Selected Articles

Is High Self-Esteem Bad for You?
by Robert Campbell and Walter Foddis

For more than thirty years, promoting the development of higher self-esteem has been a major goal for clinical psychologists and educators. Although this emphasis on self-esteem has never sat well with adherents of traditional religions, and although an occasional academic psychologist has complained that psychotherapy promotes self-indulgence, the mass media have for the most part been supportive of the self-esteem movement. But a spate of recent articles suggests that the tide may be turning.

When Senator Robert Torricelli failed to admit wrongdoing as he resigned, Andrew Sullivan's opinion piece in Time magazine (October 7, 2002) blamed "the sheer, blinding brightness of the man's self-love" on the self-esteem movement. An article by Erica Goode in the New York Times (October 1, 2002) proclaimed that "'D' students . . . think as highly of themselves as valedictorians, and serial rapists are no more likely to ooze with insecurities than doctors or bank managers." Worse, the writer said, some people with high self-esteem are likely to respond with aggression if anyone dares to criticize them: "Neo-Nazis, street toughs, school bullies . . . combine preening self-satisfaction with violence."

In the pages of the New York Times Magazine (February 3, 2002), psychologist Lauren Slater maintained that the self-esteem movement has produced a "discourse of affirmation" that ladles out praise regardless of achievement. She concluded that self-appraisal and self-control need to take the place of self-esteem in psychotherapy. In the Christian Science Monitor (October 24, 2002), conservative commentator Dinesh D'Souza said of self-esteem that "unlike honor, it does not have to be earned."

Most such media critiques draw on the well-publicized research findings of the same three social psychologists: Roy Baumeister, Jennifer Crocker, and Nicholas Emler. But, as we shall see, these psychologists rely on mistaken conceptions of self-esteem and on flawed research methods.

Psychologists against Self-Esteem

Roy Baumeister, a professor of psychology at Case Western Reserve University, is the academic psychologist best known for claiming that "D" students, gang leaders, racists, murderers, and rapists have high self-esteem. Examining empirical studies on how murderers and rapists respond to self-defining statements, Baumeister and his colleagues have pointed out that these individuals consciously believe they are superior, not inferior—a belief that, Baumeister says, is characteristic of high self-esteem.

Baumeister does not claim that high self-esteem necessarily leads to aggression; in order to do so, it must be combined with an ego threat (a challenge to one's high self-appraisal). In a study that has gotten less media attention, Baumeister and Brad Bushman tested this hypothesis experimentally. Participants were given the Narcissistic Personality Inventory, which contains such items as "If I ruled the world it would be a much nicer place," and the Rosenberg Self-Esteem Scale. (See below for more about these questionnaires.) The ego threat was a strong criticism of the participant's intellectual competence. Participants were given the opportunity to aggress against the people who had criticized them, by delivering a blast of noxious noise. (Since this was a social psychology experiment, the noise was not really delivered to the critic.) What the results showed was that the narcissism measure, not the self-esteem score, predicted the strength of the aggressive response (the intensity and duration of the noise). But because those who scored high on the narcissism questionnaire also tended to score high on the self-esteem scale, it looked as though some people with "high" self-esteem are aggressive when their sense of self is threatened.

The research of Jennifer Crocker, a professor of psychology at the University of Michigan, has indicated that deriving one's self-esteem from certain "external" contingencies, such as appearance, is associated with potentially destructive behavior, including alcohol and drug use, and eating disorders. Crocker and her colleagues conducted a study with applicants to graduate programs who based their self-esteem on academic competence. They found that such students showed greater increases in self-esteem on days of acceptance and greater decreases on days of rejection. The stability of self-esteem is an important area of investigation because several studies have found that people whose self-esteem is unstable (that is, fluctuates substantially on a daily basis) are more emotionally reactive to everyday events. They are more likely to become depressed when confronted with daily hassles and are more prone to anger when their self-esteem is threatened.

Crocker's findings have led her to conclude that the pursuit of self-esteem has significant costs. Crocker has gone on to contend that self-esteem ought to be non-contingent: not based on any source at all. If people value themselves positively without conditions or criteria, Crocker maintains, they will be less likely to suffer from problem drinking, maladaptive hostile reactions, and depression.

Nicholas Emler, a psychologist at the University of Surrey, is a researcher whose work has garnered extensive media attention in Great Britain. He also believes that high self-esteem is a source of trouble. His 2001 monograph Self-Esteem: The Costs and Causes of Low Self-Worth reviews a wide range of published research, concluding that low self-esteem is not a risk factor for delinquency, violence against others, or racial prejudice. On the contrary, he suggests, high self-esteem is the more plausible risk factor. Relying on Baumeister's and Crocker's evidence about the pitfalls of self-esteem, as well as other research, Emler asserts that people with high self-esteem are more likely to engage in risky pursuits, such as driving too fast and driving drunk. Lastly, Emler finds little evidence that self-esteem and educational attainment are associated, since even failing students can show high self-esteem on questionnaires.

