Barrier to better health care: Republican definition of freedom
Republicans oppose the health-care law's insurance mandate because it curbs freedom. Do they oppose traffic lights, too?
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Many of us, after all, choose to marry. This decision substantially restricts us and increases our responsibilities. Yet the responsibilities marriage entails also give new meaning to our lives. Liberating ourselves from every commitment and every shared responsibility would not be freedom. It would leave us each isolated and unfulfilled: freedom as truly nothing left to lose.Skip to next paragraph
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This does not make the health-care law right or wrong. The problem is that the rhetoric prevents us from making that judgment. We need to take back the meaning of freedom from those who cheapen it with simplistic bromides.
Similarly, Republicans will tell us that any attempt to understand or act on notions of social responsibility – whether we talk about health care, poverty and crime, or history and the roots of terrorism – is to deny individual responsibility and excuse evil. But this is rubbish – and let us again use a simple but real-world example to explicate this.
Thousands of people die every year because of infections they acquire in hospitals – and many of these occur because doctors don't wash their hands! Clearly, here is an egregious act of irresponsibility. It is unconscionable that a doctor would fail in such a simple duty. Even liberals would agree.
But what is the remedy? After all – no one is perfect. Doctors sometimes forget to wash their hands, or they neglect to because they are too busy. By all means, let us find ways to remind them and hold them accountable. But it also turns out that the simple act of placing sinks closer to the patients dramatically increases the rates at which doctors wash their hands!
Move the sinks
So, is moving the sinks a surrender to carelessness and to evil? If you think so, fine. But in the meantime, doctors will remain imperfect humans, and if we leave the sinks where they are, waiting for doctors to attain perfection, more people will die. Attach whatever political label to me you choose – I would move the sinks.
I know of no one on the left of the political spectrum who accepts the right's characterization that they are against personal responsibility. They believe in both personal and social responsibility, as these are complementary, not competing, notions. Trying to address major public problems with just a greater push for personal responsibility is like tying one of our hands behind our back. We must leverage social responsibility, too, enabling us to use both hands to tackle our toughest problems.
If public schools or public drinking water and sewer systems were invented today, would Republicans oppose them, along with the traffic lights?
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According to the simplified notion of personal responsibility, people should take it upon themselves to get educated, keep their water clean, and properly dispose of household waste. It sounds good in theory, but would you live in a town that had no schools, and no water or sewer treatment, but gave every household the "freedom" to manage these concerns on their own? Probably not. Thankfully, citizens across America have the freedom – through government – to manage these problems collectively. A century ago, that is what they did, and we are all the freer for having school, water, and sewer systems run by our cities and towns.
So when Republicans dismiss any government or collective action in the name of freedom and personal responsibility, think of traffic lights and hospital sinks, and use your own freedom to think more carefully and rationally for yourself.
Anthony L. Schlaff, MD, MPH, is director of the Master in Public Health Program at Tufts University School of Medicine. The views expressed here are his own.