Tuesday, August 18, 2009

Oliver O'Donovan and Public Health Care

“It is a Western conceit,” O’Donovan writes, “to imagine that all political problems arise from the abuse or over-concentration of power; and that is why we are so bad at understanding political difficulties which have arisen from a lack of power, or from its excessive diffusion.” He cites the example of Somalia, admitting that “such power as there has been has, as a matter of course, been abused.” But a more crucial problem is that “political power was never strong enough to cope with the daunting natural obstacles.”

Disease and famine, he suggests, are as crucial “enemies” as tyrants and invaders, since they are “depoliticizing forces” that “prevent people from living in communities, from coordinating their efforts to the common good; from protecting one another against injury and maintaining just order; and from handing on their cultural legacy to their children.”

The above is a short blog post from Peter Leithart, where he is summarizing some of Oliver O'Donovan's thoughts from his 1996 book, "The Desire of the Nations." The skepticism of nation-state power that O'Donavan bemoans is relevant to the current debate over reforming health care. One of the main criticisms that is lodged against pursuing the option of a public health care plan is that health care is not a right, it is actually a commodity, or a privilege. Therefore, the American government, with a public health care plan, would be providing something that it does not have business or authority to provide. This has been shouted to the world via televised town-hall meetings with the threat that if we go this route we are wittingly lifting up the dust ruffle and inviting the boogy man with the S branded on his chest into our bedroom to have his way with us.

Beyond the obvious ridiculousness of such alarmism there is a more subtle problem with this warning. As O'Donovan is aptly pointing out, can it honestly be maintained that the tyrants that our military defends us from are more "depoliticizing" than the immobilization of our citizens from untreated disease? We have picked and chose randomly where we want government to interfere with our lives- a product of the post-enlightenment skepticism of everything authority. Yet, in the wake of increasing awareness of the things that threaten our health, and the technological wherewithall to combat them can these arbitrary distinctions be maintained? Why do we consider health care a commodity? Seriously, why? Why is this proposed plan any different from the preventative care I get from the United States Marine Corps? Why am I owed one (as a U.S. citizen) and not the other?


P.D. said...

great post. excited to see this thing up and running again.

I guess the question is, is healthcare a right or a privilege? I think it's a right. What are the other thoughts out there?

david gentino said...

Thanks for breaking the intertestamental silence there John.

That's an extremely helpful distinction - right or privilege. And I imagine if you start asking that question too much you're going to find yourself in a heap of trouble.

Is it a right or a privilege to have decent public schools in west Baltimore? Is it a right or a privilege to spend exponentially more on fiber optic infrastructure?

I wonder if who gets what has anything to do with it.

david gentino said...

From my friend Brianna:

Very thought-provoking and timely. With the citation at the end, I am assuming that this is not your own language, but can I assume that you agree? Of course you could, like me, be undecided about the issue but are sure about one thing--conservative "alarmism" and seeming dismissal of intelligent dialog is a greater danger than a public option. ... Read MoreMaybe I make two wrong assumptions, but I'm intrigued by the language of this post and the apparent depth of thought and research. I am hungry for the calm, rational and well-reasoned dialog that seems so lacking in our current entertainment media.

Jon Furst said...

Amen on breaking the silence.

This is an urgent question no doubt. It is one thing to delineate between health care as a right or privilege and an entirely different matter as to whether the government can adequately administer it. In his series or radio addresses "The Idea of a Christian Society", T.S. Eliot asks a pertinent question, "[…]what– if any– is the 'idea' of the society in which we live? to what end is it arranged?" (6) He goes on to make the point that the goal of our society, so long as it is anything other than Christian, is going to be very different from the aims of the Church. Thus, while we as Christians may abhor the thought that those that are considered a burden to society be euthenized (for example), if the government deems it advantageous, its health care will serve that end so long as the health care belongs to the government. There is a great amount of work to be done on the part of Christians in articulating their ends.

I daresay that this confusion of ends is a great reason why this discussion gets so murky.

John Paulling said...

Brianna- thanks for joining the discussion. You're right, we need much more calm, well-reasoned discussion. The lack of that, in my opinion, has been a huge part of the problem of late.