The Objectivist Conception of Self-Esteem

Is what these researchers are saying true? Has the public been led to believe that high self-esteem is a cure for personal and social ills when empirical evidence makes it out to be a cause of those ills? Not unless self-esteem consists in feeling good about oneself, or in feeling superior to others, or in taking pride in superficial attributes like appearance. The research suggests very different conclusions if one interprets it in light of the concept of self-esteem that Ayn Rand proposed and Nathaniel Branden subsequently refined and elaborated. Genuine self-esteem has two dimensions of self-evaluation: (1) an evaluation that one is competent to deal with life's basic challenges (self-efficacy) and (2) an evaluation that one is worthy of happiness (self-worth). Self-worth encompasses the conviction that one is deserving of success, love, and friendships, and the acceptance of positive feelings—such as pride and joy—as "natural" and proper to one's existence. Moreover, according to Branden, these evaluations of competence and of worth, if they are to be secure and enduring, need to be based on objective standards. The standards for adult self-esteem include self-reflective and independent thought; taking responsibility for and authentically asserting one's thoughts, beliefs, values, and actions; pursuing meaningful life goals; and adhering to moral values that are based on reason. Branden calls these objective standards of self-esteem "pillars," meaning that they are foundational to self-esteem. If we act in ways that meet these objective standards, our self-esteem will necessarily rise; if we fail to act in these ways, or betray these standards, our self-esteem will drop. In sum, these sources of self-esteem are internal to the person; they depend on self-directed psychological processes that are under each person's control.

We note that Branden's conception of self-esteem is not an isolated one. Two clinical psychology theorists, Richard Bednar and Scott Peterson, have proposed a similar model in their book Self-Esteem. For a person's self-esteem to improve, they say, he must confront anxiety with acceptance and realism. This requires coping directly with the unwanted thoughts and feelings that precipitate anxiety, such as pain, embarrassment, shame, and fear. But such realism is possible only if (1) a person perceives himself as responsible for his thoughts, feelings, and behavior; (2) he is able to accept the beliefs and feelings motivating the anxiety; and (3) he is able to disclose his authentic thoughts and feelings to others in an appropriate context. These three self-directed processes correspond to Branden's pillars of self-responsibility, self-acceptance, and self-assertiveness.

Branden makes a sharp distinction between genuine self-esteem and pseudo-self-esteem. Pseudo-self-esteem relies on "external" sources, such as being admired or approved by others, social status, or physical appearance. People tend to put their reliance on external sources to the extent that they are lacking in the self-directed psychological processes that constitute internal sources of self-esteem. Because external sources are not under our direct control, they cannot realistically enhance our feelings of competence. Self-esteem that depends on them is therefore insecure and under constant threat. Branden's notion of pseudo-self-esteem, then, can help explain how some people who have high scores on self-esteem questionnaires can respond to an ego threat with aggression, as in Bushman and Baumeister's experiment. They are people with pseudo-self-esteem; their feelings of competence and worthiness are "on the line" when challenged, and so they are more prone to defend against this threat by lashing back at the source of criticism.

Measuring Self-Esteem

On theoretical grounds, the foregoing accounts make a good deal of sense, but how can stable, realistic self-esteem that draws on internal sources be measured?

The procedures in common use for measuring self-esteem are highly vulnerable to criticism. Virtually all self-esteem research has relied on answers to a handful of self-report questionnaires. The one most relied on (Emler calls it the gold standard) was developed in 1965 by sociologist Morris Rosenberg. It seeks responses to statements such as "On the whole I am satisfied with myself," and "I feel that I have a number of good qualities."

This procedure of asking people to introspect or engage in self-report is a legitimate one. But introspective data are of no value if the person is not answering truthfully, or if he is out of touch with the feelings he is supposed to report, or if he lacks an understanding of the matter at issue. All of these problems are to be expected in measuring self-esteem.

Consider the matter of truthfulness. According to Nathaniel Branden, conscious feelings of low self-esteem are so hard to bear that people suffering such feelings have an incentive to put up psychological defenses against them. On this view, a person who is compensating for feelings of inefficacy or unworthiness might well assert, "On the whole I am satisfied with myself."

In addition, people's answers to questionnaires can be influenced by "social desirability," and certainly the growth of the self-esteem movement has led to self-esteem's becoming a socially desirable quality. Perhaps this explains why American college students frequently show average scores of 70 out of a possible 90 on the Rosenberg Self-Esteem Scale. By contrast, according to Hazel Rose Markus and Shinobu Kitayama, East Asians who express favorable opinions of themselves are likely to be criticized for immaturity, or excessive pride, or disregard for family and community. Scores on the Rosenberg Scale from China or Japan might therefore be misleadingly low instead of misleadingly high.

