Friedrich Nietzsche

Whoever knows he is deep, strives for clarity; whoever would like to appear deep to the crowd, strives for obscurity. For the crowd considers anything deep if only it cannot see the bottom: the crowd is so timid and afraid of going into the water.

- Friedrich Nietzsche

I don’t care where you stand on the recent health care debate in America. Both sides have valid points, albeit driven by completely different ideologies.

The problem with the debates on either side was that the argument wasn’t driven by rational principles, as you are well aware.

Using the heart to battle the mind

America had some tough questions to answer: why was it no longer sports the most competitive free market in the world (Switzerland now holds that crown after its health care restructuring in 1994) and why was the cost vs benefit ratio is the lowest in the developed word. It is the last nation in the developed world not to offer comprehensive health care (instead it imposes yearly and lifetime caps, making it inadequate as disaster insurance) and meddles more in the doctor patient relationships than most Northern European nations (insurance companies restrict free access to doctors and limit the prescriptions and treatments available). That is not to say that all was bad with American health care, but that the world had changed, and a change in the system was required.

This was America’ s call for a rational debate, comparing its strengths and weaknesses to that of other countries and finding a uniquely American answer that could reform the bad while keeping the good.

Instead, stake holders rushed to Washington to write big checks in order to guarantee their annual returns despite their shortcomings in performance.

And that crippled an honest debate. Since we could no longer indulge in objective analysis, something else had to be done.

Battle lines were drawn between both political parties trying to protect their stakeholders, instead of an open debate about why the system couldn’t deliver uncapped health care at 2/3rds of the cost as is the case in many nations, or why American health insurers don’t have to compete as ferociously as in some European countries. Emotional words such as ‘socialized health care’ were trumped up, ignoring the fact that America subsidizes its health care to a higher degree than some European countries. ‘Death panels’ were invented, despite the fact that there were no death panels in any other countries. ‘Rationing health care’ was presented as a doom and gloom scenario, despite the fact that yearly and lifetime caps make America’s health care system the most rationed health care system in the world. ‘Skyrocketing costs’ were predicted, despite the fact that America’s health care is the most expensive in the developed world, burdened by the highest administration cost. Tort reform was ignored as was the reason why tort reform is complicated: there are only 2.4 doctors per 1000 citizens compared to 4 doctors per 1000 citizens in Europe, leading to grueling work hours for doctors and the highest medical malpractice in the developed world. ‘Interference in the doctor patient relationship’ was boosted despite the fact that America is one of the only countries in the developed world where you couldn’t freely choose the doctor you go with and one of the only countries where insurers could meddle in your prescriptions and treatments. ‘Innovation is under threat’ said political actors despite the fact that America is only the most innovative system in terms of cancer treatments and relied on European donations of the swine flu vaccine because its markets failed to create the volume requested. Political actors also pointed to the fact that America is the most responsive system in the world, but failed to mention why that was: because many of its citizens either have no access to health care or lose that access when their yearly cap runs out (resulting in bankruptcy and loss of access to the health care system). America is the most responsive system in the world (only marginally so, but still), but only because so many people can’t actually afford health care. ‘Free markets must be protected’ was the battle cry, despite the fact that America is far from the most competitive health care system in the world, protecting insurers from full on competition and allowing oligopolies to from by state mandate. One political party had to pass reform no matter what to survive, the other had to kill it no matter what to triumph.

None of these arguments were presented as rational arguments. They were there as slogans, to raise the emotional temperature, to instill fear.

Because when we feel frightened, when we feel we are about to lose something, we lose the ability to think. Emotional arguments mainly served to obscure the real challenges we face.

And that is where politicians failed the American people. They failed to present us with pragmatic options, instead tried to defend the stakeholders by injecting so much emotion in the debate that we lost the ability to conduct a rational review in answering the complicated but worthwhile question: how can we improve the cost vs benefit ratio for the American consumer?

In the end, the biggest winners were the stakeholders…

But knowing Sarah Palin, one of the actors who injected a lot of anger and emotion into the debate, she would have written off Nietzsche’s quote by pointing out the man went mad and that his philosophical works were adopted by the Nazi’s, essentially blocking any thought about the validity of his argument…

Peace, it seems to me, is the calm in the storm, a moment of respite in an avalanche. It is a state that can last but a moment.

The same can be said for a peaceful soul: it isn’t that the life of a man at peace doesn’t experience the humdrum of daily life, but that the peaceful man resists being taken on a ride on the tiger’s back, and instead focuses with great clarity on the peace he wants in his life, eventually creating  it, moment by moment, despite the humdrum. In as such, it is an inner state that can project itself upon the world around us.

Christmas reminds us that we all should be seeking peace and stability, seek to bring the chaos around us to its natural conclusion, whatever that may be. It reminds us that we are the masters of our lives and should not be set adrift by the constant changes around us, but instead work hard to understand the nature and stages of the things around us and bring it to a state that can endure: peace.