Although written for an Evangelical audience, the autor makes important (and insightful) points relevant to Orthodox believers as well. Thank you to Orthodoxnet.com for bringing the piece to our attention.
(AgapePress) – For Christians in America who believe their faith can and should have an impact on their culture, it has not been a good year.
In less than a 12-month span: The Supreme Court struck down state sodomy laws, in effect invalidating both natural law and the Judeo-Christian foundations of our nation as a sound basis for our society; The Episcopal Church consecrated an openly homosexual man as one of its bishops; The Massachusetts Supreme Judicial Court legalized same-sex marriage; and a halftime show on the Super Bowl — in which a pop singer’s breast was exposed — shoved in nearly everyone’s face just how debauched our pop culture has become.
Nothing that Christians or pro-family groups have done has seemed to stop American society from rushing headlong down the tracks to moral oblivion. It appears that secularism and postmodern relativism have successfully teamed up to overthrow Judeo-Christianity as the dominant philosophical force in our culture.
Read the entire article on the Agape Press website.
What exactly are “secularism” and “relativism?” It seems to me that these terms are often used in a very imprecise and confusing way.
For example, take the ordination of the gay bishop by the Episcopal church. The article uses this as an example of secularism. But if you talk to the people who advocate for homosexuals within the Episcopal church, the great majority of them do so out of very deeply held religious beliefs. These beliefs may be right or wrong. I’m not trying to defend any particular belief. All I’m saying is that such beliefs are often rooted in religion — in what are perceived as the humane values taught in the gospels. It may be that such beliefs are wrong, but one could hardly say that they are “secular,” unless a very different definition of “secular” is used.
Likewise with the term “relativism.” When this term is used, typically in a negative manner, it usually suggests someone of the “if it feels good, do it” school of thought. In my experience there are very few serious thinkers who approach ethical issues from this perspective.
The more serious version of “relativism” is simply that in making moral decisions one looks at all the morally-relevant features of the situation. These include the facts of the case and whatever moral principles have bearing. In other words, moral decision-making typically involves a balance of competing claims and obligations. There are many situations in which there is not simply a single moral principle to which one would appeal. This is in my experience what serious people mean by “relativism.” To some extent it would be fair to say that we are all relativists.
Relativism refers to a flexible and situational standard for right and wrong. For example if Howard Stern uses a vulgar four-letter word in a public space, like the air waves, he gets a $250 thousand fine. If Dick Cheney uses a vulgar four-letter word in a public space, like the floor of the US Senator, he gets a call of congratulations from The President.
More mischief, Dean, hmm? Cute joke, but I trust that you are too intelligent to make a serious claim that the two examples are exact analogies. Please don’t prove me wrong!
Certainly they are not exact analogies, since children should not be allowed to listen to Dick Cheney.
Jim,
Secularism has many faces, at its best it encompasses a pragmatic problem solving approach to the individual, social, and government sphere without reference to a morality based in an acknowledgement of God. As long as such an approach is limited in scope, it can have some positive effects.
At its worst, secularism becomes a rabid revolt against God rejecting any reference to Him or any decision based on communion with God. Such a philosophy completely strips the spiritual dimension of man away and believes us to be mere biological organisms. It is profoundly, although not always consciously, influenced by 19th century nilism such as Nietzche’s. The push to identify humanity as genetically determined, personhood founded in sexual desire, and the lawsuits seeking the removal of all reference to God, especially Christianity, in public all come from the radical secularists. If they continue to grow in power and influence, Christianity will be overtly persecuted despite the “protections” of the Constitution. Unless we stand firmly on the teachings of the Church publicly and privately, individually and corporately, we stand to loose a great deal.
In that regard, it is important to read the witness of the Christians who endured the persecution of the Soviets. They have provided us with a great deal of literature. It will help us to fight the battle.
Dean (and Jim, because you allowed yourself to be tempted to play right along) perhaps you were “in a mood” yesterday but please, in all sincerity, take your childish thoughts elsewhere. Most of us here are attempting to seriously consider how our Faith as applied to cultural issues. There are plenty of other places where you would be welcome to “reveal in the irony” and giggle at crude jokes like your post above.