To make matters worse, when the usual questionnaires are used to measure self-esteem, researchers cannot check the evaluations against reality. When self-report questionnaires can be crosschecked, they are often found to be seriously inadequate. For example, many American high school students who say they are good at mathematics perform poorly on math tests. On the Objectivist conception of self-esteem, this is a critical measurement flaw, for genuine self-esteem must be realistically based.

Researchers are just beginning to explore alternatives to these self-report questionnaires. One inspiration for their efforts is the Implicit Attitude Test, which was developed by researchers who were concerned that self-reported racial attitudes might be unreliable when it is socially undesirable to admit certain prejudices. Since 1995, several implicit measures of self-esteem have been proposed. Unlike explicit measures, these do not ask people to report on their self-esteem. Indeed, "implicit self-esteem" can be defined as an automatic, non-conscious self-evaluation.

One promising method of getting at implicit self-esteem involves recording reaction times to computer-based word associations, which is the basis of Anthony Greenwald's Implicit Association Test (IAT). It is assumed that participants are not aware their self-esteem is being assessed during the test. Thus, responses can be seen as more accurate indicators of a person's self-esteem. At this point, the evidence in support of the IAT is limited but growing.

Walter Foddis and his colleagues have tried an implicit measure of self-esteem using sentence completions, for example, "My self-esteem depends on…." The completions, retrieved quickly from memory and subjected to little or no conscious review, are the "implicit" material here. Participants' sentence endings are scored based on how closely they correspond to Branden's pillars of self-esteem. One of the advantages of this approach, as compared with the standard questionnaires, is that participants are not being given ready-made socially desirable statements to evaluate, such as "My self-esteem depends on taking responsibility for my own behavior."

Foddis et al. have contrasted those who scored high on both explicit self-esteem (as measured by self-report) and implicit self-esteem (as measured by sentence completions) with those who scored high on explicit self-esteem but low on implicit self-esteem. Those with high explicit but low implicit self-esteem responded more poorly to criticism and endorsed fewer statements that they were worthy of being told they were loved. Even though they reported high self-esteem, participants who fell into this category resembled those who scored low in explicit self-esteem. Such data support the notion of pseudo-self-esteem. Among those with high explicit but low implicit self-esteem, the more extreme a person was in generating external sources of self-esteem in sentence completions, the more likely he would respond with defensiveness and hostility when criticized.

Much more work remains to be done in assessing implicit processes in self-esteem, but the evidence for their usefulness in self-esteem research continues to grow. The most pressing problem is the lack of agreement among the different implicit procedures currently under development.

Distinguishing Narcissism

Moderate positive correlations exist between scores on self-reported self-esteem and scores on the Narcissistic Personality Inventory (NPI). (A narcissistic person harbors grossly inflated opinions of his competence and his worth, regarding himself as superior to others.) Because the NPI involves self-reporting, it is subject to some of the criticisms that have been raised against the Rosenberg Scale. Researchers who sharply distinguish self-esteem from narcissism worry about the correlation between the two tests and seek better theoretical models and better measurement procedures for both phenomena.

Carolyn Morf and Frederick Rhodewalt have put forward a new model of narcissism that supports the effort to distinguish high self-esteem from vanity, self-absorption, and ego-inflation. Morf and Rhodewalt suggest that a defining characteristic of the narcissist is overdependence on social sources to affirm a grandiose sense of self. The narcissist needs other people, but only because of their instrumental value in bolstering his sense of self. Under the narcissist's grandiose exterior, therefore, is a vulnerable sense of self that is easily threatened and must be constantly supplied with affirmation.

Morf and Rhodewalt cite several studies that show how narcissists undergo instability and fluctuations in their explicit self-esteem because their self-image is both grandiose and vulnerable. For instance, in studies contrasting participants who scored high and low on the NPI, those with high scores displayed greater day-to-day fluctuations in self-reported self-esteem than did less narcissistic individuals. The narcissist's daily self-esteem was also more highly correlated with positive or negative social interactions: it depended on whether the narcissist received acceptance and whether the interactions made the narcissist feel "like himself." In this regard, a narcissist can be understood as a person with pseudo-self-esteem, who relies more on external sources for his self-esteem than internal sources.

Empirical findings suggest that other characteristics of the narcissist include viewing his abilities and accomplishments as superior, bragging to elicit positive reactions, lying about his past to make himself look better, and derogating anyone who gives him negative feedback. In short, the narcissist keeps looking for ways to obtain validation of himself, but the external validation is never enough to convince him of his own adequacy. Morf and Rhodewalt's model of narcissism ties in nicely with Branden's argument that those who do not have genuine self-esteem strive to "fake" it. The narcissist fakes it by lying and bragging to solicit admiration from others, and by downrating anyone who fails to be admiring. Morf and Rhodewalt marshal substantial empirical support for their model but acknowledge the need for more research on the relationship between psychological processes and interpersonal behavior. Focusing on sources of self-esteem could further illuminate what is going on in narcissism.

