Sunday 30 August 2009

Health and Taxes

Civilisation is an agreement. It is an unspoken acknowledgement to behave in particular ways towards strangers, and an acceptance that others have many of the same needs and rights as ourselves. We agree not to kill, hurt, or steal from others, and they agree not to kill, hurt, or steal from us. Furthermore, we agree that there are limits to our individual capacities, and that a division of labour allows us to live beyond those limits. We agree that we cannot afford some things individually, such as protection from rogue elements within and hostile groups without our own. Thus, we willingly constrain our actions in such a way as not to impede the well-being of others, and we (often not as willingly) pay in part for those services that we cannot afford by ourselves. Enlightened civilisations have further recognised that we are better off individually if we are all well-educated, and if we are all healthy.

This, fundamentally, is the rationale behind universal healthcare. We live in a time when the US, long the only developed nation without it, is finally facing that reality, and considering correcting it. The more intelligent objections to this focus on the notion that it would require individuals to pay for a system for which they might not approve, and which might not function as well as what the better-off citizens have come to expect. But these arguments tend to focus upon the failings, perceived or real, of individual systems. There are legitimate observations here, but these are not reasons to abandon the principle. Rather, they are examples to us, datapoints to be analysed, challenges to overcome. They can be overcome. It is entirely possible that America will wind up with a respelling of the same expensive, exploitive, and unjust system that it has now. I hope that this does not happen. The principle is worth struggling for, to get it right. We gain nothing, and lose much, by allowing those in less fortunate circumstances to suffer. Civilisation has its price: most of us pay taxes to fund it, but we must also remember that it also requires compassion.

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