Ideas Behind Health Care Policy Ignite Passions

Debates about health care are complicated, and it's easy to get overwhelmed when complicated things like premiums, block grants, state waivers, Medicaid and Medicare are the main topics.

But what are the ideas driving this debate? And why do debates get so heated when we're talking about something so technical?

To get some clarity about this topic, Michael Cannon, director of health policy studies at the libertarian Cato Institute, and Dr. Kavita Patel of the centrist Brookings Institution and a practicing primary care internist at Johns Hopkins Medicine spoke to Michel Martin on Weekend All Things Considered.

Interview highlights have been edited for clarity and length.

Interview Highlights

On health care as a human right vs. free market arguments

Cannon: It's not like we have one side that wants people to have health care and one side that doesn't want people to have health care. But the free market approach to this problem says, "Actually, a lot of the things that the government is doing to provide health care to people are preventing people from accessing health care." Because what markets do is they identify and they disseminate innovations that fill in the cracks in our health care sector so fewer people fall through — innovations that make health care better and more affordable — and when the government gets involved it causes those cracks to widen.

Patel: I think one of the ideas that's really at tension here is actually whether we believe health care is a human right. So you have people — I put myself in that category, a lot of physicians do as well — we think everyone should have access to health care. Now, there's a lot of details to that. What does that mean? Who pays for it? But we feel very strongly, and many do in this country, that there are basic rights that people are entitled to, and access to health care is a right that all people in this country deserve.

On the American Health Care Act that just passed the House

Cannon: I don't take positions on legislation, but Republicans have traditionally neglected health care as an issue. It's just not a Republican issue, and as a result they haven't been able to articulate why it is that their own principles would deliver better health care. What they've done here is, they've just tried to pass something that they can say is repeal, even if it doesn't repeal the Affordable Care Act. And in the process, they may actually be making the Affordable Care Act worse and setting themselves up for a lot of electoral defeats in 2018, which would then, I think, cause the pendulum to swing back in the direction of the Affordable Care Act or maybe even a single-payer system.

Patel: I'm definitely opposed to the legislation. We will not see premiums come down for everyone. In fact, we know that premiums will go up for people who are older or have chronic conditions. This isn't even repealing the Affordable Care Act. This is actually worse than what care was before.

On why politicians argue about health care so much

Patel: I think health care just touches on something that's so personal to everyone, and then this sense of, "You're taking away my hard-earned money and giving it to someone who doesn't care about their health, and that's wrong." That's tapping into something that's really basal.

Cannon: Health care is a very emotional issue because we rely on health care at the most vulnerable points in our life — and that's not just when we're sick, it's when a loved one is sick or a child is sick. If it appears that someone is trying to take health care away from you or from someone you love, you get a really strong fight-or-flight response from people. And usually it's a fight response.

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