Sources of Dispute

Fundamental differences in philosophy are one major reason that the subject of self-esteem is so much debated. What a person thinks about human nature will deeply affect his view of the matter. Thus, Baumeister seems to believe that every person either views himself as superior to others or wishes to. In his 1993 book Self-Esteem: The Puzzle of Low Self-Regard, he wondered why anyone would have low self-esteem. In a 2001 commentary, he opined that the reason narcissism fascinates psychologists "may well be that narcissists indulge the cravings that most people have."

A different strain of thinking in social psychology, which can be seen in Crocker's work, holds that human selves are socially constituted, so that your evaluation of yourself must derive from the way that others evaluate you. Within social psychology, this notion of the socially constituted self was the leading idea of two early twentieth-century thinkers, George Herbert Mead and Charles Cooley; they in turn owed intellectual debts to the communitarian pragmatism of John Dewey and to the still earlier nineteenth-century followers of G.W.F. Hegel. From this point of view, not only is much of what you do socially constituted, but your individuality is not fully real; thus, there is no way you could evaluate yourself without relying on others' evaluations of you.

Moving beyond academic social psychology, into clinical practice and education, one finds widespread distrust of the idea that self-esteem should be contingent on a person's self-directed functioning. Self-esteem should not have to be realistic, according to this outlook; it should not have to depend on how you are using your mind.

Today's clinical practice owes large debts to the humanistic psychologists of the mid-twentieth century. For example, Carl Rogers held that the therapist must show "unconditional positive regard" for the client. But where Rogers intended to encourage self-acceptance on the part of the client, others have gone much further, concluding that we should each have unconditional positive regard for ourselves.

Albert Ellis, for instance, is a prominent therapist who has argued that accepting your feelings and your actions as your own is not enough; genuine self-acceptance means never "rating" yourself at all. For Ellis, self-esteem is always unstable, ever vulnerable to threats: if you rate yourself on your competence or your worth, you may admire yourself as a hero today, but you will surely look down on yourself as a "worm" in a week or two.

But it is in America's teachers colleges and public schools that the movement for unconditional self-esteem has found its true home. Today's educational practices encourage children to think of themselves as special regardless of what they do; and the practices encourage teachers to overpraise students' work and shield them from criticism. Only on the assumption that self-esteem must not be contingent on thought and action could such practices be seen as promoting it.

This use of self-esteem to motivate "affective education" is driven by the anticognitive culture of colleges of education. When it comes to these anticognitive practices in the schools, we must of course agree with the critics of the self-esteem movement. Sullivan and D'Souza and Baumeister and Emler are right to object that parents and teachers should not be ladling out indiscriminate praise to children. But then no one with an adequate understanding of self-esteem would endorse such practices.

Constructive Engagement

Those who believe that we human beings cannot avoid evaluating ourselves, and that high contingent self-esteem drawn from internal sources is part of healthy psychological functioning, need to engage the academic researchers more fully.

Such engagement will have to take place on at least two levels. First, we must expose and rebut the philosophical and moral beliefs that are in play. As we have noted, researchers in academic psychology are animated by deep-seated beliefs about the nature of human beings and the nature of a good human life. After all, when the data collection is finished, the results have to be evaluated against some theory of what is being measured. We, looking at the data, have objected to the standard self-report questionnaires because they cannot distinguish genuinely high self-esteem from defensive substitutes. But Emler frankly accepts the existing measurement procedures—because the relationships between measured self-esteem and other variables make sense to him.

Taken alone, however, the effectiveness of this philosophical approach will be limited. Most psychologists are still being trained in the positivistic tradition, which equates science with collecting and analyzing data. They distrust "philosophical" arguments; what they find convincing is supportive data from established, narrowly defined programs of empirical research. Notice what happened when Nathaniel Branden directly challenged Roy Baumeister during a discussion of self-esteem on National Public Radio (Neal Conan's "Talk of the Nation," February 4, 2002). Baumeister indicated that high scores on self-esteem questionnaires could reflect a realistic self-evaluation not easily threatened, or a narcissistic bubble vulnerable to bursting: "You can think well of yourself because you accurately appreciate what you're good at. You can also think well of yourself just 'cause you're a conceited snob. And the self-esteem is the same in either case." Branden asked whether there could be any value in a conception of self-esteem that throws together compensatory grandiosity and self-trust grounded in mindful and self-responsible living. But Baumeister was unmoved by the argument. Self-esteem is what the studies he has reviewed are about; it is what the established questionnaires measure. Branden's merely theoretical objection was of no avail.

