Reading Reihan’s post on the costs of health care reform today gave me what has become a very familiar feeling.
Reihan’s post is well reasoned and written. I agree with him that health care reform will be expensive, and I also agree that we will all have to pay more in taxes to solve the problem– although it needs to be said that there are, in fact, many places we could cut costs in our system, that our system is hideously inefficient, and that the idea that we might be able to save some money in the long run isn’t some liberal pipe dream conjured up to rob Ma and Pa American of their health care but the honest and well-argued opinion of a lot of very smart people. I think Reihan is thinking about this in a constructive way. But he’s not talking about it in a fair way, and neither are his peers.
Why? Because many conservative blogs, from all the various strata of the ideology, have been doing a very poor job of frankly acknowledging the enormous amount of human suffering our health care system causes.
There are very many people, in this country, who need health care and are unable to get it, because of their financial or employment situations. This is a fact, and it is unavoidable. The number of people so afflicted is a matter of great controversy. A great amount of virtual ink has flowed for the purpose of taking shots at the various quoted figures of the uninsured and the underinsured. And who can say, exactly. But it is a great many people. It is millions; even the most rabid partisan must acknowledge that millions of people in this country lack adequate health care coverage. Millions of people, in the country with the most powerful economy in the history of the world, cannot access desperately needed health care because they can’t afford to.
Our system leaves people suffering. Americans, today, don’t go to the doctor because they can’t afford to, though they are in pain, often debilitating pain. Our system leaves people in financial ruin. Those who are uninsured or underinsured and face major medical conditions are often left with bills that leave them destitute, bankrupt, or both. The numbers, again, are controversial. Whatever they are, they are again real, and again large. Our system also kills people. Prevention and early diagnosis are the foundations of Western medicine. People don’t go to the doctor, when they can’t afford it, and they don’t get early diagnosis, they don’t get early intervention, and they don’t get help until it is too late to avoid permanent injury or death.
The factual accuracy of this basic picture– in this country, there are very many people incapable of affording health care, and it often has dramatic negative effects on their lives– is not in dispute.
None of this is the end of the story. For many, it is not even the most important part of the story. I’m not trying to argue that it has to be, although as for myself, it is. What I am arguing is that it is a part of the story, and one which must be acknowledged by anyone who wishes to weigh in on the subject in a morally responsible way. I am not asking for over-the-top apologetics. What I am asking for is acknowledgment, for admission that there are profound reasons for wanting to enact sweeping changes in the way we dole out medicine. There’s been a lot of scolding, from those opposed to health care reform, that those in favor of it are leaving out a key part of the discussion, and are arguing irresponsibly. I believe they might be right. But I am asking them to turn that same discriminating gaze back on themselves and to ask whether they are arguing in a way that ignores the basic human costs that inspire a desire for health care reform in the first place, or worse, in a way that ends up belittling the many victims of our system out of conviction that health care reform is unneeded or out of simple partisan zeal. I don’t expect my many antagonists to believe me when I suggest that to them. I do ask them to ask themselves.
I believe that for people in the most powerful economy in the history of the world to lack for access to health care is an obscenity. I believe it makes folly of our claims to be a moral nation and undermines the very notion of democratic community. I don’t expect people who don’t agree to change their minds. But we are not asking this for no reason; we are asking this because of real and devastating suffering. Even I don’t believe that this suffering is the only meaningful part of the discussion. I know in my heart that a discussion that fails to interrogate it as an essential fact is as useless as it is immoral.
Update: To head off a criticism– this is not an argument about not caring. There is no question in my mind that Reihan cares a great deal about the plight of the uninsured. There’s no question in my mind that most who argue against health care reform care. This is an argument about a distended policy discussion, and the efficacy of a conversation in which key information too often goes unsaid.