So when I started writing about the Just Wages, I intentionally left health care out of the picture. Why? Because health care is a virtually unlimited need.
I have no qualms about telling you that a person only truly needs so much living space, this much food, that much clothing, and so on. It is important that we not make an impossible wreck of a straightforward moral teaching, by trying to tack on burdensome ‘extras’, as if love of neighbor were synonymous with ‘upper-middle class 21st century American’.
But how much health care does a just wage pay for? Not so easy to define. Set aside all the debates about which care is most helpful, and which is not helpful at all — those are medical debates. Pretend you know what the useful stuff is, and focus on just the question of ‘how much’.
It can’t be nothing, we are certain of that. But does the requirement extend to providing every care that might possibly help the worker-patient? We have an arsenal of extraordinarily expensive tests, procedures and medicines that will extend life a few months or a few years; we have treatments that, in the event they work, will give back the recipient a nearly-normal lifespan, but for which the probability of sucess is quite low.
Those rescued months and years, those chances of success, are absolutely priceless. I am easily persuaded that, as a society, we should value the medical progress that cutting-edge technology offers. We should choose legal structures that encourage both doing the research, and making new forms of care more widely available.
But should every business owner consider it a normal cost of business, to provide wages that will cover high-cost-low-expected-return medical treatments?
I think that we need to fall back on the same pragmatic approach used for discerning just wages in other areas:
1) Remedy gross injustices. Keeping in mind that, say, access to a safe water supply remains a significant health problem for many workers around the world. Employers should begin there. I’m reminded of my friend Jenn Labit, whose factory in Egypt includes such basic amenities as a safe way to store lunches. Sounds self-evident, but it was not the standard local business practice.
2) Use the love-neighbor-as-self standard. If senior management and members of the board are willing to accept a given level of health care, it is reasonable to assume the company is making an honest effort at providing a just wage for health care.
Beyond that? We want to set up laws and regulations that make it possible for employers to efficiently provide a good health-care wage to workers. We can disagree over the details — I’m not convinced the current legislation coming out of Congress is going to be an efficient and effective fix. On the other hand, I’m entirely in love with my local water company, and do think that providing clean water is an appropriate use of community — read: local government — power. Assuming it is done well, as it is where I live.
–> The imperative to pay a just wage works both ways. On the one hand, it is up to local governments to set up community structures in a way that makes it affordable for businesses to pay a fair wage. Think: utilities, transportation, policing, insurance regulations, medical safety standards. On the other hand, the requirement to pay a just wage ought to spur businesses to use their importance in the community to push for change when the local government has fallen short of its mandate.
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