Heath care is an ethical question

Health care is very much a question about ethics as well as values. Values are about who benefits, or 'which team wins'. Ethics are about who decides, or 'what are the rules and referees'. If heath decisions and choices are more multilateral and answer more to voters over time, they are more ethical and will be more fair and sustainable long-term. If heath decisions and choices are unilaterally made based on the self-interested values of shareholders, lobbyists and insurance bureaucrats, or a given age or interest group, they are less ethical and will be less fair and sustainable long-term. So the question is not so much in details such as whether costs will rise or choices will be restricted for a given group, the question is what levers of control do we want in place for fairness to all groups sharing a sustainable economy and democracy? That's the real choice in this health care debate.

Dichotomies

The dichotomy of good versus evil is both familiar and ambiguous. Perhaps that explains its lasting power to foment allegiance or mistrust without requiring much thought or effort on anyones part - and perhaps that's why it is so often the chosen dichotomy when things get dicy. I submit that the real dichotomy underlying most dicy issues is public ethics versus personal and group values. This is both harder to initially grasp and clearer in definition than good versus evil, because it requires the extra step of asking a fairly simple question. One need only ask whether the resolution acceptable to me would be unilaterally enforced and benefit primarily me and people more like me, or would it be multilaterally determined and accomodate people less like me? If you choose the former, your definition of good versus evil is values based, driven by self-justified enforcement of solutions that benefit you whether or not they fail to accomodate others with different values. If you choose the latter, your definition of good versus evil is ethics based,driven by a desire for fair play regardless of the player. The benefit of examining the ethical question, comes from understanding that civil democracy requires it. The alternative is clubhouse democracy (or worse) that benefits those on the inside and makes life miserable for anyone different.