My wife reported that hospital charity care-costs in Oregon have been reduced by a third due to Obamacare. Why did it take so long to begin reforming healthcare? It’s amazing the irrational crap we put up with, isn’t it? But while we evolved the capacity for rationality, we didn’t evolve the emotional framework to give it top priority. In answer to the question of why it’s important to learn about evolution, a friend of mine said it’s for self-awareness, and I resisted that interpretation for a long time, but when you view human behavior from the position of genetic interest, a very foggy picture starts to clear. Why do we take positions against our self-interest? In this case, I think the answer is a sensitivity to social status. We evolved deep emotional sensitivity and perceptual modules for social status, because it was more critical to the survival of our primitive forebears than the ability to use logic. Arguably logic is the more important faculty now, but our equipment remains the same. Neither liberals nor conservatives want to be seen as freeloaders. No one really wants to admit they need help. Yet all but the most affluent of us are vulnerable to high medical costs. For years conservatives have successfully framed socialized medicine as a refuge of freeloaders without coming up with a working free-market alternative. There may be a perfect free-market alternative out there, but clearly the perfect has been the enemy of the good.*

Look around you and see how advertisers and politicians try to influence you. Robert Cialdini’s book Influence has long struck me as one of the best evo-psych books that never refers to evolution. Pair it up with Robert Wright’s The Moral Animal.

I have noticed an interesting pattern that may be a general rule. Those who want to control you, those who’ve thought through a program for gaining power, tend to dismiss if not be actually hostile to evolutionary theory. This is no less true of liberals than conservatives. Science and logic are not inherently political; they expose the contradictions and the messy power relationships of any political stance. They rob would-be despots of power, because anyone can use them.

Nature programmed us with patterns of emotional response best suited to pursuing our genetic interest in a hunter-gatherer context; these may not be in our personal interests, especially in the modern world. It is not evolutionary psychologists who seek to manipulate us, to push a theocratic or sexist agenda, just the opposite. By explicating and, I daresay, validating our neurological pressures, they undermine those who would make us doubt ourselves for their own ends. Of course scientists are agenda-driven, just like all people, but science eventually exposes error, because the data doesn’t lie.

* Here’s a link for reference:

http://www.opb.org/news/article/oregon-hospitals-more-financially-stable-after-affordable-care-act/

To those who would counter that we’re just shifting the burden from charity to tax-payers, I ask you to consider that in addition to this shift being more equitable and humane, it’s also more efficient. If people seek treatment early, their medical costs are lower, and the burden on all of us is eased. One of my conservative friends has argued that the affluent tend to give more to charity, so a shift from a charity focus to a socialized one is regressive. However, for one thing, charity doesn’t pick up the enormous slack; most of the “charity” is paid by hospitals themselves. They then raise prices, which are ultimately covered by higher premiums. So it’s socialized medicine anyway, just poorly socialized. For another thing, as I’ve argued, people don’t want to be seen as charity cases. Rather than accept charity, they put off going to the hospital until it’s too late.