Jim, concerning your serious question, to Michael I would add this. as a former Episcopalian, I can tell you that Episcopalians have historically been Christian in their “very deeply held religious beliefs”. For them to reject basic Christian believe, then their Christianity has been twisted, turned, and otherwise destroyed. By what? Well, obviously by secularizing and relativising standards of western society in the last 500 years, but particularly in the last century, accelerated beyond belief after WWII. Also, I am curious about your experince because you say that:
“the term “relativism.” When this term is used, typically in a negative manner, it usually suggests someone of the “if it feels good, do it” school of thought. In my experience there are very few serious thinkers who approach ethical issues from this perspective.”
My experience has been different. Instead of their being very few, I would say the vast majority of “serious thinkers” who do not reason from Christian presuppositions, are either explicitly or implicitly from the “if it feels good, do it” school of thought. Certainly most “ethicists” and the like found in the academy today reason like this, which begs the question, where are the “serious Christian thinkers” to be found today?
Jim, Dean, et.al.
RELATIVISM
SYLLABICATION: rel·a·tiv·ism
NOUN: Philosophy A theory, especially in ethics or aesthetics, that conceptions of truth and moral values are not absolute but are relative to the persons or groups holding them
(“Hey, if it works for you, go for it, who can then judge you” translated—“If it feels good, do it”)
SECULARISM
SYLLABICATION: sec·u·lar·
NOUN: 1. Religious skepticism or indifference. 2. The view that religious considerations should be excluded from civil affairs or public education. OTHER FORMS: secu·lar·ist —NOUN
secu·lar·istic —ADJECTIVE
TOLERANCE
SYLLABICATION: tol·er·ance
NOUN: 1. The capacity for or the practice of recognizing and respecting the beliefs or practices of others. 2a. Leeway for variation from a standard. b. The permissible deviation from a specified value of a structural dimension, often expressed as a percent. 3. The capacity to endure hardship or pain. 4. Medicine a. Physiological resistance to a poison. b. The capacity to absorb a drug continuously or in large doses without adverse effect; diminution in the response to a drug after prolonged use. 5a. Acceptance of a tissue graft or transplant without immunological rejection. b. Unresponsiveness to an antigen that normally produces an immunological reaction. 6. The ability of an organism to resist or survive infection by a parasitic or pathogenic organism.
All definitions are from the American Heritage online dictionary
These are simple words, even a modern dictionary is quite clear on their meaning. To start parsing these words as a defense against understanding is disingenuous and begs the real questions.
I included the definition of tolerance because we Christians are always upbraided for lack of tolerance by the secularists when we attempt to articulate authentic moral standards and the desire that our culture reflects those standards. They are assuming definition #1 (which by the way places secularism in the category of belief, i.e. faith). When I consider the other definitions in light of the poisonous effect of secularism both on individuals and groups, there are delightful possibilities in a debate situation. The Church has infinite tolerance under definition #6 as the gates of hell will not prevail against her. However, we as individuals do not–except by the grace of God and our own willingness to repent and allow the Holy Spirit to purify us of its poison.
Jim, this blog is for intelligent debate, not for cheap shots at personalities you dislike. If you want to express your disapproval for Cheney or anyone else, go ahead, but put some serious reasoning behind it.
With respect to the definitions of relativism and secularism:
If we go with a definition of relativism “that conceptions of truth and moral values are not absolute but are relative to the persons or groups holding them,” then I would say that much that is called relativism is really not relativism. This is really a very simple definition of relativism, and in my experience does not accurately characterize the approach to ethics of serious thinkers, even non-Christian thinkers. Surely there are people whose thinking would fit that definition of relativism, but in my experience these are largely teenagers or others who have not seriously thought about ethical issues.
Most (but not all) people can be cured of simplistic relativism through an Ethics 101 philosophy class, since it is a position that falls apart upon any serious reflection.
The kind of serious thinking that I would call relativistic involves an understanding that many of our ethical perceptions are highly conditioned by the time and culture in which we live. Relativism is also a process of ethical decision-making that, as I mentioned earlier, involves bringing a number of relevant facts and moral principles to bear. Both of these features of relativism seem very common-sense to me, and in fact probably characterise how most people make moral decisions.
Perhaps the clearest example of this is in the field of medical ethics. For example, in end-of-life issues, you will find a wide variety of people involved — clergy, medical staff, family members, the patient. There is an attempt to be clear about the medically-relevant facts — disease prognosis, treatment options, side effects, and so on. There is an attempt to understand the patient’s wishes and worldview, either through the patient’s own statement, an advanced directive, a proxy, or through what family members believe about the patient’s wishes if there is no other available information.