The point that David posed does make things rather murky. It is maybe obvious that I (and I think the rest of us here) would be more excited about beefing up the public school system in West Baltimore (Presbeluszki needs a job) than I would be about fiber optic infrastructure... different strokes for different folks though I guess. My question would be, why can't we get away from these paradigm things? Where if you think the government should provide x, you also must want them to do y and z. I think we can prioritize and make distinctions, and move forward democratically. The point that O'Donovan is making that I think is remarkable is that sometimes over-governing can create problems, and sometimes under-governing can. It is simply untrue that more government is always a recipe for disaster.

Jon, I'm not sure I understand entirely the ends thing. From a Christian perspective, and from a purely secular perspective uninsured people debilitate the "health" of society at large.

John Paulling said...

Thanks for the facelift PD

Jon Furst said...

Yeah, it looks good. Could we cut it down a bit?

Jon Furst said...

Ah, sorry for the lack of clarity. I am suggesting that you are talking about two different things; whether or not health care is a right or a commodity is one 900lb gorilla and whether the government is the one to care for it is another one entirely (a gorilla caring for another gorilla… maybe). I would suggest that even if health care is a right, and I think it is, what is done with it depends entirely on the one administering it. So simply answering your question would not imply that the government is the one who should administer it, even if the government is currently the only one who can legislate it.

Soon yet another gorilla will enter.

Christina Ottis said...

I'm glad ya'll are writing again. The point I always return to with this debate is that medical care, although a vital commodity, is in fact a service. Men and women have to go through many years of school to provide that service, so how is it a "right"? But at the same time, we probably think clean water is a necessary commodity as well, yet trained professionals are required to provide a water system. Beyond our basic freedoms as Americans: freedom of religion, of speech, of choice, most everything else we appreciate are services provided by our fellow Americans, and sought after by less developed countries. It is not my God-given right for someone to go to school and get a teaching degree, but I hope that many do so that one day my kids can have a good education.

So once we conclude that most of what we demand as Americans are in fact privileges provided by trained individuals, it comes down to what is a priority. Trust me, I am all for nationalized health care. You don't want to know how many medical bills I had after graduating college and still having to go to the doctor all the time. I couldn't even get decent insurance because of my "pre-existing conditions." It's a crappy system, but if it's not a priority to republicans, than it's not. I was just watching the West Wing episode where they were criticizing Ellie Bartlett for studying HPV and how to prevent cirvical cancer. The republicans argued that this takes money away from cancer research and other diseases that aren't contracted sexually. Josh argued that many discoveries, including penecilin, were made researching for something else. Scientists should be responsible for what research is important, not politicians. So on what basis do politicians decide what is a priority and what is not? It has to come down to the constituency. What's sad is that nationalized health care is being labeled as right or wrong, a "right" or a socialist abomination to a democratic society. The way I see it, it is just a matter of prioritizing. What is important to the American people? But this is the sad thing about the two-party system that plagues almost every issue. Instead of two equal choices, we face right or wrong, good or evil, and everything seems to be moralized.

Jordanian Eagans said...

hi. first time caller. this health care "reform" issue has mostly caused me to think about how selfish we are. all of us. we have been buying and selling health care in the states for so long that its hard to see it as something other than a commodity, to be bought and sold. if it is a commodity, then the system is fine and, really, we should be doing our best to make health care as unattainable as possible in order to make the most profit out of it. if it is a right, then the system is in desperate need of re-form, because people are being denied a right. what i find to be interesting is this: my brother is opposed to this health care reform but is also unable to financially provide health care for his family. what's that about? we seem to be so tied up in this fear of socialism that we begin to think and speak irrationally about health care reform. my brother seems irrationally opposed to the health care reform, as it would benefit him. he is also opposed to welfare, even though he benefited from it in raising his 2 children on wic. what a strange world.
i think the best solution to all of this is really insurance reform, since socialism is completely contrary to capitalism and will probably never work.

John Paulling said...

Thanks for the comments. Christina, I think "right" just has a bad ring to it when you use it the way you are using it. Although your distinction between "right" and "service" is, I think, a good one. No matter how you word it, the services that we are provided are actually services that fulfill what you think is more appropriately deemed a right. Freedom of religion, speech, and choice are abstract principles until they are embodied. This was my point with health care. When people who don't have it are unable to receive treatment then their freedoms can be more easily
violated. Great comments.