10.18.2006

 
I had a very weird conversation last night at a lecture I went to for work. The talk itself was enjoyable. But it included dinner, and I got stuck at a table with someone who simply wouldn't shut up. I think her response to a feeling of insecurity was to hold forth--without prompting--at great length, not allowing anyone else at the table to get a word in edgewise for the entire hour-long dinner. Normally at these tables of 8 or so people (which Goatdog would call a "mixer") you talk to the person on your left, you talk to the person on your right, you share a few pleasantries with the table as a whole, and basta. But this was one long monologue. In the course of which--and here I'm getting to the point--this woman went on and on, at great length, about how litigious Americans are and how terrible it is that malpractice insurance costs doctors so much so people can't afford health care. I said, "my understanding is that that's not the biggest part of the problem" and she said "I know a doctor who was driven out of obstetrics because of the cost of malpractice insurance. And I just think it's JUST TERRIBLE when people who work 40 hours a week don't have health insurance." And she continued on her merry way.

I know there have been some cases where jury awards have been out of proportion to the actual damage done. I know there are some doctors who can't afford the malpractice insurance they need to cover the kind of practice they want to have. But compared to huge profits being reaped by giant corporations, executives making outrageous salaries, pharmaceutical companies spending vast sums on lobbying and marketing, a health care system that deemphasizes nutrition and prevention because that's not where the profits are, all kinds of incentives to waste built into the system, Congress intervening to force brain-dead people to be kept alive at enormous costs (OK, well that's relatively minor too but I had to throw it in there)...how big a problem is litigiousness, really? Compared to negligence? And compared to the other factors that make our health care system rotten to the core?

So I wonder two things: why is it so hard to have an analysis that looks at the larger context, rather than laying it all at the feet of people who feel victimized and think they have nowhere else to turn?

And second: why can't I make myself understood? For one thing, this woman used her incredibly overbearing manner to set the tone for the discussion so completely that there was nothing I could say; everyone just nodded politely whether they agreed with her or not. But I've been feeling like this a lot lately. Do you, dear readers, have this experience, of feeling like everything you say in a group context is either completely ignored, as if you hadn't spoken at all, or considered crazy? I can't tell if it's just that I'm stupid? Or that what I'm saying is so far out of the mainstream, or the realm of accepted discourse, that it makes no sense?

Or maybe I'm only imagining that I'm talking at all?

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