1. Health care reform: Time to move past fee for service? (h/t Yglesias):
In 1929, Michael Shadid, a doctor in western Oklahoma, proposed an idea for making medical care affordable to farmers. Rather than pay piecemeal for treatments, farmers would each contribute $50 a year to a cooperative. Dr. Shadid and his colleagues would pay their own salaries and expenses with the aggregate sum, and no farmer’s annual bill for family medical care would exceed $50.
Horrified by the plan, other Oklahoma doctors tried to revoke Dr. Shadid’s license. The conflict was soon duplicated across the country; cooperatives sprang up, and the American Medical Association tried to beat them back. The A.M.A.’s members, as the historian Paul Starr has written, felt threatened because the cooperatives “subjected doctors’ incomes and working conditions to direct control by their clients.”
The issue was clear: Who controls the doctor-patient relationship? That question has been at the core of every big subsequent battle over health care. Should doctors determine not only their patients’ treatment but also their own pay, through the fee-for-service system that has survived since the 1920s? Or should patients have more power in the relationship? And who could claim to act on patients’ behalf, monitoring treatments and bargaining with doctors?
2. Abortion: Looking back at Tiller’s murder from two sides of the abortion divide:
The son of a prominent Wichita physician, married 45 years, the father of 4 and grandfather of 10, a former Navy flight surgeon, a longtime Republican, Dr. Tiller, 67, insisted that he would not be driven from his hometown, where he belonged to its oldest country club, was a devoted member of one of its largest churches, was active in Alcoholics Anonymous, was deeply involved in his alma mater, the University of Kansas, and adored his local Dairy Queen.
Indeed, he made a point of performing abortions the day after he was shot in the arms.
“His is the only abortion clinic we’ve never been able to close,” Troy Newman, president of Operation Rescue, said in an interview.
Yet what thousands could not achieve in three decades of relentless effort, a gunman accomplished on May 31 when he shot Dr. Tiller in the head at point-blank range while the doctor was ushering at church.
3. The racial divide: Eric Holder was right; Americans cannot talk straight about race:
IN a speech delivered earlier this year, during Black History Month, Attorney General Eric Holder drew headlines by criticizing the tenor of public discourse on race. “Though this nation has proudly thought of itself as an ethnic melting pot,” Mr. Holder said, “in things racial we have always been and I believe continue to be, in too many ways, essentially a nation of cowards.” The nation’s leading law enforcement officer — who happens also to be an African-American man — was widely criticized for making this provocative comment.
Yet during this past week — as I have watched the controversy unfold over the arrest of a black Harvard professor, Henry Louis Gates Jr., by a white Cambridge, Mass., police officer, James Crowley — I have come to appreciate the prescience of Mr. Holder’s remark. It is as though we are determined to prove him right — as if our talk about race must be forced into a comfortable and familiar, if false, narrative where villains (“racists”) and heroes (“victims of racism”) are clear-cut, and where all one need do to stand on the right side of history is to engage in a bit of moral sanctimony.
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