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Health care debate must necessarily begin with a discussion of America’s root political philosophies.    

As summer progresses, hardly a day goes by that doesn’t challenge America’s hegemony, from the Gulf of Mexico turning into an oil slick to the Iranians amassing nuclear weapons. In the midst of the chaos, we have to live with a health care reform bill which has nothing to do with health care and virtually nothing to do with reform. The reason I believe that America became so polarized and divided on this issue is that we have forgotten the philosophical basis on which our country was built. This is not Europe, Canada or Mexico. This is a unique country once known for greatness and now known for ambivalence and timidity.

To properly review our origins, I believe we need to go back to a few key philosophic texts. This year marks the 50th anniversary of the publication of John Courtney Murray’s landmark book We Hold These Truths; Catholic Reflections on the American Proposition. Murray’s four pillars of the American experience will help form the lens through which we should be able to view any and all governmental activities. The first of these inherited truths is that we are a nation of judgment and one which is dependent upon individuals to be above the lies of politics. This view, much like that of Edmund Burke, distinguishes the Anglo-American political tradition from that of continental Europe, which subjects the individual to the whims of the state.

It is very interesting to note that everyone in the United States argues about the individual’s rights, but no one ever speaks of the individual’s responsibilities. What may seem good, kind and reasonable today may bankrupt another generation. Adding money to social security benefits may seem a good thing to do at this time, but may be putting a noose around our children’s necks.

The second foundational truth of the American proposition grew out of the Christian middle ages. It is the principle that just governance exists by and with the consent of the governed. Social pluralism of the middle ages held that the individual put society ahead of government. This is one of those truths which is self evident to everyone and yet practiced by no one. Everyone is looking for an answer and a handout. No one is looking to do any work or to give anything up. “A government that can give you all that you want must take from you all that you have.” The balance of these equations is out of kilter in America at this point in time.

The third truth of the American proposition as quoted by Murray is, “the state is distinct from society, limited in its offices toward society.” Society exists prior to the state. Long before there was the United States of America, long before there was any governmental organization, there were people helping people. There were people drawing reasonable limits, people deciding what they could afford and what the best possible outcome could be. They also understood the idea of futility. Where have these people gone? This medieval distinction between the society at large and its organizational structure, its “government,” need to be put into line so that physicians can enter the discussion with reasonable scientific information, which is balanced with a humanistic approach to the care of their patients.
The fourth component of Murray’s proposition is the profound conviction that only virtuous people can be free. Murray knew that there are no guarantees about the success of freedom. “Freedom can dissipate into license, private license into public decadence and decadence into chaos.”

“It is not an American belief,” Murray wrote, “that free government is inevitable. Only that it is possible. Moreover, its possibility can only be realized when the people as a whole are inwardly governed by recognized imperatives of universal moral law.” This should be an inherent cultural consensus. But unfortunately, there is no inherent cultural consensus. There is no more inherent understanding of limitation. It is only about “me”. We have raised a generation of people who cannot look beyond themselves. I, fortunately was raised by a generation that were molded by two forces, the Great Depression and the Second World War. They understood much clearer the necessity to come together to view the common good. The common good is never a single entity, but it is a moral and ethical internal basis, which says certain things need to be accomplished and others must be put aside.

The public square has lost its luster. The place where intelligent discussion can happen on any of these issues has disappeared. We are surrounded, on all sides, by nitwits of negativity. All you have to do is watch cable television to realize that the grand old days of true intellectual discussion have disappeared. There was a time when William Buckley carried on brilliant debates on his television series, Firing Line. Where are the Buckleys of today? We are surrounded – and I use that term advisedly – by neebobs who can no longer structure sentences or take down ideas in a clear manner without launching into ad hominem arguments as opposed to the ad factio discussion. It is an embarrassment to hear the fundamentally mean-spirited discussions on both the left and right, which stop us from carrying on a philosophical discussion of what will be the base of this government. We have broken into armed camps, which have an immediate negative response to anything said on the other side.

What is the state of understanding ourselves? Murray commented that “the complete loss of one’s identity is, with all propriety of theological definition, hell. In diminished forms, it is insanity, and it would not be well for the American giant to go lumbering about the world today, lost and mad.” What we are watching is the decline of one of the great cultures of western civilization, and until we are able to reestablish the firm pillars on which government makes decisions, there is little good that can be said about the future of health care reform in America.

 

Comments   

# Much appreciatedPron555 2010-07-17 05:11
Thank you, Dr. H, for posting this. To know that someone else is aware and is trying to make others aware, assuages the ache a bit.
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# Nick 2010-07-18 12:29
So, we shouldn't look to Europe or Canada for guidance on healthcare, but we should review the writings of a Jesuit theologian, as well as the social setup during the Middle Ages?

Also, I may accept that current generation doesn't understand how to come together for the common good, and those molded by the Depression and WWII do. But can these periods be discussed without mentioning the New Deal and conscription? Can we acknowledge that those massive government interventions upon society dwarf anything that was passed in HCR legislation?

Perhaps you're arguing that coming together for the common good requires more sacrifice than what's been proposed? I can't really tell. You are making the case, however, that the current state of public debate is difficult to comprehend.
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# Translated...DensityDuck 2010-07-20 13:32
"when we raise your taxes to pay for other people's doctor bills, it's no more than you deserve, so suck it up and deal. Also stop playing that loud music, pull your pants up, get a haircut, and stay off my lawn."
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