Spitzer, the AMA and Health Insurance Reform: The Power of Passive Aggression

Yin and Yang, passive and active, the Spitzer story highlights a bigger issue for our lives than just another consumer of prostitution. We've become a society that harshly examines actions and ignores the fact that inaction is often as harmful or more harmful than action.

As reporters gleefully tear apart Spitzer and have actually referred to his wife as a "victim", we sit idly by while health insurers and physicians act to reward their own greed, to protect their own niche, excluding people from affordable access to quality and timely medical care and then we too seek absolution for our contribution to the problem through our passivity and call ourselves victims.

It has never been the legal case that NOT acting was always an out. While we want our leaders to use discernment, we expect ACTION. Whether it's a parent allowing another parent to beat a child, or someone driving along in a car where the passenger decides to rob a convenience store, we hold the INACTION of an individual as a decision for which that individual is responsible. In the political arena, the Iraq War action is as shameful to many as the inaction regarding the situation in Darfur. Still, we are kinder to those who fail to act and more freely give them the title of "victim" rather than perpetrator. However, the spouses of the powerful, are often passive aggressive, to compensate for the aggressive aggression of their partners. At least Ms. Spitzer has gotten something out of the deal. But what about us?

We have passively accepted, submitted to and put up with the erosion of our possibility of survival, both physical and financial in the face of a medical event...we are scared of rocking the boat and we figure we're getting enough out of our deal with the aggressive aggression of the insurance industry and health services providers to put up with it.

When the AMA pushes for universal health insurance (a means for individuals to pay for health services) rather than pushing for and working towards clinics, lowering prices, forming coalitions of physicians providing affordable care to targeted populations, we ignore the fact that universal health insurance will not, in any form, improve our access, to affordable, quality and timely health care. Why? It is as seemingly stupid as Ms. Spitzer's response to her husband's actions...We figure that our inaction gets us more of what we want than action.

Change is never painless. For the aggressive aggressor, the threshold of "putting up with" is lower than it is for the passive aggressor. The passive aggressor is the manipulator, the aggressive aggressor is the visible actor. And part of why the passive aggressor likes passivity is because it is a convenient way of deflecting blame. Blame is always easier to attach to action than inaction.

So why do we stand by our current health services system? Fear of change and the discomfort it brings and hope that someone else will put themselves at risk to fight for our self-interests...Passivity. Figuring we're getting enough of what we need to wait it out. It's not nobility, it's not "working the system", it's not making the best of the ever amorphous "things", it's hoping someone ELSE will do something.