Roger Ebert on the Gathering Storm

Roger Ebert inspired by Thomas Friedman leads to an interesting post:

http://blogs.suntimes.com/ebert/2010/02/the_gathering_storm.html

Here is the comment I tried to post on Ebert's blog:

I am agog at how many people have shared their stories and opinions. As for me, I don't have much to say except this: no system will work, including universal or for-profit healthcare, unless people are ethical.

Today, in almost every profession, incentives tend to push people, even good ones, into poor decisions. For example, if you're a doctor who gets reimbursed based on the number of tests you order, why not order an extra one? Does this attitude change under universal healthcare? Of course not. The only difference is who pays for it.

Conservatives understand human nature's tendency to game systems and are afraid that universal healthcare represents a massive opportunity for dishonest people to game the system and pass the buck (literally :-) Liberals, on the other hand, see the poor man in the street dying from a treatable chronic disease, or the cancer patient who can't get treatment, and are outraged. They want things to change. Neither side seems to understand that the incentives in healthcare need to change in order to promote ethics and a sustainable system.

When I see people argue in broad terms, I see no opportunity for real agreement. I am reminded of Yates: "Turning and turning in the widening gyre..."