On A Rational Discussion of Health Care Reform

Fresh Air on NPR is one of my favorite programs, and host Terri Gross has been doing a series of interviews with knowledgeable, intelligent people on all sides of the debate on health care reform and, more specifically, the actual legislation being proposed. One part of the series in particular struck me as one of the most informed, rational, and even-handed discussions of what is actually being discussed and worked on by the legislation: an interview with Jonathan Cohn, author of Sick.
Every media outlet has its bias and NPR is no exception, but if the site goes against your political grain and you can get past that you’ll be rewarded with a broadcast that said more about the proposed health care legislation than all of the town halls combined, and with none of the distasteful and shameful theatrics that townhall attendees and political talking heads on both sides of the spectrum seem bent on engaging in.

Cohn’s own bias is stated pretty clearly, and it wouldn’t take you long to suss it out anyway since, as the author of a book titled Sick: The Untold Story of America’s Health Care Crisis — and the People Who Pay the Price, it’s pretty clear how he feels about America’s current health care system. But he says that he knows his own desires in health care are far more liberal than the average American, and certainly even more liberal than Congress. In this interview he isn’t tasked with talking about what he would do if he were in charge — although Terri Gross does ask him this question and he does answer it, but she’s asked that of every person she’s had on in this series — he’s tasked with discussing each player in the health care debate, from the AMA to hospitals to insurance companies, what’s at stake for them, and what the legislation being proposed would mean for them and for Americans. He does a great job of allaying some of the rational fears that can be found if you’re willing to pick through the chaff of the shouting matches at townhalls. Here are some of the more interesting bits I found in the broadcast.
There will be no single payer system.
No matter how loudly people rail on about Obama being a communist or a Nazi (oddly, two polar opposite ends of the spectrum) or how we’re going to turn into Canada — which apparently is even worse to most people than turning into Stalinist Russia if you listen to the townhall attendees — the US will likely never see a single payer system. While polls show that the American public overwhelmingly wants health care reform, Congress is typically more conservative, even controlled by the Democrats, than the American public. A single payer system is too far out and idea for the US to see as a reality any time soon, if ever.
The public option raises issues that Congress is perfectly aware of and is in the process of trying to address.
The public option isn’t being thrown into the bill without massive debate and consideration. The main consideration is that of competition; if a public health plan has what tends to be seen as an infinite well of money to draw on, private insurance can’t possibly hope to compete against it. This is a very valid concern and many of the parties involved have different needs and desires when it comes to the public option, all of which Cohn discusses, and you can be sure that each one of the groups — which runs the political gamut — has a lobbyist working on Congress to make sure their needs are addressed. Rather than shout “Nazi” or “down with socialism” or any number of ridiculous phrases that don’t contribute to the debate at all, people should pay special attention to this segment of the broadcast so that we can have an intelligent national conversation about the very real and rational pros and cons of a public option (if it ever makes it into the bill — at the time of this broadcast it was still in consideration).
There are parts of this reform being proposed that no one is discussing that are really interesting.
Take doctors and their stake in this, for instance. When most people picture doctors they picture a wealthy guy getting rich off of as many procedures that he can make his patient go through. But the truth of the matter is, Cohn says, doctors graduate from many years of schooling with massive amounts of student loans to pay off. Their practices need to pay off these loans, and it’s far more profitable for them to go into a specialty line of medicine than to go into family care since family care pays so little relative to the rest of the medical profession. One of the ideas being bandied about in this health care reform is the idea of giving doctors more incentive to go into family care by offering some kind of student loan forgiveness. Having more qualified doctors in family care can only be better for our health care system overall. And this was only one aspect of how doctors may be directly affected by the proposed health care reform that Cohn discussed.
The best part of the broadcast is when Gross brings up each player in the debate — hospitals, doctors, the AMA, and more — and asks Cohn to discuss what that group wants in health care reform, what they don’t want, and how the proposed legislation will affect them. It’s a fascinating look at all sides of the issue.
The rest of the series is spread out over different time periods, but you can easily find them if you browse the August and July Fresh Air archives. In another engrossing episode, Gross talks to two economists, one on the left side of the spectrum and one on the right, and both discuss the economics of the proposed health care in a rational way.
So please, take a listen. Especially if you’re one of those awful townhall attendees. But I personally don’t know any of those people. Thank God for that.