American Values in the Healthcare Debate
Allan Brett, M.D. published a thoughtful piece in the New England Journal of Medicine on “American values” and health care in the United States.
Of course, thoughtful has not proved to be very useful in advancing any political cause.
Emotional, yes. Thoughtful, nice try.
Nevertheless, the coupling of the terms ”unique” and “American values” to derail a policy that Americans clearly want deserves at least some thoughtful reflection.
What are American values and are they unique?
As a side comment, the only values that matter to political decision makers appear to be the value of their campaign coffers and the value of getting reelected. The two values seem to be at odds right now, with polls continuing to show strong support for health care reform, while those that want minimal change to the status quo fill the campaign coffers of those in Congress.
Dr. Brett begins by challenging the notion that there is an archetypal set of “American values.”
“…those who championed the idea of “real” Americans (as distinct from Americans who are somehow less representative of American ideals) were precisely those whose candidate lost the election.”
He goes on to argue convincingly that the dots between American values, choice, and opposition to a single payer health system do not connect.
Thus, Americans have been misled by the rhetoric about choice. In contrast with the single-payer option, a system with multiple private insurers would continue to restrict one dimension of choice (selection of physicians) and perpetuate a choice most people would consider irrational (wasteful spending on administrative overhead).
Dr. Brett proceeds to dismiss arguments about the uniqueness of these American values.
What is relevant is whether a solution works, not whether it is unique. Indeed, the aspect of the current U.S. system that is truly unique among developed countries is its failure to cover everyone — hardly something to brag about.
Discussions dominated by references to uniquely American individualism, uniquely American solutions, or narrowly defined conceptions of choice tell us more about the political and economic interests of the discussants than about the interests of the Americans they claim to represent.
With all do respect to Dr. Brett’s compelling arguments, I don’t see Democratic politicians pulling out their Dr. Brett cheat sheet when they talk about health care in the same way the way Republicans read from Frank Luntz’s play book.
Is a single payer system “Socialist”?
In addition to playing on the words, “unique” and “American” to pluck the emotional chords of Americans, the protectors of special interests fall back on the historically successful fear mongering comparisons to European “socialism”.
I am presently reading a book about the German health care system.
The book traces the historical origins of the present system to the concern of the churches in the Middle Ages for the poor and the sick.
Don’t some of these same people go to church who are trying to derail health care for everyone? What are they hearing from their pulpits?
The book does highlight a peculiarly different emphasis on values. In 1792, while Americans were just beginning their experiment with a new constitution, the German state of Prussia adopted its body of laws that made it the responsibility of the state to look after the needs of the poor and the sick. Historians will never confuse Prussia with a socialist state. And this was almost 40 years before the birth of Karl Marx and almost 60 years before the Communist Manifesto.
A positive view of a single payer system
Another writer, Roger Newell, wrote an opinion piece for the Oregonian, reproduced in the E-zine, Truthout, describing his experience living in England with their National health Service.
He paints a positive view of the system and its effect on him, his family, and the people he worked with.
As a working pastor in that culture for eight years, it’s hard for me to express to Americans how good it felt to know that everyone in my church (and in my city, for that matter) received quality health care, whether rich or poor, over-employed, underemployed or unemployed. It gave us a sense of mutual support that cut across class distinctions, economic levels and religious differences. In over a decade I never met anyone – not a doctor, a nurse, a young person or someone elderly – who envied the American system.
Progressives need to stop being defensive.
Read the preamble to the U.S. Constitution
We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.
A single payer health care system would certainly
Form a more perfect union
Establish justice
Insure domestic tranquility
And secure the blessings of liberty to ourselves and our posterity.
There is nothing un-American in that.
I could even make an argument that health care provides for the common defense.
Many others have argued that if government sponsored health care is socialism, then so are our schools, our military, our police and fire protection. It doesn’t make sense. But the foot draggers won’t let logic get in their way.
It is time we heeded the words of Patrick Henry, “If this be treason make the most of it!”
