One
could recoil in disgust at the inefficiency and incoherence of the
process–at the fact that private insurers will continue to make
billions a year providing services the government has snown, via
Medicare, that it can provide on its own. . . . But, messy as the
reform plans are, they can still dramatically transform the system for
the good. . . . If a little incoherence is the price of that deal, it’s
worth paying. 

–James Surowiecki,  The Financial Page, The New Yorker Magazine, 1/4/2010

With all the extremists recoiling, with the inherent payoffs
necessary to pass this health policy bill, it’s unusual to see a
thoughtful perspective, explaining some of the more important issues,
pointing out the inevitable contradictions, and still supporting this
bill.  It’s helpful to see Jim Surowiecki’s comments. 

The parallels to public and even legislative ignorance about health
policy issues and their implications remind me of a parallel form of
ignorance that serves as a serious impediment, that of the lack of
public information when it comes to global affairs.  In a recent
article in Foreign Affairs, Zbigniew Brzezinski, the U.S. National
Security Advisor from 1977 to 1981, pointed out that even surveys by
the National Geographic has shown that the American public is not even
familiar with basic global geography.  Their knowledge of other
countries’ histories and cultures is not much better. 

Brzezinski continues:  With the accelerating decline in the
circulation of newspapers and trivialization of once genuinely
informative television reporting, reliable and timely news about
critical global television reporting is becoming less available to the
general public.  In that context, demagogically formulated solutions
tend to become more appealing especially in critical moments.

Brzezinski’s comment applies equally well to the American knowledge of health care policy.

But to keep from ending on a gloomy note this New Year’s Day, I want
to recommend your reading of Josef Joffe’s magnificent article on The False Prophecy of America’s Decline, in Foreign Affairs. He concludes on a triumphant note: “Globalization is us.”