Dreaming about the State of the Union

MB Lewis

MB Lewis

I watched all 70 minutes of President Obama’s address Wednesday, plus the Republican response. I tuned in shortly after I logged off  my SPH online class discussion on the U.S. health care system.  So it’s no surprise that I dreamed last night about being in D.C. and talking health reform in its hallowed halls. Class this week was devoted to values, and Professor Rich Lichtenstein was a masterful devil’s advocate as he provoked us on the hard questions: Is health care a right, even for people who aren’t working? If so, who should pay for it? Should the government require individuals to get health insurance or else fine them through IRS?

“Most health policies start with a values position,” he said. Avedis Donabedian did groundbreaking work on the topic when he taught at UM SPH, and it’s as pertinent today as ever before.

Our distance learning class in the Certificate in the Foundations of Public Health had weighed in slightly more conservatively than the daytime SPH class on whether individuals or government bear responsibility for health care. Perhaps that’s because we’re older than the residential students. Many of my 25 classmates work  in medicine, social work, research, and education (one is an emergency worker, now  in Haiti). Many say they’re taking the class to find out how the complex U.S. health care system works. They know their piece, but not the big picture.

We’re getting the big picture in class, and it’s scary. The system of largely employer-funded insurance  is not sustainable. If Starbucks spends more on employee health than on coffee, and GM spends more on it per car than on steel, how can our economy thrive? And imagine how much more costly government programs like Medicare will become as baby boomers age.

I didn’t mention how often President Obama and the Republican respondent used the words “values” and “freedom” in their speeches. I noticed it though. And I have a better understanding of why.

PS: See the public letter that 3 more UM SPH professors signed urging health care reform.

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