dentists, taxes and death by toothache

John Scalzi posted a short note about a 12-year-old-boy dying, in effect, from toothache.

Much discussion ensued. I even piped in with a tiny comment: a link to a LiveScience report that suggests The Rich See What They Believe.

A particular comment, from Papapete, however, got me to thinking:

Add the government and see what happens. The giver has no connection to the recipient and receives no emotional or moral "payoff". The recipient doesn't feel gratitude for the "gift" or the "giver", but instead feels entitled to the largesse. Instead of being grateful to the person who actually supplied the welfare, his/her gratitude is reserved for the government, and frequently resents the person(s) that the money is actually coming from. So, from a win-win situation to a lose-lose situation in one easy step.

It's not lose-lose, it's just not as good as it could be. And, as for '[the recipient] being grateful' that shouldn't be a goal of mitzvot anyway.

Of course, I'm not thinking of 'Christian charity' at all here. Then again, I've never had much time for that notion. I've always preferred the RamBam's Eight Degrees of Tzedakah.

The RamBam's highest degree of Tzedakah is reserved for enabling someone to become free of the need for charity or help. Not exactly the paradigm example of fuzzy, feel-good 'liberal' thinking there.

Next on the list: giving in such a fashion the giver and the recipient do not and cannot know each other. Gratitude -- or the perception that gratitude is deserved -- is to be avoided if possible since it does neither the giver nor the recipient any good.

In fact, it does both harm. The giver ends up feeling better about themselves than they should. Being able to give isn't a sign of your moral fitness, it's a sign of your relative wealth.

Meanwhile, the recipient feels the burden of gratitude, a feeling more likely to engender the resentment Papapete decries above. Better they get help from an un-named or un-knowable source (like, say, a government department, acting as a proxy for the whole society).

Back on down the Tzedakah line, the least worthy form of giving is giving only because you feel obliged to (because of social pressure) or are required to.

But even that's still a mitzvot, because good comes of it (or bad is averted, like, say, the death of a child for want of US$80.00 for dental care).

Wandering back across the religious traditions, Maimonides' very practical ethic has always felt -- to me at least -- like a good fit to John Donne's Mediation XVII:

No man is an island, entire of itself; every man is a piece of the continent, a part of the main. If a clod be washed away by the sea, Europe is the less, as well as if promontory were, as well as if a manor of thy friend's or of thine own were. Any man's death diminishes me, because I am involved in mankind; and therefore never send to know for whom the bell tolls; it tolls for thee

Single-payer, taxation-funded health care isn't perfect, and I'm happy to rant about Medicare's shortcomings here in Oz.

But the underlying basis of a taxation-funded health care system is the acknowledgement of Donne's point followed by a decision to use the RamBam's practical ethic as the basis of a public policy that makes state funds the basis of the health care system, rather than a supplement to it.

OK, it's likely not either of these things at all. At least it's not what you'll find if you go looking at the ALP's 1970s policy documents regarding MediBank. But similar ethical and moral notions are commonly a part of the practical public policy position generally known as a universal health scheme.

Which sounds like the rough beginnings of an argument for working to make universal health care work better, rather than tearing it down or suggesting it's such a bad idea we shouldn't be implementing it in the first place.

Author: Brian Forte