Consequently, there is a vital need for focused empirical research programs on self-esteem. Initially, these programs will have to concentrate on improving the measurement of self-esteem and distinguishing it more clearly from narcissism. Better measurement procedures will, in turn, lead us into inadequately explored aspects of genuine self-esteem, and that, we believe, will require further elaboration from all of the competing theories, including Branden's.

Once the measurement problems have been alleviated, and self-esteem's nature has been better elaborated, the connections between self-esteem and various behavioral outcomes will need rechecking—and not just the links with our success in school or our employment history or our ability to refrain from crime or drug abuse. Self-esteem also needs to be related to issues that matter to counselors—and clients—such as the quality and durability of our intimate relationships, or our ability to overcome misfortunes and difficulties in life.

We are not recommending empirical research of this kind just to relieve academic psychologists of some of their theoretical muddles or to convince them of facts that clinicians already know. Genuine empirical questions remain about the nature, functioning, and development of self-esteem, and better psychological research will give us a chance to answer them.

Robert Campbell is a professor of psychology at Clemson University. Walter Foddis is a doctoral student in clinical psychology at the University of Waterloo.

Why on Earth... Are We So Polarized?

by Bradley Doucet

September 5, 2009 — As if we needed more proof, the ongoing dustup over health care reform in the United States has made it painfully obvious that the “culture wars” are alive and kicking. President Obama’s overtures to bipartisanship notwithstanding, there is little love lost between the Left and the Right. Liberals and conservatives routinely suspect one another of base motives and substandard intelligence—and on occasion, I am sorely tempted to conclude, like H. L. Mencken, that both sides are correct.

But although there are rubes and rogues among us, it rings hollow to me to think that they comprise any large percentage of the population, especially given that other explanations are readily available. For one thing, psychologists have learned that confirmation bias is a widespread phenomenon. Part of the reason we have a hard time understanding why smart, ethical people would believe the things they believe is that we don’t really try to understand. Most of us have a tendency to seek confirmation for our ideas when we should instead try to falsify them, retaining only those that survive the challenge. Specifically, we tend to expose ourselves more to ideas we already agree with, and also to give less credence to those instances of disconfirming evidence and arguments that we do happen upon. Avoiding these pitfalls takes will, commitment, and conscious training in the art of thinking straight.

There is another good reason why it makes little sense to condemn large swaths of the human race as either stupid or evil. Far from one side or the other being immoral, conservatives and liberals both tend to want to do the right thing. According to evidence unearthed by University of Virginia Psychology Professor Jonathan Haidt, they just honestly have different notions about what that means.

The Five Foundations Professor Haidt, whose ideas were profiled last week in the 25 th anniversary issue of The Utne Reader , has been studying “the moral foundations of politics.” He thinks that the bitter, partisan culture wars keep both sides from seeing the big picture: “I do believe that if liberals ran the whole world, it would fall apart. But if conservatives ran the whole world, it would be so restrictive and uncreative that it would be rather unpleasant, too.” On his home page , Haidt expresses hope that his work can help us transcend partisan feuding. He stresses, “We must respect and even learn from those whose morality differs from our own.”

Haidt analyzes moral beliefs in terms of five sets of fundamental moral intuitions:

1) Harm/care

2) Fairness/reciprocity

3) Ingroup/loyalty

4) Authority/respect

5) Purity/sanctity.

These intuitions, which he believes are innate but malleable, underlie our ethical views. While one could think of other categories that might even seem more fundamental, these five were selected for their wide dispersion across cultures and their links to “plausible and published evolutionary explanations of related psychological mechanisms.”

In several studies , Haidt and his colleagues found that liberals were primarily concerned with the first two categories, harm and fairness. Conservatives’ concerns, on the other hand, were more evenly distributed across all five categories. While concerned about harm and fairness, they were also concerned with group loyalty, respect for authority, and issues of purity and sanctity. Haidt and his coauthors conclude, “These findings help explain why liberals and conservatives disagree on so many moral issues, and often find it hard to understand how an ethical person could hold the beliefs of the other side.”

A Rational Ethic

Does this “Moral Foundations Theory,” as Haidt calls it, provide a means of toning down the political shouting match? Understanding where your opponents are coming from does indeed have the potential to help. The alternative—impugning their motives or intelligence—is certainly no way to bridge the gap.

At best, though, this is merely a beginning. Disagreements over the five moral foundations can only be moderated through a rational examination of their basis in reality. What does adherence to the foundations accomplish? How does each of them contribute to the long-term needs of rational beings like ourselves? Reducing harm is a laudable goal, to be sure, but is the robust welfare state favored by modern liberals the best way to do it, or does it instead breed dependency? Fairness is also clearly important, but is inequality necessarily unfair, or is economic liberty the best way to even the playing field?

