Because most philosophies that frown on reproduction don't survive.

Monday, July 14, 2008

Virtue Isn't Quick and Easy

A follow up thought on the Obligation vs. Individualism post: Several people have pointed out to me here or elsewhere that if there is not a single, government run, consistent program to provide certain benefits to those who need them, there is no guarantee that people will receive the benefits that they need.

Not only does this not surprise me, but this was, at least so I intended, conceded in my argument. One of the reasons why we set up bureaucratic social programs is because we don't want to accept the level of inconsistency and unfairness that can result from organically developed community systems of mutual obligation.

Some have, however, taken this argument farther and suggested that it is simply impossible for needs such as health care, unemployment, etc. to be provided through any system other than a large government run one, which spreads the risk across millions of people (and allows nearly unlimited deficit spending.) It's all very well to want personal mutual obligation to take care of things, I'm told, but you simply can't deal with some issues that way.

I disagree. It is possible to take care of all of these things at the community level through mutual obligation. And there is a test case which we can look at to see how that looks. The Amish applied to congress to receive an exemption from social security. They do not pay into it and cannot receive benefits. They also avoid Medicare and Medicaid, and do not purchase health or homeowners insurance. They do this not primarily because such things are not mentioned in the bible (as is their motivation for avoiding many modern technologies) but because they believe that it is their duty to care for the elderly and the sick directly through the community. They do use modern medicine, but they pay out of a self-administered community mutual aid fund.

This can be especially rough on them, because after having a number of generations in a fairly closed community, some Amish groups suffer from increased incidence of genetic diseases. (Things are made further difficult, as the WSJ article linked describes, because many hospitals refuse to give the Amish the same prices that they give standard insurance companies.)

I think we could generally agree that the Amish have us beat when it comes to maintaining a solid community and sense of mutual obligation.

Now lest anyone get the wrong idea, I'm not saying that society as a whole should drop all safety net programs and live like the Amish. They manage to pull off what they do because they have a long community history and a religious commitment to sticking to what they're doing. And what they're doing is I think, in regards to community mutual obligation, right. However, the country as a whole is massive, religiously and ideologically diverse, and has no history of enforcing that kind of community commitment. If we tried to provide health care the way the Amish do, it would not work.

But since I think they do have something rather close to the right model, if we believe that community and mutual obligation are virtues, we should when changing our system seek options that are more like it rather than less like it. And always try to gauge how our well intentioned attempts to provide services for everyone will effect social cohesion.

The problem is, the quick and dirty solutions is much, much easier. Our national government is so big and so powerful that its easy to convince ourselves that if we bring it into play and throw money at a problem, we can fix the problem and let our consciences rest easy. Because federal programs can be so big that they touch everyone in the country, it seems much simpler to say, "We should have national single payer health care" than it is to try to push hundreds of thousands of communities (which are hard to even define in any rigorous sense) to take responsibility for caring for all their sick members.

Encouraging millions of people to behave virtuously is a very difficult job, and will never meet with complete success this side of eternity. Massive government effort can sometimes ammeliorate some of the social ills resulting from people not being systematically virtuous -- at at the same time it reduces people's incentive to be virtuous. (Indeed, not only reduces the incentive, but to an extent removes the opportunity and obscures the need.)

The difficulty (which we spend a great deal of energy in the political sphere fighting it) is deciding where to strike the right balance between making sure that the worst suffering in society is avoiding, while not removing the need for community obligation. Because sadly, given our tendencies towards selfishness, if our need for community is removed, we will often fail to practice it.

8 comments:

Kurt said...

That is a wonderfully thoughtful reflection that is the basis for discussion. I think it also shows the influence of a Catholic sensibility (which may not surprise you) as well as a liberal sensibility (which I understand does surprise you!).

It is missing one part, which, if I may, I would like to add. If the principle is the virtue of small, communal means of addressing human needs, it is not just a matter of "big government." Many (most?) of the private providers of human needs are also large and impersonal and subject to the same failures. We purchase (or our employer purchases for us) life and health insurance from large corporations (or, if our employer is a large corporation itself, it may self-insure). We invest our retirement savings in large mutual funds. We often don't even know what companies these mutual funds invest in, let alone feel or take any responsibility as corporate shareholders. Even take non-profit Catholic organizations. We have life insurance from the Knights of Columbus. It is a large, nation-wide insurance pool Would it be better if each KoC lodge had its own insurance pool as a way of better connecting Knight to Knight?

Darwin said...

Kurt,

Actually, I would agree with you that our current system of massive insurance companies is not the best for society. (I just think that a governmental single payer system would be even worse.) If it interest you, I did post a while back where I did a bit of pie-in-the-sky thinking about how a community re-enforcing health care system might work:

http://darwincatholic.blogspot.com/2008/02/how-to-pay-for-health-care-conservative.html

The only thing I would add to my comments there would be that given my conservative principles, I would prefer that membership in a health care group not be mandated (on the those who don't work don't eat theory) but I included one in my sketch anyone on the theory that society does not have the stomach to allow people to experience the consequences of their actions to the tune of not having coverage for a major injury or illness.

On the KofC, you probably know that in its origins the Knights were a mutual benefit society -- one of the 19th century organization types which sprang up to fill that need which insurance and government aid now deal with.

Generally, I'd say that their shift from being a mutual benefit society to being an insurance outfit is not a positive one -- though I buy the Knights' life insurance on the theory that I'd rather have my money for such things going to the single largest donor to the Pope's charitable funds than to some major insurance company. However, I'd point out that one of the reasons (aside from legal restrictions) why the Knight shifted to an insurance methodology is that as our living standard expectations in the US have become higher and higher over the last 125 years, the cost of providing the financial replacement for the early death of a husband and father has become much, much higher.

Also, it should be noted that the Knights have admirably retained a lot of the community-type services that go along with their insurance. A local Knights rep will help out with the funeral and paperwork and other things in the way in which a representative of a commercial life insurance company would certainly not.

Antique Mommy said...

Love the way you write and the things you discuss here, although I'm not bright enough to contribute much to the discussion. Came here via Et Tu. Putting you in my Bloglines.

CMinor said...

Was interested to learn the Amish were actually having to pay more than insurance companies. You'd think doctors would cut clients a break in exchange for being able to collect at time of service rather than having to go through insurance to get paid.

Literacy-chic said...

Hmmm... The Amish Litmus test. Works better than some, I'd reckon! ;)

(That's all--just had to drop what I considered a clever phrase! Of course, I know it probably wasn't...)

Enjoyed this. Goes w/o saying, no?

Kurt said...

DC,

Your thoughts on health care in your longer article are quite simulating. Katherine raised the issue that the Obama health care plan lends itself to an evolution in the direction you propose. Do you see the case for a more likely evolution from some other source?

The other reservation I would have is cherry picking.

Darwin said...

Kurt,

Katherine is a very nice lady (in that she generally maintains a very even tone despite coming in for a lot of broadsides), but she also happens to be the proprietor of the Catholics For Obama blog, so while I'm sure she means it, there's a bit of salesmanship going on there.

So far as I can tell, the Obama plan puts us very much on the road to centralization rather than localization, and so it seems to me that it's going in the very opposide direction from what I would prefer. As for whether I see much likelihood of our heading in that direction any time soon: not really.

There are a huge number of societal and economic forces incenting us to keep a highly individualistic system -- whether it's done through insurance companies or the government. I don't like it, but there it is.

Nancy Mehegan said...

There is an interesting post on the story of the Amish and their exemption from Social Security taxes. It was a struggle for them. Post is at http://www.Vaboomer.com