The unfortunate aspect of posing the problem of health care reform in terms of governmental vs. libertarian responses, as Ari Allyn-Feuer does in his October 30 column “Reform in a Regulated Market,” is that it neglects the specifically social aspect. Issues of provision and regulation come up, but in rather specious ways. Does “socialized” health care—making it a social priority—necessarily mean governmental control? I would say not. For instance, is the American Medical Association, the professional organization of doctors, a governmental agency? No, it is a voluntary association of civil society. Medical licensing may be legally required, but it is not administered by the government. Our society is already largely self-regulated, and not simply through market mechanisms, but through a host of other non-governmental ways. Thus, it is already entirely conceivable that under present social and legal conditions, health care could (at least theoretically) be socialized without being administered by the government. Various religious institutions provide examples of this kind of social activity, not driven by market incentives. The only question is whether such institutions are sufficient to address the magnitude of the problem of providing health care. What does it take to provide quality, “affordable” health care to all (including those who cannot afford to pay anything)? The current debates around government policy dodge the issue in spurious ways, for instance posing health care as either a “right” or a “good” (commodity/service) and then questioning the appropriateness of a governmental role (in either case). But we can pose the question more simply and ask what kind of social issue health care actually is, and whether and how it can be properly addressed both in a public manner and as a matter of politics and social change, which is not reducible to the role of government. Politics is not reducible to (government) “policy.” We need to inquire into such possibilities.
Ph.D. candidate, Committee On History of Culture