Posts Tagged ‘health care’

Joe Wilson’s Dialogue

Years ago, before I had a better hold on my temper, I screamed at a star player during a kids’ softball game. It was stupid and reprehensible. The game was emotionally charged, and I lost my cool. I promptly apologized to anyone and everyone who would listen.

My point here is that we all say insanely stupid things now and then. So I am not here to pile on Joe Wilson. Instead, I want to explore what his outburst during the president’s health care speech—and the aftermath thereof—can tell us about dialogue.

Many commentators have already covered the obvious: that “you lie!” is emblematic of the remarkable incivility that has pervaded recent headlines and town hall meetings. But where does this incivility come from? The language gives us a clue: it’s the kind of speech used by those who (a) have deeply held beliefs or vested interests and (b) perceive them to be under dire threat. Threats induce our fight-or-flight response, so Joe Wilson spoke fighting words.

The problem is, we can’t dialogue like that—so we can’t resolve anything that way.

Dialogue, by our working definition, requires a clear mind and a listening heart—an openness to the other—so we can think together toward the truth of the matter. We need this “thinking together” because no one has a corner on the truth. But we cannot cultivate the required openness if we cling to our beliefs as the only way to perceive the issue.

The health care debate is a great example. There are many good ideas on the table. But how can we think together about them if we do not open our minds and hearts? Rejecting openness just leaves us with the same vested interests and tired phrases that obscure the dialogue: “you lie,” “death panels,” etc.

Then there are the strange mechanics of apology in our current age. Whenever someone says or does something inappropriate on the public stage, he quickly apologizes. Pundits just as quickly parse the wording of the apology and conclude that it’s not enough (or it’s not sincere). The offender may apologize again, and that’s not enough. Ad nauseam.

This raises two lessons for dialogue—one based on truth, the other on grace. First, dialogue cannot proceed unless the participants share a commitment to honesty. So apologize only if you’re sorry; to craft a faux apology leads to mistrust and distracts from the dialogue at hand. Second, if you receive a sincere apology, forgive and move on.

How do these lessons promote dialogue? Consider that dialogue often involves discussions of sensitive issues among people who disagree. Discussions get heated, and yes, people can say intemperate things. That requires a mechanism for honest apologies and ready forgiveness. The participants can’t be expected to maintain their openness and trust—and thus advance the dialogue further—if “offenders” issue insincere apologies and “offendees” let their resentment linger. 

If we’re going to move forward on social issues, we need dialogue. That, in turn, requires us to open our minds and hearts and keep them open, even when the discussion boils over. 

But how do we get to this openness in the first place? This, I believe, is where the Divine can play such a powerful role. Good topic for next week.

Anatomy of an Internal Dialogue

Can the way of dialogue make any impact on health care reform? Consider its effect on one human mind (mine) and tell me what you think.

When the latest version of the debate heated up in earnest, I had no grasp of the issues whatever. So I started reading, listening, and thinking—and discovered some interesting insights. One article, written by the president of a regional health center, came out in favor of single-payer as a way to cover everyone and drive costs down. On The NewsHour with Jim Lehrer, Richard Armey (one of my least favorite politicians) talked about allowing insurers to compete across state borders, thus giving people more choice and driving costs down. I read about the Massachusetts model and what it might teach us. Because I learn by writing, I also wrote an article to ask questions about the issues.

At first, and through most of this process, I’ve leaned in the direction of single-payer. Now, after hearing other good ideas, I’m not so sure.

And that’s the point.

Preparing for authentic dialogue means absorbing ideas and perspectives from many parts of the ideological spectrum, even—especially—those that drive us crazy. It’s critical to hear from conservative and liberal, doctors and hospitals, government officials and poor people, those who have been denied coverage and the insurers that denied them.

This is hard work. It asks us to set aside our vested interests and emotional stakes. For instance, I resent the health insurance industry because a family member was denied coverage for desperately needed treatment. But to sort out issues as complex as this, I have to set that resentment aside…and listen.

How do we get to the point where we can do this? By cultivating certain attitudes of heart, especially openness to others—and the willingness to take on the risk that such openness involves. When we absorb other perspectives and listen to other people, we might find out we’re wrong. In my case, I might learn that health insurers include good people with honorable intentions. If I do, I’ll have to let go of my resentment permanently.

Which, by the way, will bring more peace to my soul and more generosity to my spirit.

If we do this hard work—if we approach the health care debate with an open heart and an inquiring spirit—we give ourselves the chance for good ideas to emerge. Good ideas sometimes lead to good policies. By contrast, the current climate of shouting and misinformation actually distracts our attention from listening, weighing alternatives, striving for consensus, and letting good solutions emerge.

We have nothing to lose by applying the way of dialogue to health care. And we have much to gain—maybe even a workable, compassionate policy, worthy of the name reform.  

The Health Care Kerfuffle: Dialogue, Anyone?

I must be hanging around the wrong media. Only two days ago did I become aware of the wild rumors surrounding health care reform.

The strangest of the strange is that under the new plan, seniors must undergo counseling that encourages them to cut their lives short. (, an arm of the Annenberg Public Policy Center, debunks this rumor in a recent post.)  But there are other rumors as well: The plan amounts to government rationing of health care. Ordinary people would lose their current insurance under the proposed plan. Health care reform will cover illegal immigrants.

Some of these rumors, on their face, involve legitimate concerns and deserve accurate answers. Others don’t stand up to a moment’s thought. The key for our discussion here, though, is that none of them are true—and yet some government leaders and pundits keep spreading them.

This is reprehensible: not just because misinformation is reprehensible in itself, but because it makes serious dialogue—which might lead to a more satisfactory resolution—much more difficult.

This is nothing new, of course. With every issue du jour, it seems, comes at least one claim or well-turned phrase that subtly shapes public perceptions. That might be fine if the phrase precisely captured the truth of the issue at hand. Unfortunately, those who craft such phrases are often less interested in seeking out truth—or even dialogue—than in promoting their argument.

As an example, think of how Republicans have used the “tax and spend” label to taint legislation from Democrats, regardless of the merit of the particular bill at hand. (Don’t most bills—even those for the best programs—involve taxation and spending?) Or consider the phrase “a woman’s right to choose” (or even the terms pro-choice and pro-life), as if the entire complexity and delicacy of the abortion question could be boiled down to a single sound bite.

When we hear these words and phrases over and over, we automatically begin to assume that they’re the only way to think about the issue. To borrow a business cliché, these terms set the “box”—and make it more difficult to think outside it.

Health care reform is far too complex and nuanced an issue to reduce to sound bites, let alone wild rumors. Dialogue, in contrast, would help us explore those nuances and bring them into the light. But where do we start?

Maybe we start with questions. Last year, realizing how woefully ignorant I was about single-payer and HSAs and whatnot, I started asking questions about health care. Maybe the answers to the questions we raise would start a dialogue. Maybe the dialogue would take hold—and reach the people who make the decisions.

Idealistic? Perhaps. But dialogue has more potential to generate a satisfactory solution than the rumors do. So let’s start the conversation.