I welcome guest writer Rev. Ted Tollefson . . .
The “Golden Triangle” of Health-Care Reform
Rev. Ted Tollefson, Unitarian Universalist Society of River Falls, WI
With gratitude and respect to my political mentors, Ted Kennedy and Ronald Reagan
When we were building our house 19 years ago, friends introduced us to the “Golden Triangle”of construction: Cost, Quality and Time. We were told that two out of three was good construction; three out of three was extraordinary. They were right. Our project was completed one day early, under budget, with a few minor problems with our decks. I believe that a similar standard can be applied to Health Care Reform. The Golden Triangle of Health care Reform is Cost, Quality and Coverage. A really excellent system would provide affordable, quality health-care for all Americans.
Though many of us would like to believe that America has the best health care in the world for patriotic reasons, the facts tell a different story. We spend more than any country in the world, rank 37th in quality outcomes according to the World Health Organization, and still fail to cover 29 - 46 million Americans. For a nation that prides itself on leadership and innovation, that is an embarrassing outcome. Japan, Taiwan, Germany, Switzerland, France and England spend less money, cover more people and produce better outcomes (life-expectancy, infant mortality....). By any measure, America has a long way to go to catch up. We are one of the few “civilized” nations where every year thousands of our neighbors are driven into bankruptcy by outrageous medical expenses. [source: T.R. Reid, Sick Around the World]
The interesting thing about a triangle is that all three sides are connected and each is necessary. Applied to health-care, this means that we can start with any side of the triangle and have something constructive to offer. Dr. Denis Cortez of the Mayo Clinic has pointed to the connection between Cost and Quality. Too often, we are paying for multiple procedures not positive outcomes. Some hospitals may be tempted to do medically questionable procedures to generate more income and protect themselves against medical malpractice suits. Cost and Coverage are also connected. Americans who have health insurance are donating at least $1000 per year to subsidize the uninsured who seek routine medical care in higher cost Emergency Rooms. Again, we are paying too much and getting too little. Quality and Coverage are connected because the under-insured or uninsured may delay treatment until major, expensive interventions are required.
Behind the health-care debate about tangible factors, there is an equally important moral debate. Those who vote Red/Republican can be powerful advocates for the value of self-reliance. They point out that there are many things that informed and disciplined citizens can do to improve their health at little cost: drink less, quit smoking, exercise more, reduce obesity. Those who vote Blue/Democratic can be equally powerful advocates for the value of mutual responsibility. Because our lives are so deeply intertwined, we can never avoid shared responsibilities. When we skip flu vaccinations, we may risk infecting those who are especially vulnerable: young, old, and those with immune deficiencies.
The rarely noticed irony of this debate is that when the Republican party champions “self-reliance”, it carries forward a theme which Reagan gleaned from the writings of the American Unitarian Ralph Waldo Emerson. When the Democratic party testifies to shared responsibility, it stands on the Golden Rule and the breath-taking moral clarity of Jesus who declares that when we minister to the “least among us” we are ministering to Him (Matthew 25). Health and holiness require a balance between self-reliance and mutual responsibility, care of self and care of others.
Our political parties, our moral philosophies need each other and complement one another. Working together, we can indeed form a “more perfect union”. If the debate about health-care is framed by equal respect for the “Red” truth of self-reliance and the “Blue” truth of caring for others, if we look for the inter-connections between Cost, Quality and Coverage, our health-care system will improve. It's not in our national character to settle for the 37th best health care system in the world! We can do better, and if informed speech is guided by respectful listening and learning then, by God, we will.
Blessed are the peace-makers
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