Ideology and self interest won't win health care debate

The knives have already come out in the fight against health care reform in 2009.

On the one hand we have ideology, represented by former Rep. Dick Armey, who complains that some Republicans are getting weak-kneed in their rejection of any but the most "market-oriented" (i.e., tilted toward the wealthy) reforms.

Then there's pure self-interest, as in this study by physician recruiters LocumTenens claiming 20% of doctors will quit practice if they have to treat everyone.

Neither objection addresses the sad fact we discussed yesterday. The poor and uneducated may be gulled for a time into rejecting claimed allies who are themselves bejewelled and degreed, but not forever.

We know what happens when the poor have no access to the market or the political process. Reproduction becomes the only security, and violence is directed against those seen as oppressors.

There are very real demographic and social changes taking place in American society, as access to education becomes a fault line and ideology makes our society increasingly feudal.

We can either hang together or we will surely hang separately. Either address the reality of premature death in the present system or wait for the top to blow on this powderkeg.

Your choice.