Health Care Reform a More Complex Conversation Than 'Simplistic' Debate, Say Experts at Center for Ethics Panel Amidst what Dr. Adrienne Asch called a “cacophony of claims and counter-claims” in the political wrangling over America’s ailing health care system, the Center for Ethics at Yeshiva University sponsored a seminar of straight talk on Oct. 5, titled “Health Care Reform: Ethics of Public Policy, Ethics of Public Debate.” Held in the fully packed Jacob Burns Moot Court at YU’s Benjamin N. Cardozo School of Law, the seminar offered the opportunity to “step back and decide where wise policy should come from,” said Asch, the Edward and Robin Milstein Professor of Bioethics and director of the Center for Ethics. Thomas H. Murray, president of the Hastings Center, a nonpartisan bioethics research institute, called the national debate on health care “simplistic” and advocated a “more complex conversation” to include issues of justice, fairness, solidarity, quality, efficiency and stewardship. Murray’s dismay was shared by three fellow panelists: Peter Barland, emeritus professor of medicine and pathology at YU’s Albert Einstein College of Medicine; health care economist Mary Ann Bailey, also of the Hastings Center; and Trudy Lieberman, director of the Health and Medicine Reporting Program at the City University of New York’s Graduate School of Journalism. After citing some grim metrics—47 million Americans uninsured, another 40 million inadequately insured, one-half of personal bankruptcies caused by insurmountable medical bills—Barland prescribed a cure somewhat beyond the parameters of pending legislation. “We have to get doctors out of the fee-for-service mode,” said Barland, who suggested a “medical team approach” as an alternative, modeled on Minnesota’s Mayo Clinic, where semi-salaried doctors “do not profit from excessive tests [but are] judged by their peers on the quality of their care.” Bailey said the soaring cost of private insurance is an ethical issue that militates against the wish of most Americans to be free from worry about health care. Such freedom, she said, is impossible within a current unmanaged system that provides erratic access and often quite low quality. Innovation, Bailey maintained, “is much better done as a cooperative enterprise than a competitive one.” She said a nonprofit, single-payer system would be “the best solution,” but that some manner of government-backed competition for private payers was more likely to be achieved. Lieberman accused all sides in the debate as being “disingenuous” at best. President Obama and advocacy groups, she said, are vague; Republicans engage in canards about socialism while Democrats parrot slogans invented by pollsters; and the media fail to note critical details, such as a lack of meaningful cost control in Congressional bills under consideration. “What will come out of the sausage mill,” Lieberman said, “will be what the special interests want.” Co-sponsors of the seminar were Wurzweiler School of Social Work; Benjamin N. Cardozo School of Law’s Program in Family Law, Policy and Bioethics; the Institute for Public Health Sciences; and the Yeshiva College Student Council.