The health-care diagnosis is clear, the treatment less so

So, we went ahead and did it.

A liberal and a conservative talked health care for two hours in front of a crowd of about 300 people.

And no one killed each other. No eyes were gouged or bones broken. In fact, hairs barely even got mussed.

The time was last Thursday. The place was the soaring, Frank Lloyd Wright-designed sanctuary of Beth Sholom synagogue in Elkins Park. The event was the first Bernard Wolfman Civil Discourse Project.

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Despite the lack of the rhetorical fisticuffs, most of the audience stayed attentively to the end.

The liberal was David Nash of Thomas Jefferson University. He’s a fan of the Affordable Care Act who sees universal access as a doable goal. The conservative was Stuart Butler of the Heritage Foundation. His Washington think tank has been an intellectual engine of the conservative movement for decades.

I got to moderate the discussion.

Here’s one striking thing I found out: These two hypereducated gentlemen, who definitely did not cast the same ballot for president last November, pretty much agree on some big points. Like core values of the health system. Like a diagnosis of what currently ails it.

They agree that right now we’re getting mediocre results from a system that costs way too much, that wastes money that should go to other legitimate societal goals.

They agree the system is riddled by perverse incentives, dubious practices and a lack of transparency. They agreed that until ordinary people can gain some reliable clue about the actual cost of the health care they receive, the unsustainable cost spiral will continue.

‘The disease business’

They agree that, as Nash put it, hospitals aren’t in the health business, they are in the disease business. In other words, too little prevention, and too many procedures done simply because some sucker will pay for them.

In fact, Nash and Butler agreed on so much at one point that, civility be darned, I implored them to talk more about where they disagree.

And that comes down to this: Nash thinks government should take the whip hand in fixing those problems; he thinks markets have failed at the job. Butler thinks the opposite: To him, government has clearly messed the bed, while the authentic marketplace solutions he favors have barely been tried.

Not a surprise, that traditional philosophical split — but not the venomous, misleading war of words we’ve seen over Obamacare.

My favorite moment came during a discussion of the costs of ill-advised end-of-life care, Butler said how he appalled he was to see colleagues of his embracing the phony, demagogic phrase “death panels” to blast Obama’s attempt to deal with the problem.

Nash, for his part, acknowledged that the way the Obama administration has fumbled its hyped electronic health records initiative gives him pause in arguing that government is the solution here.

No one left as a convert to the other side’s views. That wasn’t the goal.

But many learned that, beneath the shouting, scholars who really grasp the issue share a lot of common ground.

All in all, not a bad night’s work. 

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