We will make mistakes if we go forward, but doing nothing can be the worst mistake. What is required of us is moral ambition. Until our composite sketch becomes a true portrait of humanity, we must live with our uncertainty; we will grope, we will struggle, and our compassion may be our only guide and comfort.
~ A. Stone, Law, Psychiatry, and Morality
This is very interesting to me. I think it gets at many of the unspoken assumptions that divide Tea Party supporters from those of us who shake our heads in disbelief.
My hypothesis is that what all the events precipitating the Tea Party movement share is that they demonstrated, emphatically and unconditionally, the depths of the absolute dependence of us all on government action, and in so doing they undermined the deeply held fiction of individual autonomy and self-sufficiency that are intrinsic parts of Americans’ collective self-understanding.
The implicit bargain that many Americans struck with the state institutions supporting modern life is that they would be politically acceptable only to the degree to which they remained invisible, and that for all intents and purposes each citizen could continue to believe that she was sovereign over her life; she would, of course, pay taxes, use the roads and schools, receive Medicare and Social Security, but only so long as these could be perceived not as radical dependencies, but simply as the conditions for leading an autonomous and self-sufficient life. Recent events have left that bargain in tatters.
But even this way of expressing the issue of dependence is too weak, too merely political; after all, although recent events have revealed the breadth and depths of our dependencies on institutions and practices over which we have little or no control, not all of us have responded with such galvanizing anger and rage. Tea Party anger is, at bottom, metaphysical, not political: what has been undone by the economic crisis is the belief that each individual is metaphysically self-sufficient, that one’s very standing and being as a rational agent owes nothing to other individuals or institutions. The opposing metaphysical claim, the one I take to be true, is that the very idea of the autonomous subject is an institution, an artifact created by the practices of modern life: the intimate family, the market economy, the liberal state. Each of these social arrangements articulate and express the value and the authority of the individual; they give to the individual a standing she would not have without them.
From The Stone
No individual has an incentive to pay for providing the efficient quantity of a public good because each individual’s marginal benefit is less than the marginal social benefit. This is a primary justification for the existence of government. ~Paul Krugman (emphasis added)
The more I hear and read about opposition to health care reform the more I am convinced that the fundamental dividing line between proponents and opponents is a disagreement over the classification of health care as a public good. From a moral perspective, universal access to basic health care is extremely attractive to me. I understand that limited resources mean that not everything can be provided for everyone, but that doesn’t mean that we shouldn’t do what we can. But even if your moral sensibilities don’t cringe at the thought of raw capitalism barring sick people from their doctors, expanding access to health care is good economic policy.
Many people don’t see a sufficient incentive to purchase insurance. In the equation they see, their marginal benefit doesn’t equal their marginal cost. Consumers will (almost) always act in their own immediate best self-interest. They don’t have an incentive to insure themselves until they need it. But insurance works by spreading risk; it depends on having a large enough pool to ensure that not all participants are drawing funds out at the same time. Someone in the pool has to be healthy and paying in. As long as enough consumers wait until they are sick to get insurance, which is the economically rational thing to do, insurance premiums will increase endlessly because uninsured (or underinsured) consumers have little incentive to act against their immediate economic self-interest.
The trouble is that eventually even the healthiest people find themselves in need of a doctor’s services. And then, frequently, it’s a case of too little, too late. People without access to health care don’t get regular checkups, and they don’t seek preventative care. When they get sick, they tend to be sick longer and more severely. They work reduced hours and lose their jobs. They lose their businesses (leaving others unemployed) and their homes. More unemployed people mean less money spent, dragging down the economy. Uninsured people show up in emergency rooms, wracking up huge bills that are eventually passed on to insured consumers via increased premiums. They draw disability, social security, unemployment, food stamps, and subsidized housing. The very people most opposed to health care as a public good end up imposing the largest costs on society.
For this very reason – because the marginal benefit to the insured consumer will be less than the aggregate benefit to society of a healthy population – it’s time to bring health care into the realm of the public good. Both because it is a moral good and also because it is financially beneficial.
Rough transcript of a phone conversation at work yesterday:
Caller: Hi, I’m ___, the secretary at _____ Church, and someone called yesterday saying that (your company) had referred her to us for help getting out a shelter for abused women, and I just wanted to make sure that you knew that we don’t do that here at _____ Church.
Me: OK. I don’t think anyone here actually referred anyone by that name, but thanks for letting us know.
Caller: Yes, well, we bend over backwards for our church members, but we just can’t reach out into the community.
Me: …(stunned silence)…
While I’m gathering together my pictures and whatnot, may I recommend taking a little field trip over to the True Womanhood blog? There’s an exceptionally interesting discussion going on regarding a documentary and book put out by Anna Sophia and Elizabeth Botkin. Gentlemen, this discussion is quite germane to you as well since the Botkin sisters are trying to “reclaim” the father/daughter relationship. There are a lot of posts, but it’s well worth reading through. This is scary stuff.