I do quite a bit of consulting for the Sunflower Foundation, a totally awesome health care foundation in Kansas that invests pretty significantly in advocacy for nonprofit organizations, through an Advocacy Fellowship for nonprofit health leaders and an advocacy grantmaking initiative (as well as their own policy change work). I love, love, love getting to contribute to their work.
But, gushing aside, I’ve also learned A LOT about the Affordable Care Act and all things health policy-related through this work, since equipping nonprofits with accurate, actionable information is part of the capacity-building work of the Foundation.
And a recent presentation for the Advocacy Fellows about health care reform has me thinking. The analyst made the statement, which I’d heard often before, that health care is an example of a market failure; consumers simply don’t have enough information about insurance providers or health professionals or even their own health care needs to make a “smart” consumer choice in the health care marketplace, the way that we could expect them to do in, for example, buying a television or even a new car.
And here’s what I think: our electoral system is another example of a market failure, because we too often act like consumers in the process (showing up on Election Day to pick between choice A or choice B), and because we suffer from some of the same limitations (incomplete and often contradictory information, emotional investment that clouds decisionmaking) that compromise our effectiveness in the health care market, too.
The “market failure”, then, stems from two different, but compounding, errors:
First, we engage as consumers in a relationship that should not be structured as a buyer-seller transaction. After all, it’s hard to pivot from a passive role of choosing between Candidate #1 and Candidate #2 to an active one that insists that elected officials work for us and, therefore, should be responsive and accountable to us as the constituency. Seeing elections as consumption excuses inaction up until the moment of “purchase”, which often leaves us with unacceptable alternatives. After all, we’re not forced to buy this car or that one–we can walk away, or look elsewhere, or decide to take the bus. But, when we wait until the last minute to decide which politician we like best, we too often find that the answer is neither; except, here, the stakes are too high and the ramifications too great to make deciding not to “buy” anything unconscionable. Civic participation must transcend Election Day, and our democratic responsibility must surpass a passive act of consumption. We are not merely voters; we are citizens, and the latter must be a huge part of our identity, not just something we take out every few years.
Second, we too often make this critical decision based on sparse, misleading, and/or contradictory information, but, instead of creating red flags the way that such holes in our knowledge would if the product in question was a high-dollar consumer good (instead of someone with the right and responsibility to shape the decisions that affect our lives), we dismiss these artifacts as natural results of the political process, distortions created by the influence of money in elections, or, even, necessary evils from the perspective of a “single-issue voter” (who would ever, by comparison, buy a car that would work great to take them to work but not at all to get them home?). We try to use past voting records to predict future behavior. We sort through fear-based attack ads that we eventually begin to ignore. We rely on markers that we hope tell us something valuable about this particular “product”, because good information is elusive. While the “voter as consumer” link needs to be broken, in the interim, we need to be smarter electoral consumers, demanding transparent democratic processes, quality engagement with candidates, and a robust conversation on the issues at hand (yes, conversation, so it has to be participatory).
The health care reform debate has exposed the truth that there are some things far too important to be left to the marketplace, especially when core features of that marketplace create real problems for those trying to navigate it.
Our elections, I’m convinced, are another case.
We need to pull ourselves out of consumer mode and engage year-round as active stakeholders. It’s more work. For sure.
But otherwise we’ll end up with far too many lemons.