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Annoying People

The only thing more annoying than someone who has discovered the truth is the person who discovers it and then feels compelled to tell you what it is.

In the health care reform debate, this covers both the single-payer zealots and the market-as-religion crowd.

The single-payer crowd can be especially annoying. At a recent meeting on the subject of practical steps to take in increasing the rate of health insurance coverage in Arizona, a few vocal people derided any suggestion that wasn't part of their single-payer model as inefficient, ineffective or just plain stupid. In response to the observation that a single-payer model was politically dead in a state like Arizona, they haughtily replied that most people didn't have a clue about the true nature and complexities of America's fractured health care system, and what we should all be about is to lift this public veil of ignorance and educate them on the virtues of a Medicare-for-all approach. Once they saw how clear and rational it was, they would sign on immediately.

Worshippers in the Church of Free Markets are equally annoying. In their eyes, these single-payer believers are all socialists. They are enemies of individual liberty and freedom, and would constrict your choice to have the health care you want with layer upon layer of bureaucratic rigidity. Americans don't want Big Government telling them what to do. They want and deserve individualized plans, lots of choices in providers and services, market-driven innovation and advanced technology, and on-demand care. Only a free market and private enterprise can deliver this.

Of course, Americans want all this but don't want to pay for it themselves. But that's a minor point.

It's not the positions themselves that are annoying. There are good arguments to make for both single-payer and market-based approaches. What's annoying is the holier-than-thou attitude of advocates who broker no disagreement with their tenets. Like ideologues everywhere, they are fixed in the certainty of the true nature of things. It's the rest of us who are delusional or can't grasp the basic facts.

True believers are incapable of holding two or more contrary thoughts at once, thus denying themselves the pleasure of uncertainty and its attendant possibilities of discovery. For example, why not advocate for a health care system that is both single-payer and market-driven? Something like Medicare Part A could be single-payer, where every citizen is automatically enrolled from cradle to death, and risks for expensive care are spread equitably across one large pool. Something like Medicare Part B could then be market-based, with day-to-day outpatient and preventive care available through a wide variety of individualized plans, and premium subsidies based on ability to pay.

Exactly how this might work is a topic for another time. The point is that this sort of combination position, and many other divergent approaches to health care reform, are hidden from view in the dazzling light of ideological clarity, which blinds the beholder from seeing what lies in the shadows.

It's too bad, because people live in the shadows, not the light. It is in the movement from shadows to light that hope and innovation come alive. We are destined to seek the truth, not to find it.

And if some of us think we've found the truth, at the very least we should have the good manners not to pester everyone we meet with an endless recitation of what it is, and what they are missing.

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*The Drift reflects the views of the author, and does not represent the official view of SLHI's Board of Trustees and staff.