As for the three moral foundations eschewed by liberals, once again we must examine them rationally. It is true that group loyalty can degenerate into racism or blind nationalism, but are there not some voluntary group memberships that are more significant than ethnicity or citizenship? Respect for authority can similarly devolve into an abdication of responsibility, but we do need leaders in some sense of the word, and we all need to use information from experts and authoritative sources. Finally, although excessive concern with purity and sanctity can be distracting if not blatantly irrational, a reasonable amount of cleanliness is certainly a minor virtue. And what would life be worth if nothing were sacred? Indeed, one could say that being concerned about principles and moral integrity is itself a form of concern for purity and sanctity.

These questions have answers. As in all things, we must rely on reason as our guide, and reality as our final arbiter. To get the most out of life, we must be on guard against common lapses of thinking, and we should approach our fellows with an attitude of respect and benevolence. Disagreements will remain, though, and therein lies one of the principal arguments for liberty. As long as we are battling to see who gets to impose his will on whom, there will be endless strife. If, on the other hand, we have freedom, we can settle our disagreements scientifically, with each of us trying different “experiments in living,” to use John Stuart Mill’s phrase. With greater liberty, a more civil, peaceful world is within our reach.

Why on Earth---Are We So Afraid of Flying?
by Bradley Doucet

Fear serves an important function, alerting us to perceived danger. As long as that perception is grounded in reality, fear is a perfectly rational and useful response. The release of adrenaline into the bloodstream helps us prepare for fight or flight, depending on our ongoing appraisal of the situation. A person who literally feared nothing would fail to plan for adverse events. He would not react appropriately when trouble occurred. And so he would not survive very long.
Fear is only a problem when it becomes untethered from a realistic assessment of the facts and overrides one’s reasoning mind instead of serving it. In such cases, fear becomes a liability instead of an asset, harming rather than helping one to live a successful and fulfilling life. An example of such unreasonable fear is the fear of flying. Commercial flights in the modern, industrialized world are extremely safe, yet various polls suggest that somewhere between 25% and 50% of us are either very or somewhat afraid of flying. What could account for this widespread, irrational fear?
If It Bleeds, It Leads
We’ve all heard the slogan “If it bleeds, it leads.” It refers to the fact that bad news is more likely to make it onto the front page, while good news is more likely to be buried on page 17. But as it happens, it also very much matters what kind of bad news. A fatal plane crash, like the one that occurred outside of Buffalo last week killing 50, gets a whole lot more coverage than the dozens of fatal car crashes that occur every day. Partly, this is because a plane crash is more spectacular, but partly it is just because it is less common. In fact, as a general rule, the less chance there is of something happening to you, the more likely it is to get covered in the news, and the more coverage it is likely to get.
Don’t just blame the media, though. Selling newspapers is a business, and it responds to consumer demand. If the media prioritize bad news, it is because consumers do so as well. Now, it makes a kind of sense to talk about the uncommon, for if something is common, you probably know about it already, and at any rate, it is not really news. The unfortunate thing is that this leads to an inverted view of the world, for the normal state of affairs—which is the absence of crisis—gets no attention at all, while the exceptional—the crisis—gets a ton of it. It also results in an inverted hierarchy of fears, in which we worry more about dying in a plane crash (very rare) than about dying in a car crash (less rare), and we worry hardly at all about dying of heart disease (very common).
But even if “Plane crashes near Buffalo, 50 dead” is news, a responsible news story would at least mention, “All 30,000 other U.S. flights departing on the same day arrive safely”—not because people don’t know it (though some would be surprised at the sheer number), but because we don’t think of it when faced with the shocking story of the crash. (It is probably too much to ask, though, for newspapers to run this headline on most days: “30,000 U.S. flights depart and arrive with zero fatalities—again.”) Instead of responsible reporting, though, we get endless coverage of the crash, from every possible angle, searing the awful event into our memories, there to distort our judgment of relative risks forevermore.
With no disrespect intended to the families and friends of those who died in the recent plane crash, why do the profiles of these particular victims qualify as national news? Why not profiles of the 40,000 people who die every year on America’s roads, or the many hundreds of thousands of Americans who succumb to heart disease every year? Every death is a tragedy to someone, but not every death merits a national news tribute. Only because they died unusually do these 50 get special attention.
Statistics 101
The first step in overcoming one’s fear of flying is educating oneself about just how safe flying really is. This requires examining statistical data, which requires the use of our brains and is thus at an immediate disadvantage as compared to shocking, dramatic, anecdotal news coverage, which appeals directly to our emotions. Our schools, furthermore, still generally do a poor job of teaching people how to think about statistics,  and a terrible job of imparting a sense of why statistics are important.
Most people have heard that flying is very safe, but many either do not know or do not understand the statistical data that prove it. In the last 20 years (1988-2007), some 2000 people have died in plane crashes aboard U.S. commercial carriers, according to a quick calculation from a table at the National Transportation Safety Board’s website. That’s an average of about 100 deaths per year. In that same period, miles flown grew steadily from 4.5 to 8 billion per year, while departures grew (less steadily) from around 7.5 to 11 million per year. So, roughly 100 people died for every 6 billion miles flown, or for every 9 million departures.
An interesting example of people’s trouble with statistics is the controversy over whether flying is safer than driving. The aviation industry prefers to highlight deaths per mile flown or driven, which makes flying look safer than driving. Some critics, on the other hand, focus on deaths per departure or per trip, which makes driving look safer than flying, since trips taken in a car are generally for shorter distances than trips taken in a plane. This criticism, though, ignores the fact that one cannot always, or even usually, substitute a short drive for a long flight—one wants to get from point A to point B, and therefore the choice is between a drive and a flight over the same distance, which makes the deaths per mile standard more appropriate. Still, there are times, such as when planning a vacation, when one could choose to drive a short ways instead of fly a long ways simply by choosing a closer destination. In addition, the per-mile standard ignores the fact that accidents are more likely (though still very rare) during takeoff and landing, which is a point for the per-departure standard.
So while it is clear that flying is very safe, figuring out whether flying is safer than driving turns out to be more complicated than it at first appears. Ottawa Citizen columnist Dan Gardner, in the introduction to his recent book Risk: Why We Fear the Things We Shouldn’t—and Put Ourselves in Greater Danger , cuts through the confusion by describing an actual statistical test of the competing hypotheses. In the year following the September 11, 2001 terrorist attacks, fear of flying understandably jumped, and many Americans changed their traveling patterns, driving instead of flying whenever possible. The result? Over 1500 extra deaths that year as a direct consequence of the switch from airplanes to cars. That’s about as many as normally die flying over 15 years!

