THE BLOG

When It Comes to Healthcare, Be Selfish

09/12/2009 05:12 am ET | Updated May 25, 2011

I don't idealize a great many people that I've known, but Richard Maddy is an exception. A violin maker, legendary string instrument rebuilder, WWII paratrooper, and son of the founder of Interlochen Center for the Arts, I met Richard when we were both serving on the alumni board of the organization his father had founded. When the board would get bogged down in the minutiae and politics of whatever problem had wound its way around us, Richard was always there to remind us what we supposed to be doing. He would ask, in some form or another, "Is it good for the kids?"

Richard is gone now, but I would like to know what helpful highly focusing question he might pose to help us think clearly about health care, as the debate (this is a debate?) gets louder, and we tend to lose sight of our goals here. Certainly one of Richard's questions is helpful -- "Is this good for our children?" But that question only gets to part of those affected. After all, this is about all of us, as individuals, as parents, as children, and as members of our local and national communities.

What simple and powerful questions can we agree on that will help us know when we've come up with the best possible solution to designing a health care system for America?

Those who are afraid that their Medicare might be taken away or compromised might want to ask the question, "Will Medicare be left alone?" Those who have health insurance but don't want to pay additional taxes for anyone else's healthcare might want to test any new plan by that threshold. Public health officials might want to ask how any new plan will affect the nation's ability to deal with a biological attack or a natural pathogen-caused pandemic. We could add to the list of who should be asking these questions of self-interest, parents, college-age students, those without coverage at the moment, and other people who are concerned about how they will be affected.

The above groups of people, taken as a whole, are likely to ask questions and be satisfied with answers that reflect their self- or community health-interest. Some of these people will be focused on the greater good. Some will be focused on their immediate, one could say, more selfish interests. But whether enlightened self-interest or not, this would be the American people asking the questions that count.

Did I leave some groups out? Yes, indeed. I realize that the healthcare industry also has questions. Will be this be good for insurance companies? Will any change be good for hospitals? Will drug companies be able to set their own prices? What will be the impact on healthcare providers? And I would answer, I don't think their questions are as important. Acting in our (the people's) self-interest, we all want doctors to be happy, not overworked, and well-paid. We want hospitals to be efficient and clean, fully staffed, and pleasant places of nurture and recovery.

I'm willing to take it on faith that the pharmaceuticals, the insurance companies, the hospitals, and even the doctors, are going to take care of themselves. So when Big Pharma promises to take an $80 billion haircut out of the goodness of their hearts, or Karen Ignagni, lobbyist and spokesperson for the insurers says that now they're going to stop denying coverage for "pre-existing conditions," I think, thanks, Big Pharma. And thanks Karen, but I'm not all that into what you have to say right now. It's a little late. What I do care about is that the National Academy of Sciences is reporting that 20,000 American's die each year because they can't get the healthcare they need.

And I am haunted by Oscar Wilde's observation that, "America is the only country that went from barbarism to decadence without creating a civilization in-between." I had always hoped we could avoid that curse. Maybe this is when we get our chance.

So when I see talking heads, "experts," and politicians talking about healthcare, I want them to answer the people's, and only the people's questions -- "How will this change be good for me?" I want the people to be heard and answered, even though our questions might seem a little selfish. Make most of us happy, and just maybe, together, we can create something we could fairly call civilization.