My Foot Is Getting Wet, I’m Pretty Sure It’s Not Raining

December 6, 2014
Eric Postal, MD
Eric Postal, MD

Increasingly soaring insurance premiums and even greater deductibles mean the bad news of health care reform is finally hitting home.

I’ve had the good fortune to travel semi-frequently, and the more dubious fortune of doing so through the tender mercies of our airline industry. One particular airline (I’ll refrain from naming names, but they’ve been in the news lately so if you’re curious it shouldn’t be too hard to figure out) has been kinder and gentler to me than most; I’ve thus tried to fly with them when it’s been an option. One of the side-effects of this is that I tend to get emails from them - promotions, announcements of new services, etc.

It wasn’t a surprise, therefore, when they sent a cheery missive last week. More chest-thumping than cheery, actually. Full of a “we’ve got great news to share with you” vibe, it then proceeded to offer some ostensibly-positive-for-the-customer verbiage that, if read with care, proved to be anything but.

For instance, new seats that will be lighter (read: smaller and less substantial), but miraculously more comfortable, permitting the airline to cram in extra passengers yet still have more leg room than other airlines (read: less than before). Some nebulous statistic about how a minority of passengers choose to check bags (the airline has heretofore not charged for them, setting it favorably apart from most), and therefore future fares will charge customers for the “features they need.” In other words...you will now pay for those checked bags.

People, unsurprisingly, don’t like hearing bad news. They like it less when someone else, especially the deliverer of the bad news, is benefitting as a result of the ill tidings. Further insult is added to injury when the deliverer tries to downplay or entirely hide the badness of the news, and is caught in the act. If you’re going to try pulling the wool over your audience’s eyes in this fashion (that is, pee on someone’s foot and tell them it’s raining), you’d best be sure of your success, since failure will mean a far angrier would-be dupe than you’d otherwise have to contend with.

Attempting such flimflammery with a smarter or more experienced audience, such as highly-educated and trained health care professionals, is a riskier prospect (assuming you’re talking about their area of expertise; we won’t get into how notoriously bad physicians can be when they try to tackle legal or financial stuff on their own). Not only are you playing to their strengths, but they have spent years developing those strengths and are likely to perceive your attempt as flagrant disrespect for their credentials.

On the face of it, such attempts would seem ill-advised. Let’s say delivering your bad news in a straightforward, honest fashion is liable to cost you 10% of whatever goodwill currently exists between you and your recipient. Suppose you whitewash it, and halve the damage to 5%...or maybe you manage a complete cover-up. In all but the rarest of circumstances, this will be a temporary stay of execution. When the truth is discovered, how much more goodwill might be lost? Twenty percent? Fifty percent? How long a delay would be worth the damage done to the relationship between you and your partners, employees, referrers, etc.? And that assumes you were even successful in your initial attempt at subterfuge; just imagine that ill-will being multiplied right at the get-go, with nothing gained for it.

This is playing out on a much larger scale, regarding the health care-reform omnibus which continues to falteringly lurch forward. When first presented, lots of folks well-versed in the subject matter - many of whom physicians - saw huge flaws in what was being proffered, and in addition to dismay at such a mess being enacted were downright insulted at the smoke and mirrors treatment used in response to their concerns.

Much more of the population didn’t have such familiarity with the health care system, and were more easily appeased…but now, with increasingly soaring insurance premiums and even greater deductibles, the bad news is finally hitting home. And that was before media began carrying the story of the law’s co-architect, Jonathan Gruber, opining that PPACA’s passage was thanks to the “stupidity” of the American voter. Indeed, nothing wakes up the victim of a con artist like hearing the con himself gloating over the matter.