Welfare & Subsidiarity
November Wed 02, 2011
This essay is part of the Public Discourse symposium on “Liberty, Justice, and the Common Good: Political Principles for 2012 and Beyond.”First of two partsThe health-care debate presents us with a moral imperative to solve an economic problem, but how we solve this economic problem has moral implications: allowing individuals and families greater freedom to choose among treatment options in a market that drives down costs, or establishing centralized control that makes utilitarian calculations of the worth of different people’s lives.As we consider the options before us in next year’s presidential race, it’s vital to keep in mind the stakes of our politics. We are accustomed to dividing our great policy debates into those that involve profound moral issues and those that involve complex practical problems. On the one side are matters of conscience and the social order—like our debates about abortion, marriage, civil rights, or euthanasia. On the other side are matters of accounting and efficiency—like our debates about economic policy, the deficit, transportation, or energy.But in fact, the most important public questions—including all of those listed above—combine elements of the philosophical and the practical. All of public policy is about setting priorities, which must always be done with an eye to both principle and practice, and every moral choice in politics must somehow be implemented in practical terms.Nowhere is this inevitable intertwining of the moral and the practical more evident than in the health-care debate that has been raging in America for the better part of two decades, and that has been especially prominent in the past two years. Simply put, the health-care debate presents us with a moral imperative to solve an economic problem. The moral character of the imperative does not negate the economic character of the problem (and therefore the need for an economically viable solution), while the economic character of the problem can never blind us to the moral weight of the matter. This combination of the moral and the economic is what makes the health-care dilemma so challenging, but awareness of the combination helps us to distinguish among the solutions offered by the left and the right.
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