The rise of mass consciousness, a uniquely modern phenomenon, has resulted in the proliferation of an idealistic, moral view of the world. It has been the most singular achievement of modernity. Nowhere has its impact, its peculiar stamp, been more evident or more pronounced than in politics.
It's ironic that a totally secularized society, inaugurated by the Age of Reason and Nietzsche's fateful pronouncement that God is dead, should produce its own brand of religion – call it humanism, or progressivism, or simply a belief in the possibility of a better, more equitable world – but such has been the case; there's no other way to call it.
Just think. Practically every single advance in the area of human rights, every significant social gain in the past century or so, has been won with "universal morality" serving as its banner, its call to arms. Indeed, one could well argue that the theory of (human) rights, the centerpiece of modern political theory, is a descendant of this peculiarly moral, quasi-religious point of view, its more or less natural consequence.
Why rights? Because "rights," properly understood, represent an extension of the moral equivalence and worthiness of persons, the incarnation of that worthiness through its multifarious manifestations; they encapsulate and make concrete the morality of persons. Which is why progress in the area of human rights represents real progress, there being no other kind.
The topic at hand presented an anomaly of sorts because unlike other rights, universal healthcare is contingent in a very real sense on the material conditions of a given society: in a nutshell, a society must be prosperous enough to be able to afford it. Since human rights, especially those pertaining to the moral equivalence and worthiness of persons, are unconditional, it follows that we can't speak of universal healthcare as a right.
Hence the needed corrective, recasting universal healthcare in terms of benefits and social or societal obligation to provide such to each and every member – again with an all-important proviso that the society is prosperous enough to carry out the program. Now we must show that the obligation in question is in essence a moral type of obligation, and that the cause of universal healthcare isn’t diminished from having been "demoted" thus from its ill-conceived status as a right. Once done, we can still hold on to the idea of universal healthcare as a moral imperative, though contextualized this time to a particular society – namely, a society which presumably can afford it.
Once again, I’d like to refer the reader to the exchange which has virtually kicked off the entire series:
PRO: Health care should not be a choice. One should not have to choose between health care or rent or food on the table. Not in a civilized world.
CON: It does seem like such a moral truism in our current context, but the context obfuscates the central issues. In simpler terms, if the world consisted of you and me and I decided I didn't want to work in the garden or help with the food or exchange you anything of value for it, should you be forced to work twice as hard for the rest of your life to do it for me? The answer might very well be yes, but there is a distinct trade-off. Food and health care don't just magically appear; someone is working their ass off to make it happen. Because our society is large and our services big and complex does not make that simple fact any less true.
Notice that the opponent as good as concedes the moral argument for he does speak of "moral truism" of sorts — namely, that in a civilized world "health care should not be a [matter of] choice" in that one shouldn't have to choose between health care or rent or food on the table. His objection is a practical one, having to do with who is going to pay for it, or more succinctly per-haps, who is going to have to work twice as hard to make it happen. Whether a "civilized world" entails a prosperous one as well is another matter; I'll assume that it does. I shall also assume that when push comes to shove, our society can afford it. But practical considerations aside – and that's a subject for another time and place – the moral point remains.
Again, I'm going to fall back on the notion of rights representing an extension of the moral equivalence and worthiness of persons (as members of a political community). And by that token, just as our fundamental human rights (to life, property, and so on), or the extended, citizens' rights (such as civil rights or universal suffrage), are but some of the expressions of that worthiness, it's no different with health care: they all espouse a system of values whereby humans and human well-being are central.
Consequently, it doesn't really matter whether health care is a right or a societal obligation, reflecting a mere possibility in the actual world and therefore contingent for the fact, because the relationship is the same – a relationship, that is, between human worthiness (and all that it entails), which is the highest value, and its different expressions. And since no material contingency can possibly upset a relationship that is essentially logical or concept-bound, it follows that every human society ought to aspire to promote the well-being of all its members, regardless of whether it can afford it or not; and this includes health care.
On this scheme of things, individuals and their well-being come before a political community or the state. It is for their benefit that the state is instituted, not vice versa. This explains why the only credible objection to universal health care is a practical one, having to do with affordability and redistribution of wealth, or the passion which infects all the proponents – a passion, I might add, that's clearly born out of moral conviction, there being no other source. (I think we can safely discount the few die-harts who still argue the case on moral grounds; they're dinosaurs.)
We've come full circle, endowing universal health care with the status of moral imperative. Its present status as moral obligation, dischargable only in some cases and not in others, ought to be viewed as a temporary condition. Which suggests an agenda for all right-thinking women and men: forging a more prosperous world, a world in which poverty and hunger are no longer, a world where all the usual amenities and dignities which are due to humans are available to all.
If a world government or the new world order is the answer, so be it. The important thing is – no one must be left out.
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