In fact, I would say that end-of-life decisions accurately illustrate what I would call relativistic thinking, in the sense that there is no one single absolutist moral principle that is brought to bear. Rather, there is a balancing of moral principles — for example, the principles that life should be preserved and that suffering should be minimized.
In other words, in my view there is a simplistic relativism (based on an immature understanding of ethical decision-making), and a sophisticated relativism (based on a mature understanding of ethical decision-making.) My objection is when a decision based on sophisticated relativism is portrayed as simplistic relativism. There is a difference, and it is an important difference. The one is not the other.
With respect to a definition of ‘secularism’ “that religious considerations should be excluded from civil affairs or public education,” I would have to say that I can’t think of anyone who would be a secularist under that definition.
Here again we have to make an important distinction. Religious influence in the public realm can be either in personal or organizational forms. I have never met anyone who objects to an individual voting for or advocating for an issue or candidate based on his or her personal faith. I have never, for example, met anyone who said that conservative Christians shouldn’t be able to vote merely in virtue of their faith.
But as religious involvement in the public sphere begins to become more organized and institutional, at that point the religious advocates begin to be perceived as any other interest group would be perceived. When they are perceived as interest groups, they begin to attract the same kind of negative attention that any other interest group would have — trial lawyers, corporations, unions, and so on.
But there is an important difference between the “interest group” aspect of religion and other interest groups. In the U.S. we also have a deep-seated distrust of when government and the church become too close. Thus, we have an “establishment of religion” clause but not an “establishment of corporation” or “establishment of union” clauses. I think it is fair to say that as organized religion — acting as an interest group — begins to flex its muscles, many people have a negative reaction to that. This reaction may or may not be appropriate, but I think it is understandable.
In various venues I have heard Christians express the sentiment that the “secularists” are trying to drive them out of the public square. In my view, this is not what is happening. What’s actually happening is that they are beginning to take the same flak that all the other interest groups are getting, in addition to the traditional distrust that many people have as religion begins to rub shoulders with government. Do religious groups deserve that flak? Perhaps not always. But if you’re going to move in the political realm, it comes with the territory. And it doesn’t mean that their opponents are “anti-religious” per se.
Jim,
What would you call folks who have continually said in word and deed that they want to prohibit all expressions of faith on public issues by public employees and political appointees? The only objection to several of Pres. Bush’s judicial nominees is that they express publicly their belief that life begins and conception and uphold the Catholic teaching that abortion is murder. To me the opposition has demonstrated a true secular attitude even by the simple definitions from the dictionary. What, if not secular, is the ACLU’s current campaign to force cities to remove crosses and other Christian symbols from all public seals and buildings? But perhaps you are correct. From now on I’ll just call them anti-Christian bigots.
Personally, I think it is impossible either logically or practically to have a genuine system of ethics that is not based in some form of belief in a divine reality. Only a divine reality can provide the necessary absolute for a system of ethics that is anything other that relativistic. Once the possibility of the divine is removed from the ethical equation, all that is left is constantly changing standard of self-interest. At that point, we are right back at the dictionary definition.
Jim, you may live in a different world that I do, because what I see opposing the traditional Christian ethic is both profoundly, rabidly secular and totally relativistic. To make the distinction you make between personal and institutional influence denies the very nature of the Christian Church in which there is no separation, there can be no separation. Christianity, by its very nature is personal response to a communal experience, i.e., living in the Body of Christ. To attempt to separate a Christian from the communal expression and experience is an attempt to force him to deny his faith.
The field of medical ethics is powerfully influenced by a scientistic mindset that is antithetical to faith and deeply materialistic. “Have to save that body boy, ‘cause that’s all there is.” Combined with a pervasive greed, it is a morass that swallows many well-meaning medical providers whole.
Again I say, the parsing of simple words, trying to morph them into intellectual conundrums for the purpose of obsfucation and rationalization is the height of dishonesty. As the scripture says, let your yes be yes and your no be no. As St. John of Kronstadt said, “Let simplicity accompany you everywhere. Be especially simple in your faith, hope, and love, for God is not a complex Being, and our soul is also simple. The flesh hinders the simplicity of our soul when we gratify it: let meekness be its crown.”
Michael — There no doubt are those who take positions to an extreme. And I’m sure that there are people who oppose any expression of religion, or any opinion that is formed through religious faith. But the point that I wanted to make is that much of what in the conservative Christian community is perceived as anti-religious or anti-Christian is more properly interpreted as opposition to an organized interest group — in the same sense that one might oppose union lobbying, for example.
