Category: links elsewhere

The living wage, health care costs, and structures of justice

When we talk about what a living wage should include, I think health care is the hardest to pin down. It’s fairly easy to know whether a person is clothed or has enough to eat. Housing is a bit more of a moving target – how much space does an individual *really need*?, we wonder; but still, “keeps me warm, dry, and safe” is a fairly straightforward criteria to assess.

Healthcare, though, is its own special world. Between the life-versus-death and quality-of-life type questions it poses, and the ever widening options for medical care, it is very hard to know and agree about what is the ‘right amount’ of health care. And if you don’t know how much your employees deserve, you can’t know whether you are compensating them adequately in this area.

Still, just because we aren’t ready to answer every question about health care doesn’t mean we shouldn’t try to answer a few to get started. Doing so may, in turn, shed light on further questions.

The other week Darwin posted A Case Study on Costs and “Basic Health Care”, and I saved it in my bookmarks for linking here. If you haven’t read it, you need to go read it. If you already read it once, go back and read it again.

[BTW, having given birth four times in recent memory, I can vouch for the reality of the situation he describes — lest anyone dismiss this as an isolated or extreme example. No, this is the birthing business as usual, pretty much the new normal in the United States.]

Here’s a quote that summarizes:

As it stands, our medical system is built around the assumption that cost is no object. And doctors are very heavily penalized based on any “avoidable” injuries or deaths that occur on their watch. The result is that instead of providing good, high quality “basic” health care, and using extreme (and expensive) measures only when necessary, we often require extreme measures “just in case”. This makes it far, far more difficult to provide “basic” health care to all.

And here is what I want to say: Wake up Republicans! Health care reform is waiting for you! When I talked about ‘structures of justice’ this is exactly the kind of thing I meant. Do not labor under the illusion that a just society – one in which the poor are not trampled underfoot – is the sole province of the dreaded far left. There are good conservative solutions to these kinds of problems, and if we as a nation were to actually enact them, well, the left would have a lot less fodder for their tendency towards grand socialist fantasies.

The living wage is not a left- or right- wing ‘agenda’. It is a moral imperative. You cannot be a just person if your profit or your comfort depends on other people giving you their labor, and you not providing them the means to live in exchange. The good news is, that if we are willing to care about the people who are too sick or too in debt or working too long of hours to be actively engaged in the political process, we can come up with sensible, free-market-compatible ways to create a just society.

Nice post at Darwin Catholic on the habit of thinking large government programs are the best way to handle social problems.

Something that concerns me with large American-government programs, is that we tend to be too rich about it. We spend money we don’t have, hence the huge national debt. I’ve noticed in contrast that when help is provided by immediate friends and neighbors:

1) Recipients expect less, and seek to do more for themselves first

2) Donors have a better sense of what they can and can’t afford

–> this even though the giving can be downright sacrificial.

It is hard to ignore needs that are right in front of us, and easier to evaluate them. When the donor is our friend or neighbor, we are more aware of the sacrifice they are making.

But privately-provided mutual aid depends on us knowing each other. In a society where we don’t really live with each other, such a system simply can’t be. We can’t know each other’s needs, because our lives are too separated. And when our lives are separated from one another, it is harder, logistically, to provide for a need even if we know of it and want to help.

As I understand it, the Amish communities that Darwin cites really do live together. They work, socialize, recreate and worship all with the same people. I don’t think every element of Amish culture needs to be re-created in order for wider American society to depend more on mutual assistance and less on governmental programs. But I do think that particular aspect of community life is absolutely essential.

On a related note, Jim Curly at Bethune Catholic has a post up about Chesterton, automobiles, and small farmers. Another piece of the same puzzle.

Inclusion at church

Ruth at Wheelie Catholic lays it all out: Why everyone ought to be included in parish life, and how to make it happen.

I’ve edited my initial reaction. Too grumpy. What I was actually trying to say:

I agree entirely with Ruth. I also think there is a deeper problem with the way our church communities are built. The difficulties facing disabled catholics are in many ways just part of a larger problem. (Well, several larger problems — Ruth has since written about “fighting to get out the front door”. But at least some of the issues disabled catholics deal with, other folks are suffering from, too.)

Also it should be observed that no one intends it to be this way — many people are working very hard to build up their parish community, and they deserve a lot of credit for their efforts.

And I’m going to stop there, lest I lapse back into my grumpiness, which won’t do anybody any good. My sympathy if you subject to the original rant.