Morality Play

Religion seems to get involved with health care, and I do not mean abortion. New America Foundation's New Health Dialogue reports that faith-based groups are going out to make the moral case for health reform.

Ezra Klein also points to how the opponents of health reform had in the past avoided morality, but now proponents too seem to avoid the moral issue. We talk instead of the need to cover people and prevent them from getting sick or dying in the terms of cost-benefit analysis, bending the curve, and quality adjusted life years (QALY).

This is not to say that QALY and other matters are not important. However, when it comes to health care we particularly have some problems addressing our moral problems. Perhaps it is a sense of system justification. We avoid talking about the moral failure of people who are uninsured or driven to bankruptcy because of underinsurance because we would rather think that they "deserved" it when they clearly do not. We feel uncomfortable with such immoral structures that we thus ignore and avoid speaking about it.

In many ways too, our lack of any moral element leads to a strangely stilted discussion, where our budgets become stand ins for morality and the politics that advance that. It is like one famous legal paper said about the death penalty. Once the Court made it a constitutional matter, it left the realm of the moral and became a legal standard. To this day the debate on the death penalty is shrouded in the words of deterrence, effectiveness, constitutionality, and budgets.

Our economic and budgetary outlook often does obscure those matters we do not like to discuss like morality. And, as the American Prospect blog states, cost-benefit analysis (CBA) and CBO scores shroud our political judgments in the cloak of scientific/wonkish objectiveness, when such a matter does not exist. Where are the legal realists when you need them?