In my English classes I’m at that point in the semester when we discuss the three fundamental elements necessary to think and write critically about a thesis: description, compare-contrast, and effect-cause. (Until yesterday I would have said cause-effect, but then one of my students pointed out that actually we should say effect-cause since we notice the effect before we look for the cause. Go students!)

To make clear how these three fundamental elements work, consider the current health care debate which has as its thesis something like the following:

Because so many Americans do not have insurance or can’t afford the insurance they have or are surprised to find that the insurance they have doesn’t cover their illnesses or discover when they become ill that they are no longer covered, and because private insurance companies can deny coverage based on pre-existing conditions and because there is too often too little competition between insurers and because medical care has devolved into a profession in which doctors and their patients are no longer the primary focus of health care and because these intolerable conditions obtain right here in these United States of America, the only industrialized nation without universal health care, we, the American people, have decided to reform health care in such a way that all will be covered and that will enable doctors and their patients to focus on staying and getting well.

This is a mouthful I know, which probably, even at this length, has left some important concerns out. It certainly leaves out President Obama’s paramount point in his speech on health care reform that fixing health care is a moral imperative: we need to fix health care because the moral character of our country must extend beyond me to you; each of us is to a degree our brothers’ and sisters’ keeper because we care about others, not just about ourselves.

Ideally, we and our government representatives should critically examine this thesis using the three fundamental elements of critical thinking:

Description: We need to describe in detail each element of the thesis, using evidence as necessary as well as examples and illustrations. We can quote statistics, and certainly we want to hear the horror stories about those who weren’t properly served and about those who died or were injured for life.

Compare-Contrast: We then need to compare and contrast our health care system with others that seem to work better and worse than ours, looking in detail at the moving parts in and design of each.

Effect-Cause: And in each case we need to examine the why of our system as well as of the others. Why does a particular system produce better or worse health care? Why does a particular system cost more or less? (Actually, it seems that there is no system that costs more than ours.) Why do doctors and patients prefer one system over another?

Sadly, much of our “discussion” of health care here in the US is about as far from critical thinking as is possible for a people who have putatively evolved beyond  throwing stones at one another. Shrill cries from some that we are creating death panels, are enabling government to take over medicine, and are constructing a public-option Trojan horse that will lead inevitably to “socialized” medicine in which all will wear gray suits and speak without humor are hardly signs of a rational, critical discussion.

For an antidote to this sad state of affairs and to celebrate critical thinking, see T. R. Reid’s The Healing of America, reviewed by Dr. Abigail Zuger in The New York Times, in which Reid describes health care in the world, compares health care systems, looks carefully at why they work, and examines possible effect-cause solutions to what ails us in the US.