01 January 2007

Ideology threatens reform

In "Health Care Problem? Check the American Psyche" in the Sunday New York Times business section, Anna Bernasek writes that single-payer is the answer to the health care crisis in the United States.

"Yes, single-payer — that much-maligned idea that calls for everyone to pay into one insurer, typically the government or a public agency. The insurer then pays doctors, pharmacists and hospitals at preset rates. Patients who want unapproved procedures and doctors not willing to accept the standard payment remain free to deal with one another directly, outside the system."

That sounds like what Health Care for All Colorado says: The government pays, you choose your doctor, and you and your doctor choose your hospital, should that become necessary. Like in France. You could call it Medicare for everyone.

"There’s only one catch," Bernasek writes. "Most Americans just don’t believe it can be done. The health care crisis may turn out to be more of a problem of ideology than economics."


Ironically, here in Colorado, the Blue Ribbon Commission for Health Care Reform has a commissioner who frequently cites the issue of ideology. She's Linda Gorman, from the Independence Institute, a libertarian think tank. At the commission's November meeting, for instance, she fretted about the commission's looking into underinsurance — part of its mandate from the legislature.

Underinsured was a qualitative judgment, she insisted, and if the commission was going to look at the underinsured they should also look at the overinsured. This is a private decision, she said.

At the December general commission meeting, she fussed over adding members of the public to the commission's committees — another mandate from the legislature. "Quite possibly these committees will be packed with ideological advocacy groups," she warned.

In that same meeting, she claimed that the commission's charge from the legislature — comprehensive reform — seemed to be out of the question. "Look at the facts. Washington, Tennessee, Kentucky all did reforms that had enormous unintended consequences," she said, adding that the only reform worth considering was Medicaid reform.

At a December evaluation committee meeting, she argued against adding members of the public to the committee process, complaining that public input had thus far been a waste of time. She claimed that every member of the public who had commented to the committee had simply stood to rattle off ten minutes of some speech they'd given fifteen hundred times — and that they should be more considerate of commissioners' time.

The more I thought about that afterwards, the more outraged I felt. I felt like Alice, down the rabbit hole, being told outrageous things — but worse, since those things may have been true in Wonderland. They're not true in our nominally reality-based world, however.

I was there. I was one of the public commenting. I heard the other public comments. What she complained about had as little bearing to reality as did Bush's claim that there were weapons of mass destruction, or that Saddam hadn't allowed weapons inspectors in, and that's why troops needed to be sent. Brownie, you're doin' a heckuva job...

In fact, public input at the full commission gatherings has been limited to a couple minutes per person at the end of the six-hour-plus meetings. At the first meeting, there were representatives from various organizations — AARP, Health Care for All Colorado, etc. — who stood to explain that their group supported the commissioners' work and were committed to fixing the system. A couple said universal health care should be the goal. A couple said please look not just to what other states are doing, but also other countries. I stood, my heart in my throat, because I'm not a public speaker, and told the commission about my brother Paul's death, how his lack of insurance was implicated, and that their work could save people's lives. It is a matter of life and death to fix the broken health care system in the United States.

And now here this commissioner was, a couple weeks later, saying that I had wasted her time, spouting off something I'd mouthed a thousand times before.

Ideologues are people who don't listen, whose minds are made up on the basis of their rigid and coherent system of belief — favoring one point of view above all others and adhering to that point of view...

Gorman left before the public comment time began at the second commission meeting. Her mind seems to already be made up, with no need to hear from someone whose experience doesn't fit in with her rigid and coherent system of belief.

I assume she'll continue to fight to keep ideologues off the committees.

Does this fit into "Takes one to know one"?

Couldn't we send her to France?

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