Conflict - for the Sake of Heaven

I just wrote this essay today; I think it is important enough that I am posting it here and also to my more 'permanent' collection of writings on my website (http://rabbidonlevy.com/Conflict.aspx). I also may just use it was the basis of my sermon this Friday evening.

The title of this essay is a direct translation of the Hebrew phrase, 'mahloket leshem hashamayim.' It’s a rabbinic principle that disagreement and conflict are not intrinsically bad and can be good if channeled toward a good end. Everybody who has studied Judaism deeper than the weekly Torah portion is aware of the long-term conflict between the schools of Hillel and Shamai in the ancient academy. The two schools had completely different approaches to halacha (Jewish law). They disagreed with one another on virtually every point of law over a period spanning generations. But they had a common goal: that the people Israel would work to please G-d by living up to their individual and national responsibilities as G-d’s Chosen People. Because of this mindset, they worked through their disagreements toward a good result for their people.

The entire Jewish tradition is based on the premise that conflict is a natural and even healthy part of life. Did not Abraham famously argue (respectfully but argue nonetheless) with G-d over the fate of the inhabitants of Sodom and Gomorrah? Was not Jacob re-named Israel (‘he who strives with G-d’) because of his inner conflict over his G-d-ordained destiny? Did not the entire people come to be known by Jacob’s new name? (The appellation ‘Jews’ is later and represents the ancient split between the Northern and Southern kingdoms.)

But conflict has developed a bad name these days. Conflict, it is said, can only result in bad things: at the very least, bruised feelings, and at worst, outright war with every intermediate possibility between. To many people, the very existence of conflict indicates failure. As a pastoral counselor, I found this to be the mindset among many married couples on their way to divorce court; at a gut level, they took the fact that they’d had conflict to mean that they’d failed as a couple – that there was no redemption possible. They would never admit that; as I said, it was more at a gut level than a logical level. On a logical level, if we’re honest with ourselves, every occasion where two people disagree can only result in two basic outcomes: one party submerges his/her opinion and goes along with the other; or the two must resolved the disagreement through conflict. And in reality, at the end of the day only the second alternative is likely; one of the parties will likely tend to submerge his/her opinions enough times until he conflict becomes unmanageable. In other words, in one way or another, conflict is an inevitable fact of life for all but the hermit. But we do tend to hold idealized images of certain conditions – including marriage – which blind us to this reality and make it difficult to even accept the existence of conflict. Conflict has acquired, unfairly, a bad name.

Politics is an area where conflict always exists and is always in the open. At the risk of sounding as if I’m over-simplifying things, I’ll point out that there are essentially two competing worldviews in our American political arena: those of the conservative and those of the liberal.

If you’re a third-party person, a Libertarian or a Green or something else, please don’t flame me! I think that it is not just the two major political parties that are party to this conflict and the divide it creates; the smaller parties pretty much fit in on one side or the other. But that’s another essay, for another time.

Just for the sake of disclosure (if you didn’t pick it up already from any of my earlier posts in this blog), I’ll tell you that I’m a conservative. But as an observer I would point out that both sides of the conservative/liberal divide are full of individuals who are not helpful to the clash. The reason is that they are unable to step past their own positions and see the merit in the person on the other side. In other words, because I think your position is stupid/poorly reasoned/selfish/will lead to a bad end, I’m unable to put aside that I think you are stupid/a poor reasoner/selfish/a malefactor who would lead us to a bad end.

Let me give you an example. The biggest, or at least the noisiest debate in American society right now is the one over health care – or more accurately, over the way health care is funded and dispensed. Most of the liberals I know want a unified (‘single-payer’) system similar to that in many other countries, including (but not limited to) Canada and those of Western Europe.

Yes, I know that this is not the 'program' that is on the table right now in the legislation that is being considered. But President Obama and many of his supporters are on record as favoring such a solution, and many experts agree that the legislation being considered in its many forms will put us on the road toward that kind of a system.

In other words, many liberals want a very (some might say radically) different system than what we in the US have today.

Most of the conservatives want the current system but with certain government controls (such as those which make it difficult for insurance companies to compete across state lines) removed or lessened, and other controls (such as those which might prevent companies from dropping coverage, or which might limit malpractice lawsuits) increased. In other words, the system that we have now but with tweaks and adjustments to make it better.

All this is no surprise; by definition it is in the nature of liberal thought to favor transformative change (and President Obama campaigned on that very principle), while it is in the nature of conservative thought to favor more modest change!

But to listen to the public discourse, the conflict doesn’t sound as benign as that. To many liberals, the conservatives are 'heartless bigots' who want to 'deny health care to the poor and vulnerable.' To many conservatives, the liberals are 'socialists' who want to 'keep the liberal-controlled federal government in power by controlling the jobs and well-being of a majority of the country’s citizens.' To conservatives, they (the liberals) are the 'heartless ones' who want to ‘pull the plug on Grandma’ and assemble ‘death panels.’

