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In regard to the first of these, the Senate health care reform bill,  Atul Gawande writes, in the New Yorker of April 5, “The major engine of opposition remains the insistence that health-care reform is unaffordable….In 1965, health care consumed just six per cent of U.S. economic output; today, the figure is eighteen per cent.

“[Health care] costs are curtailing all other investments in the economy, and, if they continue to rise as they have been doing—twice as fast as inflation—the reform’s subsidies, not to mention America’s prosperity, will indeed prove unsustainable.”

Are the Tea Partiers right? Should we all be opposed to the Senate Bill? Gawande would say no. Why? He points out that the Bill recognizes what is driving costs up, —a system that pays for the quantity rather than the value of care,—and agrees that this can’t continue without undoing the country’s prosperity.

But, he says, the same Bill has within it the power to change the cost equation. Furthermore, without the Bill, or something like it, health care costs will continue their steep rise.

For the Bill, he says, replaces the present emphasis on quantity of care, that which is most of all driving costs up, on value, and on the quality of care eventually driving out quantity and the associated high costs.

And to this end the Bill creates a new Center for Medicare and Medicaid Innovation that will permit communities and local health systems to promote value, by experimenting on their own with ways to deliver better care at lower costs.  You’d have thought that the Tea Partiers, most of all, would have recognized this.

So that “far from being a government takeover,” the health care reform Bill “counts on local communities and clinicians for success.”

Gawande admits that the assumption that communities and clinicians, that individuals, all at the local level will do the right thing, is a bit “scary,” but at the same time isn’t it common sense that only at the local level, where health decisions are made, or should be made, by individuals and their doctors, can the costs of care be lowered?

What then about the libertarian refusal to accept the evidence for global warming? Why is this? Robert Crease writing in the Wall Street Journal about this year’s annual “Gathering” in honor of Martin Gardner, the author of Scientific American’s “Mathematical Games” column, suggests the reason for this. He says,

“Mr. Gardner’s fans include psychologists and cognition researchers interested in discovering why people regularly and seemingly inexorably fall victim to optical illusions, faulty logic and pseudoscience. … Al Seckel, a former Caltech cognitive neuroscientist, used sensory illusions to demonstrate how humans “map” incoming information to support pre-existing organizational perceptual frameworks, even if the incoming information is contradictory or false.

“As an example, Mr. Seckel noted that global-warming skeptics who lack training in science yet appear to argue on a ‘technical level’ tend to be libertarians. If global warming is correct, that suggests large-scale governmental regulation is needed, contrary to the core beliefs of a libertarian. ‘It is easier for a libertarian to attack the science of global warming,’ Mr. Seckel said, ‘than to alter one’s core libertarian beliefs.’

Here again, isn’t it common sense that one often attacks, be it the government takeover of health care or the theory of global warming, that which is at odds with one’s core beliefs, even when the evidence for it, say in the case of global warming, is widely accepted by the scientific community?

For the libertarian to accept global warming (no less than for the Tea Partier to accept the Senate health Bill) would be to accept a dominant role for government, because global warming, if it is in fact a threat, can only be adequately countered, if at all, by world wide government action, anathema probably to Tea Partier and libertarian alike.

This entry was posted on April 2, 2010 at 9:18 am and is filed under Current Affairs. You can subscribe via RSS 2.0 feed to this post's comments. You can comment below, or link to this permanent URL from your own site.