Saturday, June 30, 2012

The Health of the Body Politic


“When people accept futility and the absurd as normal, the culture is decadent. The term is not a slur; it is a technical label.” — Jacques Barzun, From Dawn to Decadence
To many of us who count ourselves in the liberal —sorry, progressive—tradition, the last week of June 2012 will be regarded as a peak among valleys, an historic moment. That was the week that the Supreme Court, by a 5-4 count, upheld the healthcare law put forward by Congress and President Obama. It is legislation, incomplete though it is, which will make life better for millions of people. You might even say it was the right thing to do: that a government of the people, by the people, and for the people ought to care about the welfare of its people. You could say that, but having said it you ought not to be surprised at the outraged reaction of many who will not see this as fairness and equitable treatment for most, but a terrible imposition against the few. 

I try not to let the paralyzing complexity of the process blind me to the straightforward belief that universal health care should be available for all. That the United States is the only rich country in the world without such a plan is shameful. It is shameful in the old-fashioned sense that we ought to be ashamed of ourselves, feel the burden of guilt on our shoulders, and be determined to do the right thing. The “right thing”, of course, is the point at which the debate splinters into a thousand yelps of “who is to say what is the right thing for everyone? What’s right for you might not be right for me!”

Well, yes, that might be true if you believe in turning individual preferences, whims, fancies, fads, and choices into general rules for human society. But serious discourse on the moral rights and obligations involved in this issue often stalls over this wild-eyed belief that we are, every one of us, so different that we share nothing in common, not even our needs as human beings. 

In the inevitable tension between the individual and the community, we generally find creative ways to fulfill most of our wants as individuals without disabling the needs of our communities. We’d feel cheated if it were otherwise because we expect the community to honor our individuality. That’s the American way. But why is it so hard to wrap our heads around the fact that we wouldn’t have individual rights if all of us, as a community, hadn’t made it so? As individuals, we only have two options for asserting our rights: either we blow everyone else away or we work together to create a society that protects all of us individuals together. 

Hobbes thought only the Leviathan of absolute monarchy could keep us from each other’s throats. Otherwise, our natural state would result in lives that were “nasty, brutish, and short.” Others, including Jefferson, thought that reasonable people could freely make decisions together that would benefit the one and the many. We have the freedom to  voice our opinions, even our unreasonable ones, because of that deeply-held belief. 

Americans are nothing if not pragmatic; we usually take the cheapest, fastest, and most effective route to the solution. But we rarely speak the language of duty, especially about those we dislike or fear. Instead, we speak the language of economy, the lingua franca that unites us all in the glib glossalolatry of capitalism, marketing, and public relations. If you really want to make the point about the need for ethics you must show why it is profitable to do the right thing. Doing the right thing simply because we’re convicted it’s the right thing will often draw blank stares, because as a society we’ve lost the capacity to imagine that two or more people could agree on a moral duty. But if you hint at loss of profits or a public shaming at the hands of the media you’ll be making sense. 

So the argument for universal health care on that ground would take into account that we’re already paying the bills for the poor who are without health insurance. Requiring everyone to have health insurance that they can afford will lower the overall costs to our society; gradually building an emphasis on preventive medicine will lower the costs too. 

In the months leading up to the election we’ll be bombarded with propaganda from both sides. In order to divert the missiles and drones a lot of chaff will be blown into the air by publicists, lobbyists, campaign aides, and the candidates themselves. The Republicans are developing battle plans for a final assault on the Death Star of Obamacare. 

I’m going to lock on to a guidance system that allows two perspectives on the target: one is that people have basic rights as human beings—and adequate health care is one of them. The other is that the greatest benefit to all of us accrues when we all share the burdens.