Validity the Problem Discussed in the Case

Validity

The problem discussed in the case is whether or not the government should manage health care in the United States. The authors identify several problems with the current health care system, including costs that are rising faster than inflation, that health care coverage costs are rising even faster than that, and there are millions of uninsured. The problem can be tackled by using any of a number of logical approaches. Arguably, none of them were used by the articles, whose arguments would not cut muster at a decent high school, let alone in a journal.

Causal thinking seeks to understand the causes of the problem, as a means of identifying the areas where remedy should be applied. There are several causes of the problems. Costs are escalating in part because of innovation, which drives higher quality but also makes costs increase. Insurance companies also contribute to the cost, because of profit-taking. All told, health care providers and insurance companies are in a position where they take profits that are very high because buyers and payers do not have adequate knowledge of the cost structure of health care services -- they are price takers.

Had the authors applied causal thinking, they would not say such absurd things like "free health care causes the spread of disease" -- they would have looked for evidence to back up their claim and found none. The causal analysis breaks down again when they claim that people who presently cannot afford health care would see no changes if health care was free -- how does that work? When you lower the price, more people can afford it. Call it cause and effect, or call it supply and demand, but the authors do not seem to understand basic cause-and-effect models here. None of their claims flows from an understanding of the causal links in health care.

Another model of thinking is logical, which can be inductive, deductive or abductive. To understand the underlying reasons behind a problem, abductive reasoning is the most appropriate, because it relies on inference to the best explanation. This method of thinking still relies on understanding the causal pathways. The first thing is that there are many problems in the health care system, and your solution must relate to an objective that you have. The ACA might address the problem of the uninsured, for example, but does it address the rising costs? Maybe.

All of this leads to a need for reductionist thinking. At its heart, the authors are presenting a binary choice -- the current system or a system that is 100% managed by government. Such a simplistic understanding of how health care works -- the authors even acknowledge that the current system is 2/3 paid for by government -- means you have to reduce your thinking down to the basic level. That means the question is -- are the problems in the current system caused by the free market aspects of the system, or by the government intervention in the system? The authors conclude the latter, though they don't attempt to provide any hard evidence to support their claims. Using shoddy understanding of freshman economics is hardly good enough to make an adult-level argument, but credit the authors for trying. It's just that they are out of their depth here.