How Facts and Values Divide us | Eastern North Carolina Now

The United States spends more on health care than any other industrialized country but doesn't get better results, as measured by average life expectancy

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    Publisher's note: This article appeared on John Hood's daily column in the Carolina Journal, which, because of Author / Publisher Hood, is linked to the John Locke Foundation.

    The United States spends more on health care than any other industrialized country but doesn't get better results, as measured by average life expectancy. Have you heard this claim before? Did you respond with agreement or skepticism?

    In recent years, I've devoted much study and practice to exploring why we disagree so vociferously about public issues. My goal hasn't been to eliminate political disputes. That would be impossible and silly. Indeed, I've spent most of my career arguing about public policy. I'm not going to stop advocating my views and trying to influence governmental decisions.

    What I really want to know is why our disagreements seem to have become so solitary, poor, nasty, brutish, and endless. Both opinion polls and everyday experience confirm that most North Carolinians, like most Americans, are dissatisfied with the way we practice politics.

    The current political discourse alienates and separates us. It fosters an impoverished, simplistic understanding of what are often highly complicated problems. It is nasty and brutish, resembling less a self-governing republic than amateur night at a seedy comedy club. The only Hobbesian adjective that doesn't apply here is short. It's like we're all crowded into a steamy station wagon on a trip that never ends, all the while bickering about who touched whom first.

    We the people are resentful about all this - registering some the lowest ratings for our political leaders and public institutions in the history of survey research - but also culpable ourselves. Politicians are to blame for failing to set a better example. And the rest of us are to blame for following their example, rather than demanding they truly lead or duly leave.

    I am far from having a full toolbox of solutions for all these problems. But I will offer two insights I've drawn from recent experiences with the North Carolina Institute of Political Leadership, which trains those who aspire to elective or appointive office in our state, and with the North Carolina Leadership Forum, a project based at Duke University's Sanford School of Public Policy that convenes current leaders from government, business, and nonprofits to promote constructive engagement across our political differences.

    The first insight is that we can't have meaningful arguments without sharing at least some of the same facts. Some people come to believe things that are demonstrably untrue, certainly. More common and more problematic, however, is that we have some facts but not all of them, or not a clear-eyed understanding of what they mean.

    The second insight is that we mostly share a common set of values but we don't rank them the same way. Consider these five terms: freedom, virtue, security, equality, and prudence. You may well respond favorably to most or all of them. But depending on which one ranks highest on your priority list, you probably lean Republican (for the first two groups, libertarians and traditionalists), Democratic (for the second two groups, communitarians and progressives), or split your ticket.

    If both facts and values separate us, are we doomed to an endless cycle of antagonism and frustration? No. If we better understand why other people might reasonably form a different conclusion about a political issue, we'll be less likely to go nuclear on them. We may even crack the door open to a real conversation that could change their minds - or our own.

    Don't worry, I'm not going to leave you hanging about health care. Yes, it is indisputably the case that America is a big spender. But it's less clear that we get little from our investment. Average life expectancy is affected by many things, not just the availability and quality of medical services. If we exclude fatal injuries from homicides, car crashes, and industrial accidents, for example, America's average life expectancy is at the top of the list (p. 22).

    Already thinking of responses to my claim? That's great - as long as you aren't just thinking of ways to attack or insult me. Let's trade facts. Let's compare our priority lists. Let's talk.
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