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I would not presume to say I know all the assumptions in the Health Care Debate. I do, however, notice that health care reform has started to look like a verbal hacky sack and as each side takes their turn kicking the issue around they fail to notice that this matter is stuffed with assumptions.

 

To understand the problems with Health Care Reform we need to note the assumptions and turn them into questions and then move forward based upon the answers. 

 

One liberal assumption is that everyone deserves health care. It seems like some liberals just assume that we all are on the same page, that we all see access to health care as a problem and that we all want to fix it so that people who can’t get health care services will get health care services. When we turn this liberal assumption into a question, we get something like this:

 

Question: Does every human being have a right to health care services even if they can’t afford it?

 

A Conservative Answer: No. No one has a right to anything just because he or she exists. If you work and earn money it is your money. No one has a right to take your money away from you and spend it on someone else’s health care. If the person with earned wealth wants to give some of his or her money away to help less fortunate folk, that’s their right, that’s their business, and that is voluntary charity.

 

A liberal might answer it more like this: Yes, everyone has a right to health care services, and if they can’t afford it then those who earn to the point they have large reserves of wealth should be required to contribute to paying the cost for health care for these less fortunate folk.

 

A Conservative Counter Might Be: No. If it is your money, if you earned it, then it belongs to you. If the government can just take it then the government is just an institutionalized robber, with agents that carry guns, and has the power to fine you, arrest you, shoot you, and/or kill you if you refuse to give them the money they demand. If people WANT to help less fortunate people then they can do that voluntarily, through charities and philanthropy.

 

A Liberal Response: If the poor, the sick, the people with incredibly bad luck, the victims of violence,  accidents, or illness need help what are they supposed to do?

 

A Conservative Response: Churches can, should, and do step forward to help the less fortunate.

 

A Liberal Reaction: And what if the Churches don’t respond? 

 

 

Conservatives: Yes, it is sad, but a lot of these unfortunates are unfortunate because they are too lazy and too dumb to get off their fat poverty laden butts and get jobs. Why should people who have initiative and talent and work hard to create wealth be penalized and have their hard earned money redistributed to losers. And really, why should I pay for the health care of people who smoke, have unprotected sex, eat diets high in saturated trans-fats, and never ever exercise?

 

Liberals: So you are saying we have no obligation to our fellow man, it’s every man for himself?

Conservative: Yeah!

 

Liberal: What about children. Do we let disabled children die? If there are children unlucky enough to be born to poor losers (and there are hundreds of thousands of such children) should we just let them starve, go without education, allow them to live without medical attention, and let them run naked in the streets as they forage through our garbage bins for food?

 

The Conservatives are not on the same page when it comes to children. Some Republicans would make some provisions for children, but not for their parents. Some would make some exceptions and allow for some government assistance to the most vulnerable in our society. Others would go for a tough love approach. “You coddle these losers,” they might say, “and they have no motivation for getting off their lard-asses and trying to better themselves. The losers of society will take a government safety net and turn it into a hammock. If there is no safety net, there will be fewer lazy non-contributing bums in society. If we let losers starve, or get sick and eventually die then smarter, more motivated, talented, productive people will be left!” 

 

Obviously I’m debating with myself here, imagining conservative positions. I’m creating a conservative straw man and then attempting to beat the stuffing out of him. It is not fair. It is not fair unless my guesses about conservative opinions are close to the truth.

 

When I look at the health reform debate, I look at the assumption behind the rhetoric.  Liberals assume that we all agree that human beings, especially humans who are citizens of the richest nation on earth, have a right to health care services. If liberals have this assumption, they are very, very wrong. Many conservatives do not share in this assumption. If conservatives feel that health care belongs to those of substance, wealth, and privilege then they have nothing in common with progressives. If conservative believe that poor people, unlucky people, disabled and disadvantaged people have no automatic right to free health care then talking with liberals is going to be a futile effort, and a frustrating waste of time.  because there is no place for compromise in these two positions.

 

I once worked as a contract negotiator for teachers and school support staff. Often it was very difficult to find places where compromise was feasible. To compromise you have to look at the other side and try to find places where your interest is similar to their interest. Sometimes you look for things that you want, but you are willing to give up, in order to gain something else. Like little kids we are going “I’ll do this, if you do that.” Both sides give up something, and both sides gain something. Sometimes the parties in a negotiation are too far apart. Sometimes one side’s goals are diametrically opposed to the goals of the other side. Sometimes what one side wants is exactly what the other side does not want. When this happened in contract bargaining the teachers would declare impasse. Impasse meant that there was no area of shared interest that each side was dug-in, their goal was a line in the sand, a bottom line, there was no wiggle room, the deal on the table was a final offer, a deal breaker demand, a last best offer

 

My fear is that this is exactly the position we are in now. There is no overlap in the position of liberals and conservatives. There is no wiggle room. One side wants health care for everyone, and believes access to health care is a human right, while the other side feels like the only right is the right to keep what you earn even when others around you are suffering and dying.