Academic journal article Organisational and Social Dynamics

A World Ruled by Satan: Thoughts on the Debate over the Affordable Care Act

Academic journal article Organisational and Social Dynamics

A World Ruled by Satan: Thoughts on the Debate over the Affordable Care Act

Article excerpt


This paper explores the psychodynamics of public life with special reference to the debate over the Affordable Care Act in the US. Emphasis is placed on: (1) the emotional resonance of the idea of care and ambivalence about the need for and source of care; (2) issues of loss, especially loss of a world in which we feel at home; (3) the way in which ambivalence about care fosters the use of public policy as a way of validating a fantasy about the capacity of the child to thrive in the absence of care; (4) the role of destructive impulse in public life; and (5) the attack on reason and thinking in public life.

Key words: Obamacare, care, dependence, community, groups, loss, reason, democracy, fantasy.

When debate takes place in a public setting there is an inherent tendency for its emotional tone to intensify. Even those otherwise inclined to reasoned engagement find themselves yelling at their opponents, though all participants, of course, attribute their need to raise their voices to the decibel level that was set for them by others. Much of this tendency for heightened emotion and the absence of reasoned discussion can be attributed to the connection between public life and group phenomena. As Freud points out, "the feelings of a group are always very simple and very exaggerated", and, it is in the nature of groups that they promote the "intensification of affects and the inhibition of the intellect" (1921c, pp. 10, 20). To the extent that public space is occupied by group-related phenomena, we should not expect reasoned engagement and a moderation of tone to prevail there.

The connection to the group dominates in public life because public life engages issues that tap into deeply-seated hopes and fears of the kind that impede tolerance of difference. In important cases, those hopes and fears have to do with protecting a way of life built around forms of identification with others that are inconsistent with the bonds of reasoned engagement. In such cases, to lose the debate over a single policy issue can be experienced as the loss of everything of value in living: and this is not necessarily incorrect. Public space always has the potential to become the site of a struggle over who owns the world and can remake it to accord with their fantasies of identity so that it will become a world in which they and not others can find a home.

The struggle over who will find a home in the world is well expressed by Chris McDaniel, a conservative Republican state senator who ran in the Virginia Senatorial primary and offered the following remarks in a keynote address to the Sons of the Confederate Veterans: "There are millions of us who feel like strangers in this land, an older America passing away, a new America rising to take its place." This sentiment was continued in a speech given after the election where he made the following statement: "We recoil from that culture. It's foreign to us. It's alien to us. ... It's time to stand and fight. It's time to defend our way of life again" (quoted in Bouie, 2014).

The tendency to see in apparently limited policy initiatives a threat to a way of life is nowhere more evident than in the debate in the US over the Affordable Care Act. This act, as its name suggests, is all about the matter of care, more specifically of whether we will be cared for and by whom. Few things have greater or deeper emotional resonance than the matter of care; and few things are more closely linked to "home" and "place" than care. In the following, I propose to explore some of that resonance with specific reference to the opponents of the new health care law. In doing so, I will distinguish between the way two different sets of opponents of the bill experience its implications. First, I will consider those for whom the salient issue is: Who will provide care? Second, I will consider those for whom the salient issue is the danger care is thought to pose regardless of who purports to provide it. …

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