We Have Nothing to Fear But Fear of Flying Itself
Overcoming a fear of flying is therefore an important thing to do, for it saves lives. For those whose fear of flying is extreme, some therapy may be required in addition to education about risks and statistics. Either way, the payoff is clear: the more people fly instead of driving, the more lives will be saved.
If man were meant to fly, some say, he would have been given wings. The obvious rejoinder is that if man were not meant to fly, he would not have been given such big brains with which to invent flying machines. Actually, an even deeper answer is that man was not meant to do anything, because the universe is not teleological. Nonetheless, those big brains can be used to learn statistical reasoning; to keep fear in its proper place; to counter emotional news stories and demand more responsible reporting; and ultimately to guide us in living happier, more fulfilling, and longer lives.

Why on Earth... Are So Many Americans Uninsured?
by Bradley Doucet

April 24, 2009 — As Congress returns from spring recess and gets to work hammering out a health care reform bill, that dreaded statistic is in the news again: 46 million Americans have no health insurance. Like many scary numbers the press serves up every day, this one needs to be examined with a skeptical eye. In reality, the situation is not quite as bad as it is made to appear.
Still, there is a problem, and it is severe enough to be worth addressing. Some millions do want health insurance but are unable to afford it. Does this not demonstrate that the free market is unable to provide for the needs of the people? Given that the free market works so well in so many other areas, it would be curious if it fell short in this one part of the economy. When faced with an anomalous effect, we should seek out anomalous causes. Indeed, upon closer examination, the U.S. market in health care is far from free.

Sizing up the Problem

The U.S. Census Bureau, in its August 2008 report , pegged the number of people without health insurance in 2007 at 45.7 million, down slightly from the previous year. The first thing to notice is that the Census Bureau itself admits that this number, from its Current Population Survey (CPS), is too high. Appendix C of the report starts off, “Health insurance coverage is likely to be underreported on the Current Population Survey.” It then dances around the issue for a page and a half, but it does direct the intrepid reader to the Congressional Budget Office’s 2003 report, “ How Many People Lack Insurance and for How Long ?”
The CBO document examines data from the year 1998, when the CPS found that roughly 40 million people were uninsured (or about 15 percent of the population, which matches the current rate). The report estimates that the number of people who were uninsured for the entire year was actually between 21 and 31 million—that is, anywhere from 25 to 50 percent lower than the CPS number. “Although the CPS is intended to measure the number of people who lack health coverage for a whole year, its estimate more closely approximates the number of people who are uninsured at a specific point in time during the year.” (Emphasis added.) It is one thing to be chronically uninsured, and quite another to be without insurance for a few months.

A further source of inflation in the official figures is the fact that many of those among the officially uninsured are eligible for Medicaid but have not applied for it. The CBO report does not provide a sense of the number here, merely saying that “half of eligible nonparticipants have private coverage and half are uninsured.” But just how many “eligible non-participants” are there to begin with? Peter Pitts, president of the Center for Medicine in the Public Interest and a former FDA Associate Commissioner, says the number is huge, writing recently that “12 million Americans without health insurance already qualify for public health coverage. They simply haven’t signed up.”

