The difficult conversation

Healthcare issues have become so politically charged that it can be very hard to have a rational conversation about them, particularly one that converses in ideas rather than hyperbole, anecdotes and party talking points.   As I have become interested in this topic, I have tried to engage a number of people in conversation, both to learn what they think and to learn what I do not know, with relatively little success.  My very practical wife, who works in healthcare as a RN/BSN at Texas Children’s Hospital will humor me for a while, but I can tell she thinks I am crazy for spending so much time on something I likely cannot change.   I have had some productive discussions with my good friend Jon, but those often end at a point of disagreement as to what the facts are (most notably the data that suggests the US ranks behind other developed nations in many healthcare metrics).   I will mention one of my favorite quotes here, just because it bugs him that it is from a Democrat.  It was Daniel Patrick Moynihan, probably among others, who said that, “Everyone is entitled to his own opinion, but not his own facts.”  It is difficult indeed to agree on much when we each start with our own facts.

As I was reading the T.R. Reid book referenced in my last (and first) post, I came to an understanding – later stated explicitly in the book’s conclusion – that for all our discussion about what the right way to “fix” healthcare is, we overlook the most basic question of what our national values are in this area.  After all, our policies should reflect our national values.  Reid cited to leading healthcare economist Bill Tsiao, who agreed that we must start with the value question.  I frame it this way:  Do we as a society owe it to one another to provide access to basic healthcare?   I like that wording because it asks specifically about our ethical values.  It does not ask whether healthcare is a “right” or even presuppose any particular system or role for the government.  But if our answer is “yes” then we have an ethical obligation to design our system in a way that accomplishes that.

I recently ran a Facebook poll that asked this question.  I received just 24 responses in 48 hours, which may say as much about my social profile as anything.  Although my Facebook friends are pretty evenly distributed across the political spectrum, the vast majority of respondents were from my more liberal friends.  So it is not surprising that 22 of 24 people answered “Yes.”  The two “No” answers were both made anonymously.   It appears that there was a strong selection bias.  It may be that people who would tend to vote “no” don’t even want to engage on the subject.  That, in turn, makes it very difficult to get people who could sway the GOP to really think about what it best for the country.

For what it is worth, I answer the question, “Yes.”   I am not convinced that healthcare is a right.  It certainly is not a right provided by the Constitution, as I read the document.  But I do think that we as a society owe this basic compassion to each other.  And it may surprise you that my Tea Partier friend Jon agrees, citing his Christian faith as the moral basis for his answer.

 

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