Your turn on health care reform

"You are entitled to your opinion. But you are not entitled to your own facts."

— Former Senator Daniel Patrick Moynihan

With July behind us, the most intense heat this summer might come from town hall meetings on health care. Members of Congress are getting angry earfuls from folks attacking any mention of a "public option" (funded in part — some say almost completely — by the private insurance industry), and we're getting a taste on this column's readers forum. One reader skewered my case (June 27) that what's truly radical is a medical status quo that has us spending twice as much per capita as any other country (and three to four times more than most advanced countries) in return for crummy-to-mediocre health outcomes and up to 10 times more paper-shuffling costs than other systems, while stockholders who are doing nothing to improve anyone's health drain billions out of the system and CEOs pull down seven- and eight-figure bonuses for finding new ways to deny patient claims.

No, said the commenter, what's radical is the notion of a bigger government role in health care. "We're supposed to turn over a new business to a bunch of people that can't even do their own job? "¦ Who, in their right mind, can see any outcome other than the government destroying the best health care system on the planet?" Well, most older Americans, for starters, who in Medicare have pretty much the notorious single-payer system (where the government processes and pays all insurance claims and patients are free to choose the physicians, nurses, hospitals and treatments they want). Pollsters tell us seniors are dramatically more satisfied with this arrangement than other Americans are with for-profit health insurance. So are massive majorities in almost every other affluent nation, where government is either the sole or dominant insurer (those boiler-plate horror stories about long lines deserve major skepticism — in some cases they're outright lies, and most of the others neglect to mention that private supplemental insurance, much like ours, is available for services above and beyond a publicly insured package for basic needs). But single-payer, which people in other countries consistently report liking more than we like our system, is "off the table" in the current debate, probably because of the kind of passion illustrated in a response to last week's column:

"From the hundreds of thousands, maybe even millions, of private sector jobs that would be lost, to the loss of coverage senior citizens will receive, with government officials making decisions on the value of their lives, to government controlling family planning, journalists should be filling the papers and flooding the airwaves with the devastation the health care package would reek [sic], yet all we hear from them is the echoes of President Obama's lies... So not only would Americans no longer be able to insure themselves and their families against catastrophe, the millions working in the insurance business would be out of work." Okay. I read here four key points. The first — preserving existing jobs no matter what their intrinsic value — is strange coming from conservatives, who fought tooth-and-nail against the recent bailouts that saved plenty of auto-worker jobs. If first priority goes to holding today's jobs harmless no matter what, how can we solve any big problem?

The writer's other three points, according to all available coverage that doesn't come from the health insurance industry or a Republican Party publicly relishing this chance to "break Obama," have not the slimmest connection to reality.

Now, I don't expect to convert readers with this or any other column. I understand there's a mighty divide, bigger than this one issue, that I can't bridge. It lies between those scorning huge corporations pledged to maximizing profit to their shareholders under all circumstances, and those scorning government they see as addicted to power for its own sake. But unless we're ready to wholly give up the ideal of representative democracy, we damn well better hold ourselves and others to higher standards of accuracy. (And this doesn't all run in one direction: The president also ignores the truth with suggestions that his plan will bring down costs, unless it takes on the staggering inefficiency of the private claims system, the profits diverted to non-producing investors, the fortune spent on high-tech maneuvers to postpone death a few weeks or months and our propensity to take our sniffles to the doctor because "my insurance will cover it.")

One more premise calls us to come together across the big ideological divide: protection of the right of citizens (and members of Congress, for that matter) to speak their mind at these town halls. Watching public option advocates shouted into silence this week reminded me of the screaming crowds who frightened Florida officials into suspending the 2000 presidential vote recount at a crucial moment.

And remember how well that one worked out for us.

Jeff Golden is the author of "Forest Blood," "As If We Were Grownups" and the novel "Unafraid" (with excerpts available at

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