Aside from the Medicaid mix-up, there is another qualification to bring to the official figures. When the uninsured were asked why they lacked health insurance, 10 percent of nonelderly adults reported that they “have not needed insurance” and another 1 percent said they “do not believe in insurance,” according to the CBO report. This indicates that at least some of the uninsured are uninsured by choice. This is not necessarily irrational; someone who is young and healthy may choose to take the tiny risk of investing elsewhere temporarily. Someone who is very well off may be able to afford to pay for likely risks out of pocket.

Further evidence that some significant portion of the problem is voluntary can be found by examining incomes. Returning to the Census Bureau report, we find that 8.5 million of those who lacked health insurance in 2007 had annual household incomes of between $50,000 and $75,000, while an additional 9.1 million had household incomes above $75,000. Surely these 17.6 million of the uninsured could have afforded health care, right?

The High Cost of Government Regulation

Although the scale of the problem is not quite what it is made out to be, there are nonetheless millions of Americans who want insurance but remain uninsured for extended periods of time. The number might be “only” 10 or 20 million, taking account of the issues raised above and allowing for overlapping categories, but that still represents a significant problem.

The most commonly cited reason for lacking health insurance is its high cost. And the cost is high. According to the National Center for Policy Analysis , a family policy in Massachusetts will set you back a shocking $16,897 a year. That is enough to make even many higher earners balk. In Wisconsin, however, a family policy is a much more affordable $3,087 a year. How can this be?

Simply put, the government of Massachusetts regulates the market for health insurance much more heavily than Wisconsin’s does. As the NCPA explains, “The federal McCarran-Ferguson Act, which lets states set their own requirements for coverage, has protected state markets from competition, and led to an assortment of mandates—many of which the insured do not want or need.” Heavily-regulated states require health insurance policies to cover such vital necessities as acupuncture, massage, marriage counseling, contraceptives, fertility treatments, and—I kid you not—hairpieces (required by seven states). Residents of Massachusetts, in other words, are forbidden by law from purchasing the kind of basic, no-frills insurance policy available to residents of Wisconsin.

The second most commonly cited reason for lacking health insurance is lack of access to an employer-sponsored insurance plan. The reason why this matters is that employer-provided plans are tax exempt, while plans purchased by individuals are not. This makes individually-purchased plans more expensive, punishing the unemployed and those who work for smaller companies that provide no health benefits.

Blaming the Free Market

If any industry in the United States illustrates the unintended negative consequences of government regulation, health care is it. Yet this government failure is often blamed on the free market and used to justify further regulation. In the most heavily-regulated states, guaranteed issue (no one can be refused) and community rating rules (everyone must pay similar premiums regardless of risk factors) push prices even higher, yet some argue that these should be adopted nationwide. At the extreme, some Americans want a universal health system like we have in Canada, trading high direct monetary costs for burdensome taxation and, yes, long waiting lists—despite what Michael Moore would have you believe.

If the market for health insurance were truly allowed to function freely, it would respond to the laws of supply and demand, just as markets in other areas of the economy do. Competition would exert downward pressure on prices and ensure a wide range of products, from no-frills basic insurance to gold-plated luxury insurance. No one in their right mind would need to go without basic care, just as no one in America today goes without shoes or a watch, unless they have good reasons to be barefoot and watch-less—while soaking up rays on vacation, say. But if the government were to mandate that all watches had to meet the standards of a high-end Rolex and come bejeweled with diamonds and sapphires, there would be many a bare wrist out there on the streets.

Of course, the free market does not guarantee that people will receive a certain good or service. It just ensures that no one is prevented from working out ways to get that good or service using their best judgment and efforts. Free markets do not ensure either good judgment or productiveness, but they do enable and encourage those virtues. The small minority who were unable or unwilling to fend for themselves in a free market would be free to seek out support from family, friends, community organizations, and other forms of voluntary charity.

Beyond economics, there is the question of why someone should be forced to buy acupuncture insurance if he is to buy insurance at all. Why, too, should a woman who watches what she eats, exercises regularly, and doesn’t smoke or drink to excess be forced, by community rating rules, to subsidize someone with an unhealthy lifestyle? Even subsidizing someone who is sick through no fault of his own is not “insurance”—which is about risk-mitigation, after all—it’s charity, and should be treated as such. As usual, lack of freedom and lack of fairness go hand in hand.

But health care is simply too important, some will argue, to be left to the free market. On the contrary: health care is too important for excessive regulation to continue depriving people of the freedom to buy the coverage they want and need. In the name of a supposed entitlement to health care, some people are willing to impose unchosen obligations on others—with the predictable effect of impoverishing us all.

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