Health care is arguably the most divisive political topic in the country today.
But what would happen if you got groups of ordinary people together to discuss the ethical questions that arise when we try to provide treatment while controlling costs?
For example, suppose there are two treatments that equally effective but one is twice as expensive. Should insurance be required to pay for both options or just the least expensive? Should the patient have a choice?
Researchers at the University of Texas Medical Branch wondered whether people agree on the broad values that are behind such decisions.
The study coordinator, Dr. Howard Brody, director of the Institute for the Medical Humanities at the university, said researchers assembled two groups in Galveston to discuss those ethical questions.
People reached consensus in several areas.
• Most thought health care was becoming unaffordable for many people. There are limits on what people can pay.
• Most wanted to include quality of life — not just the quantity of time added to a life span — in evaluating treatments.
• Most said a trusting relationship with a physician was vital. People wanted someone who could help them make good choices.
• Most expressed some healthy skepticism about the state of scientific evidence behind various treatments.
• Most wanted to preserve as much personal choice as possible.
The groups were made up of people who were at least 65 years old but whose backgrounds were diverse.
One was based at St. Vincent’s House. One included members of the Galveston Association of Island Neighborhoods and the Galveston Citizens Police Academy Alumni Association.
Several people involved in the discussions said the words “Democrat” and “Republican” never came up.
Instead, there were thoughtful discussions about whether the public at large should pay for treatments that would add, say, two months to an individual’s life span.
Perhaps a discussion of the cost of prolonging life is so sobering it transcends the politics of sound bites.
Those who were involved in this project painted a picture of hope — hope that people meeting to talk about these problems can find a consensus on health care that has largely eluded political leaders in Washington.
That’s the way consensus is usually reached in this country — from the grass roots up.
These discussions are healthy. They ought to be encouraged.