Friday, August 28, 2009

Self-interest on parade

If you want to see how self interest is ruling the public health-care reform debate, take a look at two stories in the Denver Post today, one on the front page, and the other on the "Health Reform" page, which today is 15A.

The Page One lead story, by Allison Sherry, reports how Patti Gabow, CEO of the Denver Health Medical Center, has written metro-Denver counties asking for millions of dollars worth of compensation for care Denver Health has provided for citizens of those counties in 2008.

The self-interest of Denver Health is obvious. The health system, described by the Post in a story earlier this week as one of the best in the country, is going uncompensated for those same millions of dollars worth of care, and it wants money to cover the costs from counties where the patients live.

Sherry's story said Denver Health is asking Jefferson County for $9.8 million, Arapahoe County, $12 million, and Adams County, $11.3 million.

That's a lot of money, but only fractions of $318 million in uncompensated care Denver Health offered patients in 2008, yet Sherry reports that officials in Jefferson and Adams counties don't seem too interested in paying their fair share.

"We don't believe it's a responsibility for county government to compensate hospitals for uninsured care," Sherry quoted Mark Tandberg, a division director in Adams County, saying in response to Gabow's letter posting the bill.

That response, of course, is in Adams County's self interest. Tandberg, serving his taxpayers, takes the conservative stand in the health-care debate: Government shouldn't subsidize universal health care.

Sherry reports that Kathryn Heider, a spokesman for conservative Jefferson County, also blew off Gabow's request. "I think we probably won't be pursuing it," she told Sherry.

Sherry, in the meantime, has a little self interest in writing the story itself since she is the writer of the earlier story that lauded Gabow's operation as one of the most efficient providing uninsured health care in the nation.

Reporters live and die (literally, since their jobs are at stake) by the give-and-take of story for story with sources. Sherry writes a well-reported story about Gabow's good standing in the national debate over health-care reform, and is then given access to the more powerful story about Gabow's demand for repayment from local governments.

The second story that puts self-interest on parade in the Post's coverage of health-care reform is the story on 15A about certain Catholic bishops in America, including Denver Archbishop Charles J. Chaput, turning against the Obama reform plans, none of which is certain as yet.

That story, by David D. Kirkpatrick of The New York Times , connects the relatively new opposition of the bishops to old and long-held Catholic opposition to use of federal funds to pay for abortions.

Chaput is a vehement abortion critic and during the election campaign last year anti-abortion campaign flyers targeting Obama were passed around the parking lots of Catholic churchs on Sundays. Chaput's book, "Render Unto Caesar," goes somewhat lightly on the issue of abortion while urging strongly that Catholics stand up in the public square and marketplace to denounce political positions that run contrary to church doctrine.

I'm going to review the book soon on where I write about literature, so you might look for the review there when I finally get it done. Consider that last sentence to be promotion of my own self interest.

The New York Times story quotes Chaput as writing in a diocesan newspaper column that Obama's health-reform plan is "not only imprudent; it's also dangerous."

The Times story immediately adds, "The bishops' opposition ... is another setback for Obama's health care efforts."

The opposition also, however, serves the bishops' self interest by not only boosting the church's anti-abortion stance, but also by trying to boost the bishops' personal political credibility within their own congregations.

You could say anything anyone writes boosts someone's self interest, and that probably would not be too far from the truth.

But when self-interest powers a national debate that is supposed to target a common good, specific arguments that benefit one interest over another ought to be pointed out.

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