Why we need universal health care, among other things

It’s the day before Thanksgiving, and soon one of our most shameful national events will begin in newspapers around the country.

What could this be? Our local paper calls it “Season of Sharing”, and it also goes by holiday-themed names such as “Lighting a Candle”, “Giving Tree” and so on. The newspapers identify local residents in dire need, with the help of social agencies and non-profits, and feature their stories as a way of soliciting help from readers.

During the holidays people are, or wish to be seen as, more generous: this is the season of food drives for food banks (which scramble for food every month of the year), the time when families descend on social service events to volunteer and feel good or show caring behavior to their children while dishing up holiday meals to people who only eat this well once or twice a year. I don’t need to point out the blind spots here. My point is different.

Let me describe one of the most egregious examples I have seen of the “Season of Sharing” phenomenon. A few years ago our paper featured a young man in his early twenties who had lost a leg to leukemia at age 11 or so. He was still using the artificial leg fitted to him a decade or more earlier. He worked full time, spending a good deal of each day on his feet; the ill-fitting prosthesis was painful and did not work well but he had no alternative. He had no medical insurance at his job and did not make enough to save up for a new leg (several thousand dollars, perhaps, including fitting). His mother also worked but her medical insurance of course did not cover him any more and had not been adequate to such a need when he was a minor, either. This young man was suggested by some agency as a person who could not be helped by the existing social welfare system.

Why was this young man having to depend on the kindness of strangers for a chance to get a prosthetic leg that fits so he can work and walk without so much pain? Is this the best way for our nation to respond to such needs?

The Rush Limbaughs of the world denounce universal health care as coddling of citizens who should take care of themselves and could if they’d just work harder. English statutes of long ago differentiated between the helpless––old and sick, babies and children–and the “sturdy beggar”, someone who could work if he would. Assistance to the former was available though limited and begrudged (read Oliver Twist); the latter group, also called vagrants and rogues, were considered to be undeserving criminals. We’ve maintained this distinction and pretended that there is living-wage employment for everyone who wishes to work, and that healthy families can be maintained by anyone who tries hard enough. At the same time we rely on unemployment, illegal immigration, union-busting, and foreign guest-workers (in skilled occupations) to keep wages low and employees compliant. (The foreign guest-workers not only work cheaper but fill jobs that our educational system allegedly can’t prepare people for.)

This condemnation and denial of care can be attacked on many grounds, including our definition of what is right, moral, compassionate. William Blake wrote that “A dog starved at his master’s gate, Predicts the ruin of the state”.

But let us only examine it coldly from the standpoint of the best interests of society, regardless of morality. Not to belabor the point, in our current social and economic environment a country can no longer ghettoize poor people so that they quietly starve, or prey primarily upon one another. And from the ranks of the poor and working poor (who cannot afford health insurance, who are one car breakdown away from unemployment, who do not get time off to care for a sick child) come young people whom we need to fill jobs, pay taxes, solve future problems, and care for us when we are old.

The child who cannot pay attention in school because of untreated illnesses such as chronic ear infections, or because of hunger, or because his or her family moves every other month or lives in a car or at a campsite, or in an uninspected rental with no heat, mold on the walls, and open sewage in the backyard: what are the odds that this child will receive a good education, go on to work, stay out of trouble with the law, not become a teen mother or absent father, and in short become what we like to call “a productive member of society”? And who suffers, besides that person and his or her family? Does Rush Limbaugh really think that our country is not damaged in a strictly material sense?

In a truly efficient and rational capitalist state (no, I am not a socialist or communist, not even a community organizer) perhaps we could simply round up the non-productive of whatever age, elderly or teens or doomed toddlers (and parents of same), and exterminate them. (In the movie Soylent Green, they were even turned into food for the rest of the populace.) At least then we would be aboveboard about what we were doing. Our current course reminds me of when I used to live in the agricultural area near Sacramento and people would dump unwanted pets and boxes of kittens on our roads because “farmers always have room for another dog, or a few barn cats”. Guess who got to drive away feeling okay, and who had to cope with the sad task dealing with dying kittens, feral dogs chasing sheep, and so on? The top strata of society have gated communities, apartment buildings with doormen, cars with locked doors, to insulate them from the suffering and crime. The rest of us have to wear blinders and harden our hearts if we wish not to see and feel the suffering; we cannot wall ourselves off from the crime and violence. Our country as a whole is made worse in many ways, which affect us all.

Of course, a contribution to the most pitiful “Season of Sharing” case is supposed to make us feel that we have done our part, and that there is a safety net for the truly deserving.

The fallacy of this self-serving pretense will become harder to deny as the economy grows worse and people at nearly all levels are affected with job loss, retirement fund evaporation, inability to afford health care or college, and so on. Those who felt that only those who “deserved it” were suffering, will have to figure out why the suffering is now their own as well.

Some claim to believe that private charities will take care of the old, the disabled, the helpless. But upon examination they mean only those who are old/disabled/helpless––and poor. For themselves and their relatives, they will find other better solutions, they will demand the best. And they overlook the patchwork undependable nature of voluntary social work, the potential for bias (racial, religious, ethnic, etc.) in providing services, and the fact that, like the Season of Sharing, it makes beggars of the needy. They will be helped if enough individuals are generous or guilty, if churches choose to run soup kitchens or tutoring programs in their locale, not because they are our fellow citizens and we have a collective duty to them.

Government social agencies are far from perfect. But they are responsible to all of us, they are directed to serve all citizens without bias, they can be improved when we demand it. Whether we are moved by morality, self-interest, or concern for our country’s future, the choice is clear: establish universal health care and make it work. If you disagree, try explaining your position to the young man who needed a new leg.

One thought on “Why we need universal health care, among other things

  1. This aside may be a cautionary anecdote from days long gone, though still here like you wouldn’t believe, but Ho Chi Mihn and Giap held that they did not worry themselves about the logistical needs of the Viet Cong. They said the VC took care of themselves. As the marginalized boys compress in the new ghettos some leader will most certainly emerge, and the child soldiers of Africa will no longer be cruel strangers to us. Unlike Cavafy’s Byzantines we luckier ones will not await an entertainment from the barbarians, nor welcome the promised new blood. Compassion is not appeasement; it is just good business.

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