One hears over and over that most Americans are happy with their health insurance and the health care they receive. I assume that is true. Righties hold this up as proof that most Americans don’t want to change the system. Polls say that is not true, or at least it wasn’t true before the “death panel” rumors got started. But I want to look at the fallacy behind the assumption that if most Americans are happy the system doesn’t need changing.

Our health care system is something like an old and slowly sinking cruise ship. Passengers on board the ship are having a reasonably enjoyable time. The food and entertainment are pretty good, and everyone still gets clean towels every day. However, in order to keep the ship afloat, from time to time the crew cancels the tickets of a few passengers and tosses them overboard.

At first most of the passengers were not aware this was happening. Or, if it was happening, passengers rationalized that the people tossed overboard must have done something to deserve it. But now enough people have been tossed overboard that most passengers were at least acquainted with one of the tossed, and knew he or she was not a bad person. Further, it is dawning on many that the selection process is random and could fall on anyone at any time, not just those in the cheapest cabins.

Meanwhile, slowly and imperceptibly, the ship continues to sink. The passenger-tossing strategy is just postponing the eventual drowning of everyone on board. So even though the cruise is pretty sweet for those remaining on the ship, there is a growing sentiment that there ought to be another way to keep the ship afloat.

Then the ship’s management announces that maybe there’s another way to keep the ship afloat, but it would require a lot of money to make repairs. Management promises it will only collect money from wealthy first-class passengers and will make up the rest of the difference by budget tightening.

The ship’s passengers divide into two factions. One faction wants to leave well enough alone. They refuse to accept that they might find themselves heaved overboard. They believe the cruise ship company will want more money from all the passengers, not just the wealthy ones, and they don’t see why they should pay more money to fund someone else’s cruise. They also deny that the ship is really sinking, even though all kinds of data have been collected showing that it is.

Passengers in the other faction are not just afraid of being thrown overboard. They also reason that expensive repairs are going to have to be made anyway, because the cruise is not sustainable. If nothing at all is done, eventually the ship will entirely flood with water and disappear into the sea.

The ship also has old and inefficient engines and other systems that make it more expensive to operate than most other cruise ships. If the repairs are done right, the ship could become more cost efficient to operate, and at some point in the future the repairs might actually pay for themselves. However, the longer the repairs are postponed, the more expensive the eventual repairs will be.

The anti-repair faction fights back by spreading rumors that the budget tightening will require passengers to be tossed overboard. The fact that this is happening anyway doesn’t register with these people. Soon they have the whole ship in an uproar, and leaders of the pro-repair faction begin to get death threats and find hate messages spray-painted on their cabin doors.

And there we leave the story, because we don’t yet know how it will turn out.

This is not a perfect analogy. To make it closer to reality we’d have to have vendors who are making a lot of money running the ship as it is begin the rumors to stop the repairs. We’d also have some anti-repair people coming up with nonsensical plans for saving the ship without repairing it. The plans amount to tossing people overboard, but they hide that part of the plan with lots of clever rhetoric.

And, of course, when the ship really sinks those wealthy enough to call for private rescue will transfer to one of the “socialist” ships.

If I had to guess how the story will turn out, it would be that a compromise is reached that amounts to patching the ship with chewing gum and duct tape, and passenger tossing will continue but at a somewhat slower rate for the immediate future. In a few months everyone will realize that nothing was really settled. Both factions will blame the other for the failure to find a solution, and the fight will resume.