Concerning the opposition to some court nominees, I have to say that I have not followed that issue very closely. But I think that you have to look at the larger context of what is happening. You have a president whose base includes conservative Christians, and whose stated favorite “political philosopher” is Jesus Christ. You have a new federal program designed to channel tax dollars to “faith-based” organizations. You have the Bush administration actively courting Christians, up to and including asking for church membership lists, a move that even some in “the base” objected to. And on and on. In that context, the religious background of judicial nominees is politically significant. For example, during most administrations nobody cared if an appointee used to work for an energy company. Now, it’s an issue. In a Kerry/Edwards administration whether or not you’re a lawyer will be an issue.
I’m not saying that you don’t have a legitimate concern here, but I think there is a more general dynamic at work. Again, context is important.
Concerning medical ethics — I don’t know what your background is. I can only say that there is no substitute for direct experience. I’ve worked in a university hospital for 20 years, and have volunteered with our ethics department in a variety of roles. You have to get to know the people involved in medical ethics. This will probably include your own priest. You have to see how decisions are actually made in concrete situations. Personally, I don’t find medical ethics to be a hotbed of secularism. Again, I don’t know your background, so enough said about that.
Concerning the role of the church in society, well, I’m not a scholar. But I’ve always been very impressed with “. . . when thou prayest, enter into thy closet, and when thou hast shut thy door, pray to thy Father which is in secret . . .” So I’m not very enthusiastic about “civil religion.” I want to meditate on the Ten Commandments; I don’t want them displayed in the city hall. It seems to me that part of the purpose of civil religion is to make us feel good about ourselves; that we’re in some sense on God’s side, and He on ours. But I think that an encounter with God should be one of the most disturbing things — a terrible thing, really. So terrible that the necessity of forgiveness and grace is obvious.
Jim, regarding my background. My father was a physician who disliked hospitals because he felt they did not treat the whole person in the context of his community, so he went into public health after getting his MPH from Harvard. He was director of the Wichita/Sedgwick County Dept of Community Health for 23 years. During that time he created programs and got them funded that would still be ahead of their time if subsequent directors had not dismantled them and replaced them with approaches that are more bureaucratic. He was twice elected chairman of the Public Health component of the U.S. Conference of Mayors, which at the time had never happened before. So I grew up in a house filled with discussion on health and public policy. I was in a pre-med program for a couple of years in college before being drawn to history. I have studied as much as I can with the resources (time and materials) available to me the course of medical technology and practice over the years. Although in recent years I have spent more time on the study of Church History and doctrine. At the church I attend, we have many tremendous physicians with whom I have had some interesting discussion over the years on these issues.
I look into these men’s eyes as I ask them about medical issues, sometimes when they are treating me. I see an environment where they feel forced to be far more authoritative than they actually are. I see the uncertainty that they cannot admit openly to me most of the time. I remember a candid conversation I had with a hospital administrator when interviewing for a health educator’s position 25 years ago in Boston. He told me the biggest problem then was hospital size. The economics required large hospitals while good patient care required small hospitals. Economics always won. It has only gotten worse.
I would agree that secularism is not the real problem in the medical field, but the concerns I have are three fold. 1) The medical training is largely dehumanizing. The effect of the teaching on “clinical detachment” often causes the physician to distance himself from his humanity and his patient’s humanity when treating. Combined with the insane hours required, the medical students are ground down. 2) Medical technology has become all too often a substitute for listening, observing and exercising genuine clinical judgement to arrive at a real diagnosis with the whole person in mind. The technology also creates distance between the doctor and the patient in a way that encourages unproductive and frivolous lawsuits and over testing. 3) Teaching hospitals frequently place the emphasis on research at the expense of genuine and appropriate patient care, particularly in the area of organ transplants.
I’ll admit, I’m a radical on organ transplants. Despite the “official statements” of some Orthodox jurisdictions on organ transplants, I’m against them, primarily due to the materialistic, mechanistic mindset I see in the public statements of many prominent transplant specialists. I have also seen way too many stories from people who felt pressured to have organs harvested from their loved ones to completely dismiss them although they are anecdotal. Combined with the documented black market in organs from third world countries, organ transplantation causes a major ethical dilemma. At best, it remains a sophisticated form of human experimentation. It is my understanding that long-term survival rates are still not much better than they were a decade ago. I also think it highly inconsistent that the doctrine of the Orthodox Church opposes cremation because of the holiness of the body, yet allows organ transplants. In addition to the purely ethical concerns, I feel that transplantation violates basic tenets of the Church.
