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Monday, August 31, 2009

Health Care Summary

Each time I touch the issue of health care in America I get all sorts of responses from otherwise passive readers. It has been gratifying to see that this blog attracts a diverse bunch of visitors, with all sorts of opinions and positions. I must also say that some of the comments have been as educative as anything I've read in mainstream publications or ueber-blogs.

My lesson, however, has been to stop using the issue as a foil for other topics, since it's too radioactive. Foils need themselves to be mildly interesting or easily recognizable, but shouldn't be major bones of contention - because if they are, they overpower the attempt to wield them.

The folks having the discussion are free to continue at it, of course. If I don't censor our in-house agitator Fake Ibrahim, I certainly won't bother them.

Just for the record, here's my basic position on health care, unencumbered by rhetoric tricks for other purposes.

Any reasonably wealthy country ought to have a system that ensures that all citizens have access to reasonable health care. Everyone having access means the illnesses we accumulate as we age need to be covered, otherwise the system is meaningless. And, yes, the electorate needs to define how they're going to pay for the system.

Beyond that - if it's national, or private, or hodgepodge; who decides, who adapts, who tweaks; what is the level of "reasonable" and what needs to be paid for separately; and all the other fiendishly complex questions - these need to be hammered out by the particular electorate, according to their particular conditions, mores, traditions, and abilities. Nor are the decisions of the past eternally correct: what worked well before may no longer work so well after; the compromises made by a previous generation may not seem such a good idea to a latter one - unless they actually do.

Sometimes there are issues where one side is right and the other is wrong. Eastern Europe's communist regimes foiling the aspirations of their nations, for example; the present Iranian regime suppressing freedom. Rarely, you'll even find crass moral imbalance within a democratic discussion. The Civil Rights Movement of the 1960s is a fine example. Most of the time, however, discussions in democracies tend to be more about interpretations or differing legitimate values, rather than clashes between good and evil. Hard as it may be for the Americans among you to see, this one seems to be of the former type.

Now let me see. Where did I put that helmet? It was right over there....

6 comments:

  1. Yaacov -

    You wrote:
    "Most of the time, however, discussions in democracies tend to be more about interpretations or differing legitimate values, rather than clashes between good and evil. Hard as it may be for the Americans among you to see, this one seems to be of the latter type."

    I think (and hope) that you meant to say "former" not "latter" and that you think our healthcare debate is about "interpretations and values" and not a battle between "good and evil"!

    (I still adore your blog, btw)

    Nycerbarb

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  2. Yaakov,

    I appreciate that you don't have a dog in this fight and want to stay out of it, so I will content myself with a single point and try to keep it short.

    You state that "Any reasonably wealthy country ought to have a system that ensures that all citizens have access to reasonable health care. Everyone having access means the illnesses we accumulate as we age need to be covered, otherwise the system is meaningless." This is precisely what the fight is about. This is not a case of two sides fighting about how to provide health care for all. It is transparently between those who want to provide it and those who do not. There has been no proposal from the Republicans or the conservatives that even pretends to provide health care for all.

    This is why the argument is so nasty. The people who do not want health care for all have to resort to all sorts of lunatic fantasies about "death panels" and "socialism" (a dirty word here) in order to cover up the fundamental cruelty of their position. Those who want it are properly appalled by having to argue such a basic point of human decency.

    Because we are debating whether or not to provide health care for all, not how to do it, the rights and wrongs of the battle really are as clear-cut as in the battle over civil rights. In fact, the sides are the direct descendants of sides in that battle 45 years ago, the parties, the political philosophies, and (to the degree that it is possible after nearly a half a century) many of the people on each side. And anyone who remembers the battles over civil rights will recognize the arguments of those opposed to reform. Many of the arguments against universal health care are practically identical to the arguments that were made against civil rights and they are not one bit less nasty and irrational than they were 45 years ago.

    This is not to say the the national debate is mirrored on your blog. The only commenter who might be opposed to universal coverage is Mr. Lowinger and, as I pointed out in the other thread, it is not clear that even he is.

    I wish that we could have a half-way reasonable national debate on how to provide health care for all. There are certainly many difficult questions involved, and the quality of what we get will depend on how we answer them. But we are not arguing over how to do it, we are arguing over whether to do it at all.

    David E. Sigeti

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  3. Explain please to me again, Mr. Sigetti, why Federal intervention in the civil rights era, which was needed to overcome de jure segregation at the state level, has anything in common with the federalization of medecine. While you're at it, please explain exactly why it is a federal responsibility to "provide health care for all."

    And given the history of the 20th century, just why shouldn't "socialism" be a dirty word?

    Oh now I get it, everything is attributable to the "fundamental cruelty" of the Rethuglicans.

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  4. David,

    I don't see it that way at all. I read and agree with the conservative opposition, but I support the idea of universal healthcare.

    Simply put, there is a huge lack of trust in Obama's government when it comes to this issue. The White House raised a lot of suspicion by attempting to push 1,000 pages of complicated legislation through in record time. The money involved is huge, and there has been no good explanation of how we will pay for this. The American people are wary of having the government beaurocracy involved in their healthcare, as well they should be. It is okay to oppose this massively important bill, while still desiring an acceptable level of healthcare for all citizens of this country.

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  5. Sharon Begley at Newsweek has been doing some excellent coverage on the healthcare debate.
    http://www.newsweek.com/id/212131/page/1

    A little more relevant to the subject matter of this blog is her 25 Aug column about why people believe lies.
    http://www.newsweek.com/id/213625

    Although she is talking about health care, we can substitute Israel, or any other subject for that matter. She writes:

    Some people form and cling to false beliefs about health-care reform (or Obama's citizenship) despite overwhelming evidence thanks to a mental phenomenon called motivated reasoning, says sociologist Steven Hoffman, visiting assistant professor at the University at Buffalo. "Rather than search rationally for information that either confirms or disconfirms a particular belief," he says, "people actually seek out information that confirms what they already believe." And God knows, in the Internet age there is no dearth of sources to confirm even the most ludicrous claims (my favorite being that the moon landings were faked). "For the most part," says Hoffman, "people completely ignore contrary information" and are able to "develop elaborate rationalizations based on faulty information."

    Sigh.

    Nycerbarb

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