The reality is this: each side favors a very different approach to the difficult problem of providing the best level of affordable care to the most people. Most agree that health care costs are out of control and need to be reigned in while ensuring more Americans have the coverage for the care they need. But the rhetoric of the conflict is so powerful that, by and large, neither side can see the other as well-intentioned. Neither side can see the other as having the same goal. Neither side can see the merit in the other, because they can’t see the merit in the other’s position.

I'm using an example from politics to illustrate the problem when our conflict is not for the sake of heaven. But it applies to all spheres of relationship: from the most intimate, to the most global.

I was discussing this recently with a correspondent of mine from Berlin, a woman who is deeply concerned with the problem of conflict in civil life and who wants to promote the ancient Jewish concept of mahloket leshem shamayim to help combatants and potential combatants solve their conflicts by peaceful means. I think she is on to something. I am therefore offering the following as a suggested formula for employing the concept in conflict:

(1) Assume that the other has the same good intentions that you believe you have, and try to make them see that you have the same good intentions that they think they have. Yes, there truly are malefactors about but most individuals try, or at least see themselves as trying, to be benefactors. If you start the conversation by giving the other the benefit of the doubt, and working to make them see that they would be doing well to give you the benefit of the doubt, that would certainly make a good start. If in the course of the conversation you find that you gave the other the benefit of the doubt mistakenly, you can always adjust the conflict to that reality. But I guarantee it won’t happen often.

(2) Once you have made the leap of seeing merit in the opposition, you will be in a better position to see merit (or at least good intention) in their positions. Even if you can’t see the merit in their means to achieve the end result, you might see merit in their envisioned end result. And that means quite a bit. If two sides to a seemingly-intractable conflict see their positions as basically intending to reach a similar end, that automatically makes the conflict less intractable. It means that the negotiation necessary to reach a method of reaching the end will have much more of a chance of success.

(3) One must be extremely careful not to use ‘code words’ or ‘code phrases’ that cast aspersion on the other side’s intentions. These loaded words and phrases have the effect of closing down debate and discussion rather than opening it up. When the conflict in question is one in an intimate male-female relationship, one must understand that men and women communicate very differently. But that's a different subject for a different day!

(4) Even if agreement is ultimately elusive or impossible, this exercise is not a waste of time. It is far better to oppose someone on the basis of disagreeing with their solution, than because one thinks them of no or little merit. It changes the very character of the conflict.

You’ll notice that I haven’t used the word ‘compromise.’ A compromise is a device to reconcile two positions to hopefully make both parties somewhat happy by giving each part of what they seek. If one achieves steps one to three above, a compromise might be the vehicle by which an ultimate solution is found that all can accept. But the act of compromise in and of itself will not tone down the hurtful rhetoric that unfortunately seems to poison so much of our discourse today.

So let’s disagree and thus have conflict. But let’s try to keep our conflict leshem hashamayim and thus, we will go a long way toward ensuring a good result.

The Healthcare Conudrum

Like many conservatives and middle-of-the-roaders, I find the idea of a unified, nationalized health care system, which many analysts predict will be the only possible outcome of the legislation that President Obama is pushing congress to pass this summer, frightening.

Like many Americans, I have watched elderly parents struggle with the Medicare system. Medicare patients are forced, if they are unable to pay for supplemental insurance policies or to ante up out of their own pockets for costs not covered by standard Medicare Part A and B coverage, to enroll in Medicare Advantage Plans – HMOs which are set up specifically for, or which accept Medicare patients at a set fee by the federal government – and thus have an incentive to cut costs in every way possible to make a profit of the business of providing health care for their elderly patients.

When my father, of blessed memory, was sick, every decision by his MAP created a nightmare of a clash of wills between my brother and me on one hand, and the MAP’s care director on the other.

The push-and-pull we had to engage in, as bad as it was, would have been impossible had we not had one trump card on our side; we could have pulled Dad out of that MAP and put him in standard Medicare Part A and B coverage. Therefore, while the MAP seemed intent on saving money on Dad’s back, they could be swayed on some decisions out of fear of ultimately losing an enrollee. But as Dad became sicker and sicker, that trump card became next to worthless.

(Lest one think that I am attacking indiscriminately all MAPs, after a geographic shift we enrolled Dad in one in the new state and its care decisions were mostly quite reasonable.)

With a nationalized health care system, for which there would be no alternative, one loses that trump card altogether; all decisions concerning provision of care would be in the hands of faceless bureaucrats who could stand behind their offices and would have no compulsion to even reveal their names to disgruntled patients.

