Over at the Hasting Center’s new “Values and Health Reform Connection,” blog Joanne Kenen’s candid post, “Honest Debate, and Candid Solutions” caught my eye. I recommend it to HealthBeat readers.  (Kenen writes The  New America Foundation’s “New Health Dialogue Blog.") Below, an excerpt:

“Liberty. Justice, Responsibility, Solidarity.

“These are some of the American Values highlighted in the Hastings Center’s report on Connecting American Values with Health Reform.

“Watching health reform unfold here in Washington, however, that ‘Connection’ is painfully elusive.  The debate is not a careful calibration of competing rights, values and obligations. It’s a political moshpit. Instead of values, we have vitriol.

“Outside of Washington, even extremely astute people ask me why we can’t fix a health care system that is inefficient, inequitable and downright inexplicable.

“I patiently explain that this fight is not purely about policy (or values). Health policy becomes a gritty proxy for politics.

“Values, or at least ideology – particularly about the size and reach of government – play a role in politics. But an awful lot of what passes for policy debate is trench warfare before the next election.  Look at the list of amendments proposed for any of the major bills – and ask yourself how many are meant to improve the health and well-being of the American people and the American economy, and how many are meant to score points, woo donors, placate interest groups and create a C-Span moment.” [my emphasis]

To read the rest of Kenen’s essay, click here.

The Hastings Center, a nonpartisan bioethics research institute, recently asked me to write an essay to help launch their new group blog, The Values and Health Reform Connection. The website focuses on American values, and why they matter to health care reform.  Here is the link to the blog. 

Below, an excerpt from the piece that I wrote:

“While many speak of health care as an individual ‘right,’ I prefer to think of universal coverage as something that we, as a civilized nation, desire for all members of our society because we recognize each other as equally human, vulnerable, and in need of care.

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When I reported on the waste in Medicare Advantage plans not long ago, HealthBeat reader Don Grunt pointed out that not all MA plans are alike. He wrote: “I'm a Medicare Advantage product manager in Oregon where 45% of beneficiaries sign up for MA plans (highest in the country) because we offer good plans and the competitive market keeps us honest.  So I don't work in Miami or any of the wild west of MA plans.”

Oregon is one of those states that belongs to what I like to call “Canada South” (a region that includes part of the Northwest as well as the northern tip of New England–Vermont, New Hampshire and Maine). These are states where medicine seems less “money-driven,” and by and large, patients get better value for their health care dollars. In many of these states, care is more collaborative. It struck me that Don Grunt, who knows the MA system from the inside, was probably right.

I kept his remarks in mind when I wrote a piece for the Washington Post’s “HealthCare Rx” last week. (I am part of the “HealthCare Rx” standing panel, a group that spans a spectrum of opinion, ranging from Ezra Klein to Newt Gingrich. Each week, Rachel Saslow, the Rx editor, poses a question.  Last week’s query: “The Senate Finance Committee is debating a bill that would trim $113 billion from the privately-run Medicare Advantage plans over the next decade, a move that proponents say will bring its funding in line with traditional Medicare coverage. Do you think such a move will hurt beneficiaries?”

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Over at TNR, special correspondent Thomas B. Edsall raises
provocative questions about the coalition of wealthy and poor that
elected Obama.  Will they stand together?  Below, excerpts from his
post, and my comments:

“The health care debate has exposed the
ideological tension in Barack Obama’s political coalition between
moderates and liberals. But it has also offered hints of how another,
less obvious divide built into the Democratic majority could wreak
havoc on the administration during the years to come.

“In 2008, the Democratic Party blossomed into a successful alliance
of the upscale and the downscale–wealthy and needy marching hand in
hand, sharing animosity to George W. Bush and the war in Iraq. The
extent to which Democrats are relying on the far extremes of the income
spectrum is striking. Democrats have generally performed well among
low-income voters in the past, but now, the phenomenon has become more
pronounced. Voters from households making less than $30,000 backed
Obama by 31 points last November. That margin was 13 points higher than
Jimmy Carter’s advantage over Gerald Ford with poor voters in 1976–and
21 points better than Walter Mondale’s advantage among the same
demographic in 1984.

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