This is perhaps one of the fundamental questions of any society. Its answer informs not only our relations with one another, but also the structure and scope of our social institutions, including our government. Though it may not be stated explicitly, this question underlies our health care reform debate as well as all other discussions of social safety net programs.
Another way to approach this question is to ask- what would you be willing to give up, so that others might have? Asked this way, the question becomes less theoretical and more grounded. Specifically, what medical care would you be willing to forgo in order that someone else was provided with basic medical care? What amount would you be willing to pay, in taxes, in order that our society did not count nearly 50 million people without access to health care (no, Tom Coburn and others, ER’s do not count)?
There are two approaches to answering these questions that I would like to explore here. One is based upon the work of John Rawls, specifically his veil of ignorance. The other relies much more on religious teachings, specifically the synoptic Gospels.
In his Theory of Justice, Rawls describes the veil of ignorance. Essentially, the choice of society (laws, rules, norms, institutions, etc.) that is most just is that which we would choose should we be making those choices behind a veil of ignorance. In other words, we would have no knowledge of our station in life, our relations, etc. Such that the choices we made would not be biased by our own notions of personal gain.
Applying this notion to health care reform- which policies would we select if we did not know whether we were rich or poor; insured or uninsured; etc. Those policies that we would pick in that situation are the most just. Now, imagine if you were behind this veil of ignorance. You do not know if, when the veil is lifted, you will have insurance or the money to purchase insurance or health care. Would you select our current system or would you instead choose one that insured everyone?
Most people would take the latter option. It is only when we are free from our own personal attachments that we can objectively make right decisions. Unfortunately, humans are very selfish and are largely incapable of imagining themselves in any position other than their own.
What of religion, though? Perhaps it can serve as a check on our selfish impulses. I cannot imagine anyone reading the canonical Gospels, particularly Luke, and not coming away with a very strong sense of responsibility for others. Whether one looks to the Parable of the Good Samaritan (Luke) or the Great Commandment (Mark and Matthew) or the story of the rich man (Mark), there are abundant examples of Jesus teaching us to care for one another and to place love ahead of material wealth. This is also fundamental to the cures and miracles performed throughout the canonical Gospels. Their purpose was not merely to display his divinity, but to provide powerful examples of man caring for man.
Care of the poor is a core feature of Christ’s teachings and the foundation for the Catholic Church’s social justice mission. These values are on display every day at shelters, hospitals and clinics run by Catholic Charities and other faith communities. Yet a sizable number of self-described Christians have not only ignored these important teachings, but subscribe to the notion of the undeserving poor.
Nevertheless, what I have presented here are two forceful arguments for taking care of others. One is based on a liberal interpretation of the just society, while the other is rooted in Christianity. Though flowing from two different founts, each comes to the same place- that we do owe one another something. That there is some amount of care- be it services or shelter or income- that a moral/good society does ensure for all of its members. When two disparate streams of thought converge in such an important place, it speaks to the gravity of their finding.
We may never agree what it is that we owe one another. There may always be debates over the merits and desirability of certain social safety net programs. But what we ought to be able to come together on is the underlying principle that we do owe each other something. It’s at least a starting point.