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Freedom and Healthcare

Posted by Christopher Long on 08/23 at 10:47 AM

As August moves into September, the heated and angry debate over health insurance reform is beginning to give way to more sober considerations. I was very pleased to hear the President finally beginning to make the ethical case for health insurance reform in his weekly address this week. After attending Senator Specter’s town hall meeting here at the Penn Stater on August 12th, I was struck by three things: first, the intensity of the anger of some participants; second, the absolute inability for some to think through the position they were advocating (as evidenced by this video) and third, the impoverished understanding of freedom many of the most vociferous participants embraced.

This third is what I hope an appeal to the ethical dimensions of the health insurance debate will begin to address, for many at the town hall embraced an insidious libertarian position that understands freedom negatively as the absence of constraint. The libertarian political philosophy is founded on the idea that each individual is fundamentally independent.  By denying the basic interdependence of human existence, libertarians argue that the only role the government should play in the lives of individuals is to ensure that no one constrains their freedom.

But freedom might be more positively conceived. Positive freedom means the ability to pursue a fulfilling life. The advantage of the more positive conception of freedom is that it recognizes the interdependence of human existence. On this view, basic healthcare is an important component of securing the freedom of citizens, because it empowers people to pursue a meaningful life. The ethical case for health insurance reform is rooted in the recognition that human beings depend upon one another and that a fulfilling life is never an achievement of the isolated individual, but always of individuals working and living together with others—be it in a family, church, city or, indeed, country.

It is always surprising to me that many people who embrace Christianity also embrace a strong libertarian political philosophy; for it seems that Jesus himself gave voice to one of the most poignant reminders of human interdependence when he said: “whatsoever you did for the least of these brothers of mine, you did for me” (Matthew 25: 40).

If the healthcare debate must center on the question of freedom, let it be the positive sense of freedom and let us think about how we can ensure that as many of us as possible can pursue happiness in a fulfilling life.

{name} Author: Christopher Long
Bio: Associate Professor of Philosophy / Director of Graduate Studies / The Pennsylvania State University

Comments

Posted by .(JavaScript must be enabled to view this email address)
08/23 at 01:09 PM

It is not clear to me how the position that “...a fulfilling life is never an achievement of the isolated individual, but always of individuals working and living together with others…” contradicts the position that “...the only role the government should play in the lives of individuals is to ensure that no one constrains the [sic] their freedom.”  Isn’t the libertarian response that government mediation actually deadens our social relationships by making us beholden to an abstract bureaucracy rather than each other?

Posted by Christopher Long
08/23 at 09:07 PM
State College, PA

The libertarian party in the United States seems less concerned about the deadening of social relationships than about the maximization of individual freedom in the negative sense indicated above.  To quote from their website: “Each individual has the right to control his or her own body, action, speech, and property.  Government’s only role is to help individuals defend themselves from force and fraud.”

You bring up, however, an important point here: the libertarian position understands government as divorced from the individual citizens that adopt and empower it.  To see government as an “abstract bureaucracy” that “deadens our social relationships” is to adopt a political stance that is fundamentally anti-democratic. For at the core of democracy is the recognition that the people are the government and that the institutions we establish are created by us and for our benefit.

This, of course, does not mean that we agree with everything that our government does; but it does mean that if we don’t it is incumbent upon us to work to improve ourselves. The problem comes, as it does now, when improvement for some means to limit government to the defense of individuals against force and fraud. In this case, an argument about a more positive conception of freedom is required. This argument, it seems to me, is best made by asserting the central importance of human interdependence.

Even if we can agree, to quote again from the Libertarian Party website, that “... each individual is unique” and that we “want a system which respects the individual and encourages us to discover the best within ourselves and develop our full potential”, we might disagree that government can play a positive role in both affirming the uniqueness of each and the potential of all.

I believe it can and, for all its limitations, in fact it very often does.

Posted by Joshua A. Miller
08/25 at 06:44 AM

Chris, I’m sympathetic to this line of inquiry, but I think your response to Brunson may be inaccurate. You write:

“To see government as an “abstract bureaucracy” that “deadens our social relationships” is to adopt a political stance that is fundamentally anti-democratic.”

Yet political theorists on the left and the right have tended to say that, in fact, government -has- become increasingly bureaucratic and increasingly distant from everyday human affairs. What we now speak of when we speak of politics is a kind of partisan cheerleading for different ideological positions, different policy platforms whose planks are not always well-joined, while the actual work of government remains the filling out of forms, the careful gathering of data, and the enforcement of highly technical rules, which our politicians have deputized a vast bureaucracy to accomplish.

This fact about the world is fundamentally anti-democratic, but it is possible to adopt a stance vis-a-vis the fact of bureaucracy that -is- democratic: specifically, to wish to submit more of our decisions to forms of accountability like the town halls. Yet I’m really -not- sure we should want to take back the authority we have granted to bureaucracy, which is fairer and more efficient than our messy political life or the frequently ignorant citizens who most wish to steer it. My own small-d democratic posture is one that feels very awkward, uncertain, and poorly grounded. That I continue to hold this posture in the face of evidence is perhaps the least rational thing about me!

Posted by .(JavaScript must be enabled to view this email address)
08/25 at 02:18 PM

Nowhere has democracy ever worked well without a great measure of local self-government, providing a school of political training for the people at large as much as for their future leaders.  It is only where responsibility can be learnt and practised in affairs with which most people are familiar, where it is the awareness of one’s neighbour rather than some theoretical knowledge of the needs of other people which guides action, that the ordinary man can take a really part in public affairs because they concern the world he knows.  Where the scope of political measures become so large the the necessary knowledge is almost exclusively possessed by the bureaucracy, the creative impulses of the private person must flag.

-Friedrich Hayek, The Road to Serfdom, 241-242 [1944]

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