A large number of issues are mingled together in the debate about health care reform. Taken together, they threaten to undermine the process entirely. Separate from all of these issues, though, is a problem in social psychology. As Americans, as citizens, many of us lack the skills and the inclination to view the options from any perspective besides that of self-interest. We don’t know how to make our decisions based on the common good. We may only see the impact of the policy choice when its impact affects us directly. Wiley Miller captured it well with his recent cartoon:
Those who have health insurance, especially those with good coverage, frequently point to the cost of expanding coverage to include those who are uninsured or underinsured: it will cost tax-payer money. This is especially true if they are already paying some of the cost of insurance for their own family. “I’m insured,” they think, “but how could I afford to pay for someone else’s insurance too?” Yet the cost of the current system is forcing many employers to cut back or stop paying insurance; those who lose their jobs also lose their insurance. Public provision of health care is, in essence, an insurance policy on one’s current insurance. (And this completely ignores the benefits to society of having a healthier workforce and getting people to treatment before their illness gets severe.)
Some opponents are fearful that health care reform might limit their choice of physicians, or force them to change doctors. This does not seem to be part of the plans to begin with. It’s hard to understand, though, how they could deem it better that millions of Americans continue to go without any doctor at all in order to preserve their relationship with their existing physician. The possibility of having to change their own care seems immediate and real, while the needs of those without insurance are distant and abstract. Without a strong sense of being part of a whole that is greater than my family, my neighborhood, and my community, it is difficult to see that larger picture.
The Common Good. A core element of Catholic social teaching is the necessary relationship between the individual and the common good. The Catechism takes pains to explain this common good as “the sum total of social conditions which allow people, either as groups or as individuals, to reach their fulfillment more fully and more easily.” Noting that it concerns the life of all, concern for the common good “calls for prudence” and consists of three essential elements:
- Respect for the person as such, and the conditions that allow the integral development of each person
- Social well-being and development of the group itself, to “make accessible to each what is needed to lead a truly human life: food, clothing, health, work, education and culture, suitable information, the right to establish a family, and so on.”
- Peace – “the stability and security of a just order”
When we care for the common good, we are caring for our brothers and sisters – and also caring for ourselves, for the times when we may be ill, unemployed, elderly, displaced by natural disaster, or any of the other unforeseeable occurrences. Political stances that appeal to the self-interest of individuals serve, by their very nature, to undermine the sense of the common good. Without commitment and awareness of the common good, our choices will be self-serving – even at cost to the common good. We find out the error of that perspective only when we, ourselves, are the ones in need.
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