Surrounded by healthcare slippery slopes
Two bits of journalism caught my eye over the weekend, both for the wrong reasons.
The first, in my hometown Los Angeles Times, noted there is a "global" push for universal healthcare coverage. China, for example, may be working its citizens to death assembling iPads or clapping them in jails when they complain, but it also has spent $124 billion to guarantee healthcare coverage for 90 percent of its citizens. That's only about $150 per person to cover some 900 million citizens, but it also represents months worth of pay for most of its workers. So it's a start.
Thailand, Ghana and even Rwanda also have put together systems of coverage and care.
"As countries advance, they are realizing that creating universal healthcare systems is a necessity for long-term economic development," Julio Frenk, dean of Harvard University's School of Public Health, told the newspaper.
There is a plan on the table to extend healthcare coverage to about 95 percent of Americans. It's called the Patient Protection and Affordable Care Act (ACA). You may have heard of it.
About half of this country, including one of the presumptive presidential candidates, wants to repeal the ACA. By contrast, the Thai healthcare system survived a recent military coup, and I have to imagine a few of those guys were Republicans.
That brings me to the second piece of troubling journalism in the New York Times. It was penned by Richard Thaler, a professor of economics at the University of Chicago, not exactly a liberal redoubt. Thaler discussed the use of the "slippery slope" to support arguments. An example: Not eating your vegetables eventually leads to prison.
Thaler noted such arguments are flimsy, because they are difficult to back with empirical data. And, as anyone like myself who has taught college composition courses, the slippery slope is one of the many "fallacies" used to improperly support an argument in an essay.
"It is downright scary (a slippery slope argument) might play an important role in the Supreme Court decision on the new healthcare law," Thaler wrote. He noted that Justice Antonin Scalia used a slippery slope during oral arguments on the constitutionality of the ACA. In particular, his concern that leaving an individual mandate intact would eventually lead to everyone being compelled to eat broccoli. It's an absurd argument, but then again Scalia regularly inserts musical lyrics into his legal decisions.
Thaler called for a ban of the slippery slope argument. "If you are opposed to a policy, state your case based on the merits--not on the imagined risk of what else might happen down the road," he concluded.
An admirable argument. If we didn't live in a country bristling with slippery slopes, peppered with policymakers whose career momentum relies entirely on slippery slopes, it might even gain some traction.
As a healthcare executive, here are some good slippery slope question to ask yourselves: If the Supreme Court throws out ACA, what will become of your hospital's bottom line? What will happen to the overall health of your patients? - Ron (@FierceHealth)