Thinking through health care reform: a compilation of diverse perspectives

When it comes to health care, people can have very strong opinions. Conversations can get heated and personal. Understandably so; we are talking about something that directly and inevitably affects us, our families, and all Americans. No one, after all, is safe from illness.

From my discussions with others, Ive found there are two basic routes to a strong conclusion. One is by gathering as much evidence as possible, from as many angles as possible, and reasoning throughideas with a critical eye to form a decision. The other is by having a conclusion in mind first and then looking, after the fact, for evidence to support it.

In the second case, where might those preconceived conclusions come from? Perhaps they are based on what group a person identifies with: Im a Democrat, and most Democrats support the reform, so I probably do, too, or Im a registered Republican, so Ill probably think Obamacare is a bad idea. Or, maybe everyone around you tends to believe one thing. Or, maybe a person whose knowledge you generally trust believes something, and its easier to listen to one person who has already worked it all out.

Compounding the problem is that people have a natural tendency to surround themselves with friends, coworkers, and news sources that largely confirm, rather than dispute, what they already believe. Its simply more pleasant to interact with someone who agrees with you.

While the two routes are not so black and white, I do think its all too easy to fall into the second type of reasoning. And its much more difficult to come to a new conclusion if youre cornered by everyone chirping in unison.

So, I decided to compile my selections for the some of the most clear, thoughtful, and diverse pieces about theSupreme Courtruling and its implications Ive come across. Taken alone, each is insightful and well-written. Taken together, they portray health care reform issues from valuably distinct perspectives. I hope youll give them a read, and that youll power through the ones that dont immediately resonate with your political instincts.

Because the Internet is a vast, vast space, and its hard to triage.

Something Wicked This Way Comes, by Atul Gawande, published in the New Yorker. Gawande takes a step back and captures the uncertainty in any health reform initiative an inherently complex and wicked problem in which Trade-offs are unavoidable. Unanticipated complications and benefits are both common. And opportunities to learn by trial and error are limited. No step forward will be perfect, Gawande reminds us, but taking no action comes with its own risks. All that leaders can do is weigh the possibilities as best they can and find a way forward.

Chief Justice Roberts and His Apologists, by John Yoo, published in the Wall Street Journal. Even though the Affordable Care Act was upheld, the reasoning behind the decision has been interpreted as a victory for fiscal conservatives, too. But the restrictions on congressional coercion may not be as significant as they appear, Yoo argues, with Chief Justice John Roberts not the hero for both sides some are making him out to be. Congress may not be able to directly force us to buy electric cars, eat organic kale, or replace oil heaters with solar panels. But if it enforces the mandates with a financial penalty then suddenly, thanks to Justice Robertss tortured reasoning in Sebelius, the mandate is transformed into a constitutional exercise of Congresss power to tax.

Unpopular Mandate, by Ezra Klein, published in the New Yorker. Two years ago, the odds that the individual mandate would be overturned were considered slim to none; yet a few days before the decision, experts predicted them at closer to fifty-fifty. Why did the Republican party change its opinion, making the clause they once supported the main target to oppose? Thats the question at hand, but to answer it, Klein expands beyond the Republican party into why people change their opinions and how in politics, on both sides, it has to do more with adhering to the beliefs of the group than rational reasoning. But parties, though based on a set of principles, arent disinterested teachers in search of truth, he writes. Theyre organized groups looking to increase their power. Or, as the psychologists would put it, their reasoning may be motivated by something other than accuracy.

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Thinking through health care reform: a compilation of diverse perspectives

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