If your family’s like mine, your holidays have been marked by some tense conversations about politics, especially health insurance.
And if your knowledge of health insurance is like mine (incomplete), this conversation probably devolved into an argument leading … nowhere. After all, everyone has an opinion about everything; but no one has a clue about anything.
In a democracy, that’s a problem.
Part of the issue is that almost no one likes their health insurance. Americans pay more than others for basic operations, are burdened by high prescription drug prices, and are living at a time when health outcomes are stagnant at best. Worse for many Americans, health insurance is actually costing more than it is saving due to ridiculously high deductibles, premiums, incidentals, and unexpected, opaque billing.
What can be done? For an analysis smarter than what you’ll hear from CNN or MSNBC (and much smarter than anything you’ll hear from Fox), I can happily recommend a brave new book by Professor Christopher T. Robertson of Arizona Law School.
Published by Harvard University Press, the book — Exposed: Why Our Health Insurance Is Incomplete and What Can Be Done about It — is useful precisely because Robertson isn’t a talking head. He doesn’t dumb the issues down, he doesn’t have an agenda, and he trusts readers’ intelligence.
This dyad — dissecting complicated issues (1) intelligently but (2) without needless jargon — is what makes Exposed an essential addition to the literature, while also ensuring it isn’t inaccessible to the reading public. Robertson explains why Americans are dissatisfied with their health insurance and uses that as a jumping off point to brainstorm potential solutions.
In addition to being refreshingly readable, the book has the additional advantage of drawing on Robertson’s expertise to synthesize insights from medicine, public policy, law, philosophy, economics, political science, and ethics. This results in an argument that is all too rare in modern America, one short on sophistry and long on nuanced insight.
This synthesis yields a deeply nonpartisan argument. The professor’s recommendations for reform aren’t results of reflexive partisanship or (worse) economic self-interest; rather, they result from ethical considerations concerning not only the state of American health insurance, but also traditional economic arguments against reform — for example, arguments centered around the bipartisan idea that cost exposure is an essential element of any healthcare system.
Put simply, Robertson argues that the consensus that health insurance coverage should always be incomplete has a dark side. Although Democrats and Republicans alike expect patients to bear a portion of health care costs through coinsurance, co-payments, and deductibles, this strategy causes widespread illness-causing anxiety while driving patients in foreclosure and bankruptcy. If cost exposure remains the primary lens guiding health insurance policy, then providers must be held legally responsible for communicating costs to patients and insurance companies must scale the amount of cost exposure to each individual’s purchase power.
So, if you want to follow-up with your angry uncle, do yourself a favor and drop the anger for a good-faith search for common ground. Check out Professor Robertson’s book. If you don’t work in public policy, law, or medicine, you will have to consume more carefully than you would read your morning news. But that’s a good thing; health insurance isn’t simple. It’s a complex issue requiring firm grounding in data before one can even begin thinking about solutions. And that latter question — “how” — in turn requires Professor Robertson’s expertise on philosophy and ethics. Sure, as David Hume famously noted, one cannot get an “ought” from an “is.” But one can at least know enough about what the “is” is before forming one’s opinion on the “ought.”
In this period of turbulent partisanship and rampant misinformation, Professor Robertson’s smart book is a much-needed breath of fresh air. The best thing any of us can do is to get informed — not misinformed by talking heads with no clue about the issues, but by thinking heads like that sitting on Professor Robertson’s shoulders.
Do yourself and your country a favor; become a better citizen. Learn. Let’s move forward together.
Author’s Note: Professor Christopher T. Robertson is Associate Dean for Research and Innovation and Professor of Law at the University of Arizona. He also teaches at the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. Robertson’s articles have been published in leading outlets like the New England Journal of Medicine and featured in the Wall Street Journal, the Washington Post, NBC News, and National Public Radio. For more on his book, click here.
Previously Published on Medium