To a certain extent, I understand your position on the institutional pressure vs private practice of religion and yet it has always been thus in the United States. Like it or not, we Americans tend to be a in-your-face, unsubtle type of people, especially about religion. The traditional Orthodox approach is to take the good in a culture and add to it the rest of the story rather than being confrontational. Our approach has worked wonders in many situations and continues to do so.
I don’t think the school prayer movement is a good idea. I would rather see more effort spent on introducing teaching that is more balanced and curriculum materials that express a genuine ethical, moral perspective. To remain absent from the current fray however is, in my mind, to abrogate our responsibility to witness to the truth with which we have been entrusted. We must avoid being identified with any political party or faction. To that end, we should end all official association with the heterodox church associations. SCOBA must speak long and often publicly and privately on matters of ethical and moral principal. We Orthodox have a unique vision and understanding of who man is and what our function is we need to share it. In my own small, inadequate way, that is what I am attempting to do here.
Michael: I’ve been wanting to engae you on the subject of universal health care coverage since you mentioned you were in the health care field.
One reason I will be voting for Kerry is his commitment to expanding health care coverage to more Americans. Our health care system is a Titanic slowly sinking. It is caught in a vicious cyle where growing numbers of uninsured seeking treatment in hospitals is leading to growing unreimbursed costs for hospitals who in turn must pass on those costs to the insured. Rising hospital costs mean higher insurance premiums which leads to more employers dropping or reducing healthc care coverage for their employees. As more employers drop health insurance coverage the ranks of the unisured swells and they cycle worsens.
We may have arrived at the stage where the amount employers in the United states have to pay for employee health care coverage may be more than the amount European employers have to pay in for national universal health insurance. After all, American health care spending per capita is the highest of any industrialized nation, while our health care indicators are only poor to mediocre.
Jim and Michael,
Interesting discussion! My wife has just started her residency training (PM&R), I worked with as an assistant to a hospital chaplain some years ago, and just over a year ago my sister had a child (Cole, if you wish to say a prayer for him) who suffers severe Cerebral Palsy, so medical ethics has been something I have been paying a little attention to lately.
Jim, my wife’s ethical “training” in medical school was appalling. It was lead by a very relativistic person who actually claimed to be roman catholic, Jewish, and Buddhist all at the same time (I am not making this up). She would attend a different “church” every Sunday. Also, while I see your point about multiple influences and concerns in a medical decision, “relativistic” might not be a good term. Christianly speaking, we have the idea of a “hierarchy” of virtue and value. Even for the non-believer, his God given conscience usually allows him to perceive a hierarchy of value and act on it. Sure, the term “relative” applies when one is thinking of one thing “relative” to another, but the ultimate decision (if acted upon) is based on a moral system that values one thing over all others. Sometimes that one thing is the shifting standards of self-interest, thus it is relativistic to the core…
Dean, In the interest of full disclosure, I am in the health insurance field, not the health care field. My obvious bias is therefore toward a private payor system.
In your analysis, you leave out one very important component–the effect on availability and cost of government mandates.
I’ll give you two real-world, concrete examples:
1. Six years ago, in Kansas, we had over 15 private companies that were issuing largely affordable individual health insurance. Today we have seven. All of the companies that departed cited an adversarial regulatory environment and extensive state mandates on coverage as a prime factor in leaving. The reduction in the number of companies resulted in higher premiums and an increase in the number of uninsured. The state regulators had the attitude of “My way or the high way”. The state’s way made it impossible for the companies to operate at a profit. (I know, profit is a dirty word)
2. On the issue of state mandates: in general the statistics show that every time a state issues a new mandate, the number of uninsured people rises. Why? The insurance companies are required to include coverage (sometimes retroactively) for which their products were not priced. Consequently, premiums have to be increase far beyond what otherwise would have been the case. Higher premiums, more lapses. State mandates often force insurance companies to change underwriting standards to remain profitable (that dirty word again) rejecting people for coverage they used to accept. Specifically: four years ago we had one company that would issue health insurance to diabetics who were well controlled but not insulin dependent. Kansas decided that health insurance companies should be forced to pay for diabetic testing supplies and syringes–result, the one company who would issue non-insulin dependent diabetics changed their underwriting rules to exclude all diabetics.