I experienced this in a smaller way recently with my son’s care. As a military retiree, my family and I are covered under Tricare, the Department of Defense’s managed care system. Retirees and their families, and the families of active duty personnel, have two options: Tricare Standard and Tricare Prime. Tricare Standard works something like Medicare Part A and B – one makes one’s own care decisions but has to pay a large part of the costs – while Tricare Prime works like an HMO or MAP. Just as with Medicare patients, those without supplemental insurance plans or extensive cash resourced to cover out-of-pocket expenses, choose Tricare Prime for the additional coverage for a reasonable annual premium. The system is divided into regions, with a different contractor managing the care of patients in each region for the government.

Eyal needed to see a certain type of specialist for several visits, but we had a hard time finding such a specialist ‘on-network’ close enough to his school that he could be taken to his appointments. The Tricare Prime standard is that, if an on-network specialist can be found within a specific radius of one’s zip code, then the contractor does not need to cover a visit to an off-network specialist. The radius is, if I am not mistaken, 80 miles. If Eyal were home, I would drive him that far to get the care he needed without question. But he is half a continent away, and he is a fourteen-year-old boy who cannot drive himself. But those facts would not move the contractor, and they were under not compulsion under the terms of the contract to provide me with redress other than to go off-network in which case Tricare Standard reimbursement rates (and deductibles) would apply; in other words, I would have paid mostly out of pocket for the specialty care. So I’ve already had a ‘taste’ of the challenge we all would face under a nationalized health care plan, and believe me it does not look enticing.

I have been stationed abroad in four different countries, each of which has nationalized health care: The UK, Germany, Greece, and Turkey. These are four very different countries, and the quality of care varies greatly between them. As an American family stationed in these places, we did not find the prospect of being referred to the local system for care as frightening in the UK or Germany as in Greece or Turkey. The language issue was only part of the frightening aspect; we also knew that mortality rates in those countries’ systems were considerably higher than in the American system, with all its problems.

We hear horror stories all the time of higher mortality rates in ‘the best’ of the nationalized systems (e.g. Canada) due to advanced procedures being severely rationed and advanced drugs being unavailable. These stories are not just anecdotal; hard statistics back them up. Survival rates from various cancers and other illnesses are markedly higher in the US than in any of these countries. Surgeries that we take for granted as being available, surgeries that prolong life or improve quality of life, are severely rationed in these other countries.

Most Americans, knowing these statistics and stories, do not want a nationalized health care system that will make us imitate the experiences of our neighbors in Canada, or our European cousins. And President Obama, in his campaign for office last fall, promised that his health care program would only provide a ‘government option’ and not interfere one iota with the coverage of Americans who are happy with their present care and coverage – which is to say, that of most Americans.

The concern of detractors is only in part that, whatever the government’s intentions, a government ‘option’ will ultimately kill competition in the marketplace and we’ll end up with a Canadian/European-style system with no options. Add to that, the President’s own recent backpedaling on the campaign rhetoric to open admission that – under his plan – many Americans will see changes to their health care. And finally, the President’s intense pressure on congress to pass legislation according to an artificial and rushed timetable – and the willingness of many Democratic legislators to be pressured out of loyalty to Obama – raises fears that, at the very least, the congress will pass sweeping, complex, game-changing legislation that will be signed into law without even having time to consider the many aspects of what they’re approving, not to mention unintended consequences thereof.

I agree that fears of a nationalized, ‘single payer’ health care system are not irrational; I believe that unintended and intended consequences of this rush to produce legislation that the President will sign, will conspire to give us a system along the lines of the Canadian/European system that will satisfy no one, except perhaps those who have no insurance coverage now.

The last time such a sweeping change in our health care system was attempted, by President Bill and Hillary Clinton, it failed because of a groundswell of public opinion against it. President Obama seems to be taking as the lesson of that failure, that the quicker he can ram through the legislation and sign it into law, the greater his chances of success in enacting this legislation that most Americans, given time to chew on it and consider, would tell their representatives to reject.

Instead, I and other sceptics would prefer the President take a much different lesson from the experience of the Clintons: he should instead work for a reform of the present system to fix its shortcomings and make better insurance coverage available to those who fall through the cracks now. Our fear is that America has elected a ‘Hard Left’ President who is so enamored of the idea that Government is the Answer to All Our Problems, that he is not really concerned about what most Americans think.

All Americans who know people who have experienced nightmares in getting health care under Medicare and other government programs such as Medicaid and Tricare and whatever, should ask themselves: Do I want the government providing my health care? If the answer is no, please do two things: send your congressman and senators e-mails telling them to reject the legislation currently underway on Capitol Hill, and sign the petition found at http://www.freeourhealthcarenow.com/.