Health Care Reform a More Complex Conversation Than 'Simplistic' Debate, Say Experts at Center for Ethics Panel
Amidst what Dr. Adrienne Asch called a 鈥渃acophony of claims and counter-claims鈥 in the political wrangling over America鈥檚 ailing health care system, the Center for Ethics at 91黑料 sponsored a seminar of straight talk on Oct. 5, titled 鈥淗ealth Care Reform: Ethics of Public Policy, Ethics of Public Debate.鈥
Held in the fully packed Jacob Burns Moot Court at YU鈥檚 Benjamin N. Cardozo School of Law, the seminar offered the opportunity to 鈥渟tep back and decide where wise policy should come from,鈥 said Asch, the Edward and Robin Milstein Professor of Bioethics and director of the Center for Ethics.
Thomas H. Murray, president of the Hastings Center, a nonpartisan bioethics research institute, called the national debate on health care 鈥渟implistic鈥 and advocated a 鈥渕ore complex conversation鈥 to include issues of justice, fairness, solidarity, quality, efficiency and stewardship.
Murray鈥檚 dismay was shared by three fellow panelists: Peter Barland, emeritus professor of medicine and pathology at YU鈥檚 Albert Einstein College of Medicine; health care economist Mary Ann Bailey, also of the Hastings Center; and Trudy Lieberman, director of the Health and Medicine Reporting Program at the City University of New York鈥檚 Graduate School of Journalism.
After citing some grim metrics鈥47 million Americans uninsured, another 40 million inadequately insured, one-half of personal bankruptcies caused by insurmountable medical bills鈥擝arland prescribed a cure somewhat beyond the parameters of pending legislation.
鈥淲e have to get doctors out of the fee-for-service mode,鈥 said Barland, who suggested a 鈥渕edical team approach鈥 as an alternative, modeled on Minnesota鈥檚 Mayo Clinic, where semi-salaried doctors 鈥渄o not profit from excessive tests [but are] judged by their peers on the quality of their care.鈥
Bailey said the soaring cost of private insurance is an ethical issue that militates against the wish of most Americans to be free from worry about health care. Such freedom, she said, is impossible within a current unmanaged system that provides erratic access and often quite low quality.
Innovation, Bailey maintained, 鈥渋s much better done as a cooperative enterprise than a competitive one.鈥 She said a nonprofit, single-payer system would be 鈥渢he best solution,鈥 but that some manner of government-backed competition for private payers was more likely to be achieved.
Lieberman accused all sides in the debate as being 鈥渄isingenuous鈥 at best. President Obama and advocacy groups, she said, are vague; Republicans engage in canards about socialism while Democrats parrot slogans invented by pollsters; and the media fail to note critical details, such as a lack of meaningful cost control in Congressional bills under consideration.
鈥淲hat will come out of the sausage mill,鈥 Lieberman said, 鈥渨ill be what the special interests want.鈥
Co-sponsors of the seminar were Wurzweiler School of Social Work; Benjamin N. Cardozo School of Law鈥檚 Program in Family Law, Policy and Bioethics; the Institute for Public Health Sciences; and the Yeshiva College Student Council.