Insurance is designed and priced to pay for unexpected and unpredictable events. The idea that insurance can and should pay for everything is absurd, it is impossible to make it affordable. In my more paranoid moments, I think that state and federal officials realize that, but in their desire to have the federal government take over health care, they keep adding all these requirements to gradually squeeze out the private approach.
While the Medicare system is probably a good idea, its institution began the huge upward pressure on costs with which we are still struggling.
There is a difference in positing health care as a fundamental right to which everyone is entitled and positing that we have a fundamental responsibility to care for those who are unable to care for themselves.
If you believe that health care is a right, then I would say that once again, you are approaching the problem from the wrong direction entirely.
All that being said, I think Joe Lieberman has the best idea out there that I have seen. It is fair, can be cost effective, and allow for good care. As I understand it, it would keep the current private system in place. If individuals are unable, due to their health or income, to qualify for individual insurance, they would be granted access to the Federal employees program. Along with that I would love to see companies be allowed to develop and sell mandate free policies as an option.
Let it be noted that the largest increase in the ranks of the uninsured recently has been among the affluent, not the indigent. The affluent are self-insuring. It has gotten to the point that it makes more sense to use their own money rather than other people’s money.
Any single payor plan will ultimately result in rationing of health care particularly in end of life care which has already begun under Medicare. In all likelihood, it would force people to pay taxes to provide abortions as well.
HIPAA (Health Insurance Portability and Accountablity Act), especially the “privacy” part, is a nightmare–another abomination foisted on us by Ted Kennedy and I am sorry to say former Kansas Senator, Nancy Kassenbaum.
I have talked with my own personal physican about his decision to not engage in any of the activities that would cause him to come under the HIPAA, such as filing or receiving insurance payments for his covered services. His minimum cost a year to be in compliance was in excess of $10,000 and probably closer to $25,000. If his compliance was not good enough, he would be liable to crippling government fines. All of this for one small office. The ripple effects throughout the health care industry is enormous.
The insurance side: As an agent attempting to find competitive group insurance for a client or prospective client and provide service, I used to be able to have off the cuff discussions with underwriters and service people to get the people I serve what they relied on me to obtain. Now, some companies will not even give me a policy number of a policy I wrote because somehow in their lawyers mind, such release of information violates HIPAA. In some instances, companies looking to find more affordable insurance are unable to obtain the required summary health information to give to another company because such information violates HIPAA.
On the personal side: If my wife is in an auto accident, and taken to a hospital, that hospital is forbidden to tell me whether or not she is there unless they have a written HIPAA release, nor can they discuss any aspect of her care and treatment with me without a written HIPAA release signed by her. Less you think this is an hypothetical situation, my brother has a friend who knew a close relative of his had been in an auto accident, he just had no idea to which hospital he had been taken. No hospital would tell him either way.
However, the federal government and drug companies can access pretty much any information they wish without prior authorization or notification.
The guarantee issue provision on groups of 50 lives or less sounds good, and initially it enabled some people to acquire coverage that would not otherwise be available. However, the provision puts tremendous upper pressure on the premiums health insurance companies have to charge to have enough reserves to pay claims, let alone be profitable (sorry, there’s that dirty word again) so that they can continue to offer insurance.
I call HIPAA, How to Interfere with a Person’s Ability to Acquire health insurance. It’s a cruel joke that creates havoc and increases prices and increasing the number of uninsured.
Under a single payor government controlled health system, the government would have access to an incredible amount of sensitive information that is simply none of its business. Only the vast inefficiency of such a system would protect us from such information being used against us.
I have heard that the costs of HIPAA, for the medical industry, when fully implemented, will exceed the costs of Y2K.
In some ways, HIPAA is a good thing, inasmuch as it raises awareness of patient privacy issues. For example, I work as a business/systems analyst at a hospital, and we are now VERY sensitive about releasing information that could be used to identify a patient. No report contains patient names unless it positively, absolutely has to, and all reports containing patient names end up in the shredder instead of the wastebasket when we’re done with them.
Concerning a single payor health system, one thing to consider is the tens of billions of dollars in overhead costs related to the billing and payment of medical claims. Medical providers have to employ armies of employees and spend many millions of dollars in computer systems in order to be able to participate in the current complex and cumbersome reimbursement system. On the other side are the insurance companies and HMOs with their own armies of employees. To the extent that a single payor system would free up resources currently devoted to billing and reimbursement bureaucracy, those resources could be used in actually providing health care.