Truth and Consequences

I think I related this experience in a previous blog but in view of the booklet I am reading, it needs repeating.
Approximately twenty years ago I went to Washington to see an Arabian horse that was advertised for sale. She was a daughter of Bask, one of the leading sires in the Arabian horse industry. When I arrived the mare was brought out for my inspection (She was well groomed and well presented). Part of assessing a horse is to observe the animal in motion, so accordingly, I asked the owner to trot the horse away from me, and then towards me. This process confirmed to me that this mare had the worst back legs that I had seen on a horse in a long time. She was so close behind that she almost hit her back legs together as she moved. I asked to see some offspring, and sure enough, her offspring unfortunately had the same terrible back legs. Now, there was no question that this was a beautiful Arabian mare, well put together in other ways, and had an excellent pedigree. During the showing of this mare, the owner said nothing, he simply watched me looking at the horse. After a considerable time, he approached me, put an arm on my shoulders in an endearing and confidential way, and said: “You know what I like about this horse, doc”? I said “Tell me”. “I think this mare has incredible back legs”, he said. “Absolutely incredible”, he said.
I was dumbfounded. First I looked to see if he was joking. Then I looked once more at the horses back legs and then at the owner again. I’m sure my expressions were bizarre. Needless to say, I didn’t purchase the horse. It occurred to me later that the good aspect of the horse were apparent. It likely was obvious to the owner that I had concerns about the horses back legs. In order to sell me the horse he would have to allay my concern about the fault, and the best way to do that would be to make me doubt my own judgment. If I perceived the worst trait of this animal was its back legs and he thought that was the mare’s best trait, then perhaps it wasn’t as bad as I thought. From that day on I realized that when someone wants to sell you something, they will often take the weakest position on a subject and present it as the strongest argument for a position. The same principle applies to issues in health care. If the major claim to changing from a monopolistic tax payer funded health care system is that it is unsustainable, then the advocates of the status quo are going to make a huge point that the present system is by far the most affordable and cost effective. Most of us can see the things we like about our health care system, what concerns governments is the large chunk health care takes out of the provincial budget, with the ever rising cost. What concerns us, the consumers of health care, is the increasing lack of accessibility, with the associated long “risk” lists. If the person making the pitch takes the negative and totally misrepresents it as a positive, we may then go along with their position. Similarly, if they take the positive and blatantly and deliberately misrepresent it as a negative, they may have taken away other options. This may require a certain amount of crass and dishonesty, but there seems to be a lot of that going around lately.
Over the last twenty years I have always kept my Arabian horse experience in mind when I sat on committees dealing with health care reform. When the government said we are going to make health care “patient focused” I groaned, knowing that we would be moving towards “management and cost effectiveness focused health care” and away from being “patient focused”. Recently, I once again was reminded of my previous horse experience when I read the title to a book titled “The Bottom Line” (The truth behind private health insurance in Canada). When someone claims to expound the “truth” about anything in the health care field, I flash back to the best thing about that horse was “its back legs”. This book sounds like it is trying to sell me something.
I shall read it over carefully and decide for myself. I note that neither of the authors are physicians. Diana Gibson has a background in public policy and has affiliations with the Trade Union Research Bureau. Colleen Fuller is the president and co-founder of Pharmawatch, a consumer advocacy group. It will be interesting to read what these two non-medical/non-physician advocates have to say. Stay tuned as I read their version of the “truth”!