decision will be beside the point.
No, it won't be. The Supreme Court decision will add to the perception that
this is not a norm. And your point is that people will need to feel it is a norm. How do you get there? All you're saying is: It could work
if we got there.
The
if is utterly empty.
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