Thursday, July 12, 2007

Duties of State: Rights of Individuals

Is universal health care a human right? If it is for people of the UK, why is it not for the people of Darfur? It is more properly regarded as a universal aspiration. I guess it is up to each nation to make a judgment on priorities, but it seems to me that there are at least some minimal standards that are in the interests of everyone in the community.

There are some basic public health matters that few will argue about. The separation of sewage from drinking water is a first priority. Immunization against the common infectious diseases protects not only the immunized, but by 'herd immunity', also those unable to be immunized successfully. Speed restrictions and traffic laws protect the whole community against death on the road. Laws against smoking in public protect non-smokers against passive smoking. Screening for tuberculosis protects the vulnerable in the community. But to what extent should the state intrude on the rights and responsibilities of the individual?

When visiting a friend in America I was surprised to find that he had to arrange to have his garbage taken away, that there were a few contractors who competed for the business in the area, and that some households employed no-one and disposed of it themselves. I presume there was some sort of failsafe mechanism that prevented people from allowing garbage to accumulate in the street attracting rats and other vermin. I was surprised because in the UK garbage disposal is the responsibility of the local authority. Before Margaret Thatcher the local authority used to employ its own labor force to do this, and one of the Thatcherite privatizations was to make the in-house workforce compete with private companies for the garbage clearing contract. But there was still a single purchaser (the local authority) and households could not opt out of buying this service through local taxation.

Exactly how much government involves itself in this way is a matter for each nation, and different communities have different traditions. How much is the basic minimum? Security is probably an essential. A standing army (though Costa Rica manages without one), a police force, prisons and a judiciary, some provision of public health facilities, roads and a transport infrastructure, control on land use; after that different traditions provide more or less. The danger of the government providing more is the reduction of personal freedom and the assumption by government that every whim of elected officials is something that the electors would want to pay for. Take twinning. Bournemouth is twinned with a town in Israel I have never heard of. Christchurch is twinned with Christchurch, New Zealand. All this does is provide an opportunity for councilors to have a junket at taxpayers' expense.

Should Christians provide more? Schools and hospitals were originally provided by religious organizations; universities were religious organizations. But it is a long step from charitable donations to local authorities or even central government providing optimum education and health care for all. There is an elision from all are equal in God's sight to all should be treated equally by the mayor. We don't expect everybody to drive the same car and live in the same type of house or even wear the same type of clothes (though GAP and Levi would like us to). Remember those Chinese leaders of the 1960s? Even they have started wearing business suits of immaculate cut.

On the other hand we become uncomfortable when we see some living in fine houses and their neighbors living in shacks made of cardboard and corrugated iron; when we see some in Christian Dior and others in rags. The Jewish doctrine of the Jubilee gave everyone a fresh start every 50 years (though it must have been hard to get credit in year 49). Perhaps the state should provide a baseline level of health care and education and leave people to buy better if they can afford it? The argument then becomes, 'how basic is basic?'

Those who live upright lives, eat healthily, exercise, save their money, invest wisely and avoid risky activities like smoking and riding motor cycles, have a legitimate gripe against those who do the opposite and turn up demanding state payouts for their heart disease, lung cancer, diabetes and fractured hips. Do those who were born with the genetic make-up that makes them fat, dim, disease-prone and even indolent have a legitimate gripe against those with genes that make them blond, blue eyed and have a foot that sends over immaculate free kicks even if it does leave them with a penchant for tattoos and a silly, high-pitched voice? Does the clever lad from the Gorbals have a legitimate gripe against the toff from Eton? Who is responsible for the man born blind?

Jesus had an answer to that. Who sinned, this man or his parents that he was born blind? neither this man nor his parents, but this happened that the works of God might be displayed in his life. The Christian has the duty to perform the works of God in the lives of the wastrel as well as the wealthy, the rotter and the Rothschild, the risk taker and risk averse. I seek to help the patient in front of me be he vile or virtuous.


Vance Esler said...

As usual, nicely stated.

Anonymous said...

It is rare that the municipal authority does not have a monopoly on garbage collection. My parents have a private collector, and it is cheaper than the city, and offers more services. One MUST sign up. It is NOT optional.

Perhaps your friend lives in the country?

The biggest drain in the US on the taxpayer is education. It is the closest thing to a black hole on the planet.

The ONLY reason the teacher's union exists is to get more money for teachers. It is not uncommon for teachers to make 60 or 70 or even 80 thousand dollars a years. They make more money, on average, than architects, civil engineers, biologists, and registered nurses!!!

Sweet!!! And you get three months off in the summer!!!

It would be good if the government was taken completely out of education. The public school system in the US is pathetic.

They recently had a 'man in the street' interview. They interviewed a public school teacher, and asked her the name of the war that we celebrate on July 4th. She answered, 'World War 5!' I kid you not.

These are the teachers that the unions promote and seek higher pay for.

justme said...

So very interesting to read yours and Vance Esler's posts (as well as all comments) on how health care is or should be provided. I gleened many insights into the workings behind both insurance and government 'managed' healthcare programs. Many thanks to both of you!