The Great Divide

In a post about HSA's, Adrienne Aldredge has to respond to a comment that includes the following:

I get the sense that the fact that people are pleased with their HSAs, that they want them and can have them, is a good reason for their existence (if not the reason). We aristocrats know better, and I’m not being the least bit sarcastic. Letting regular people make decisions about their health care, even if HSAs create incentives for them to spend more time researching their options, is a really bad idea. That’s why I prefer the Cuban model.

The "we can't let people make their own decisions [about X]" line that I've been confronted with quite a few times when debating a number of issues, and I really don't know how to respond to it, because it means there's a pretty huge chasm between your beliefs and mine. Irreconcilable differences. Adrienne responds appropriately:

Well, if you’re being honest, then we’ve arrived at an impasse. I complete disagree that letting regular people make decisions about their health care is a bad idea. As long as you and I fundamentally disagree on that point, it’s almost pointless for us to discuss health care reform.

What's one to do?