This was originally a post on COVID booster shots, but I’ve now broken it into two separate posts, the first a prologue offering a very general summary of my approach to issues in health care, and the second, a post expressing skepticism about the need to wait any longer before we roll out a COVID booster, as well as skepticism about monopolistic institutional arrangements (distributive and/or regulatory) in health care.

I work in health care, but have no worked-out view on the political economy of health care. In fact, part of the reason I accepted the (full time) job I currently have, in hospital revenue cycle management, is to clarify my thoughts on that very subject. So I’m open to being schooled on issues in health care by anyone willing and able to do so–a category that probably includes a very large number of people. For the time being, I’m willing to remain at least temporarily in a state of curmudgeonly skepticism, willing to take pot shots at almost everyone, but unwilling to pledge allegiance to much of anything. You might regard that as a frivolous position to take, considering the stakes involved. But I don’t.

Since I’m going to be writing here at PoT about health care a fair bit in the near future (I’ve done some already), take what I say in the preceding skeptical (or dialectical) spirit. My aim is, through discussion and experience, to work my way from skepticism to something more definite.

It’s not that I have no determinate views whatsoever. I’m not a blank slate. As a matter of political philosophy, I think of myself as a liberal pragmatist aligned neither with the Left nor the Right.* A liberal pragmatist (as I understand it) is someone who upholds a generic set of liberal ideals–freedom, justice, and equality among them–but adopts conceptions of these ideals, and policies implementing them, in a “pragmatic” way that both side-steps and borrows from conventional ways of thinking about policy and putting it into practice. So I have no qualms about ignoring or plagiarizing left- or right-wing ideas as I see fit.

Though I probably sound more “left-wing” to some than I really am, and often end up on “the Left” of various issues by default (at least given the moral and political bankruptcy of the contemporary American Right), I don’t self-consciously think of myself as a leftist, or regard myself as advancing a left-wing political agenda. I’m a leftist in the way that a stopped clock is correct about the time. If I end up on the Left, it’s twice-daily happenstance, not conscious intention.

On health care, I have a set of particular views on particular subjects, but no overarching narrative or account of the field as such. That said, I’m not willing to endorse (or, for that matter, wholeheartedly to reject) the ideological litmus tests of the Left’s position on health care–e.g., “a right to health care,” the need for a “single payer system,” “Medicare for All, ” or the moral-political imperative to cancel all medical debt (a recent policy proposal by Bernie Sanders). Those issues are, as far as I’m concerned, up for grabs, and both less clear and more problematic than their more zealous advocates seem to realize. Not that the “free market approaches” to health care that I’ve seen are any better.

In short, I’m not a full-fledged advocate of any familiar position out there, but operate in a spirit of skepticism about them all. My hope is ultimately to turn that skepticism to knowledge, but that’s still a long way off. So like it or not, you’re going to have to put up with a bunch of blog posts that seem to point in all different directions at once. Don’t blame me. Blame health care.

Apologies for the long, potentially self-indulgent prologue, which I almost deleted the minute it materialized. I wrote it to forestall what I anticipate to be criticisms that depict me as an apologist for right-wing capitalism and/or the status quo and/or some combination of these. Believe it or not, I’m none of the above, even if I don’t particularly think that reform will come by singing L’Internationale in the general direction of the American health care system. But feel free to tell me what you think.

---

I am a full time employee at Aergo Solutions, and am pending per diem status in OR EVS at Hunterdon Medical Center. The views expressed on this blog are solely my own, and do not necessarily reflect the views of either of my employers.