Last year, in a series of "town-hall meetings" across the country, Americans got the chance to debate President Obama's proposed healthcare reforms.
What happened was an explosion of rage and barely suppressed violence.
Polling evidence suggests that the numbers who think the reforms go too far are nearly matched by those who think they do not go far enough.
But it is striking that the people who most dislike the whole idea of healthcare reform - the ones who think it is socialist, godless, a step on the road to a police state - are often the ones it seems designed to help.
In Texas, where barely two-thirds of the population have full health insurance and over a fifth of all children have no cover at all, opposition to the legislation is currently running at 87%.
Instead, to many of those who lose out under the existing system, reform still seems like the ultimate betrayal.
Why are so many American voters enraged by attempts to change a horribly inefficient system that leaves them with premiums they often cannot afford?
Why are they manning the barricades to defend insurance companies that routinely deny claims and cancel policies?
So why are we so stupid?
If people vote against their own interests, it is not because they do not understand what is in their interest or have not yet had it properly explained to them.
They do it because they resent having their interests decided for them by politicians who think they know best.
There is nothing voters hate more than having things explained to them as though they were idiots.
As the saying goes, in politics, when you are explaining, you are losing. And that makes anything as complex or as messy as healthcare reform a very hard sell.
It's certainly true that the glib, patronizing manner of an 0bama or a Pelosi does not help the cause. But has Prof Runciman considered the possibility that most Americans are quite happy with the current state of their healthcare? And has he considered the following issues:
(1) That the US federal government has shown itself on numerous occasions in the past to be quite incompetent at doing anything?
(2) That there are a number of state and local programs that help people who cannot afford health insurance?
(3) That many young, healthy people don't want to be forced to pay for something they don't need?
(4) That once the federal government takes control of health care then the racist 'affirmative action' programs supported by 0bama and others on the left in the USA will push whites to the end of the health care line?
(5) That Americans really don't want to pay for the health care of 12 million illegal aliens that 0bama seems determined to give permanent amnesty to?