DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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Health care reform opponents do not understand each other

That is a harsh title, but I will try to convince you that it is true.  I spent the weekend discussing internal medicine with colleagues from around the country.  Of course the health care reform issue arose often.

Readers know that I do want all Americans to have some coverage.  My reasoning is that appropriate coverage may actually decrease costs, because uncovered patient have too many ER visits and complex hospitalizations.  We pay for that care through higher insurance premiums.  While I may be economically wrong, at least you should consider the possibility that such coverage will not cost as much as you might think.

But most proponents of the ACA see universal coverage as a social justice issue.  They cannot understand any argument against universal coverage, because they approach this issue from a philosophical certainty.  Many proponents consider these issues as more important than cost.

The opponents of ACA, especially the Tea Party, are more worried about fiscal responsibility than social justice.  They do not accept the social justice argument.  They see the ACA as another big government spending scheme.

So we really do not have a debate; rather we have two debates going in parallel.  We have a debate on on whether health care is a right.  Those who favor the ACA often do not understand how anyone could debate this issue.

The Tea Party (and others) believe that our country must limit spending.  They see this as a first principle.  No idea is so important that we should over spend our means.  They subscribe to the advice that Dave Ramsey gives to individuals.

So we have an impasse.  We have pros and cons that are considering different philosophical issues.

I believe this issue represents the never ending US debate.  We have a group that believes in doing the right thing through the government regardless of cost.  We have another group that distrusts the federal government doing anything.  They fear the consequences national fiscal irresponsibility, and they interpret this law from that viewpoint while eschewing the social justice argument.

So unfortunately I do not think we can have a rational debate, because the “opposing sides” are seeing the issue through entirely different philosophical visions.

I suspect that I have not made this conflict as clear as I might, so more will come later this week after I receive comments and critiques.

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