In the days since I wrote several strongly-worded posts (here and here) about Nebraska’s prenatal care bill, I’ve received some interesting feedback. I wanted to take just a few minutes to outline the complaints and then to respond.
Those who complain tend to fall into two categories:
- People who object in some way to my rhetoric about pro-life hypocrisy;
- People who object in some way to government involvement in our lives.
I’ll take Justin Green to be a representative of the first group, though he ultimately falls into the second group as well. Green writes:
The premise for providing such neonatal care is that the fetuses being cared for are deserving of legal protection. If the political left wants to use pro-life language to justify spending state tax dollars on undocumented residents, that’s fine and dandy. In fact, I’m rather pleased with this legislation.
It’s just that you can’t use fetuses as objects worthy of legal protection in one instance while opposing them in another. The argument that providing state neonatal care assistance is pro life requires one to be pro-life, no?
My response is pretty straightforward, I think, as I’m simply pointing out that people who claim to be pro-life ought to vote for pro-life legislation.
I’m nowhere arguing that fetuses have claims to health care rights; they do not. What I’m saying is that women have a right to choose whether or not to carry fetuses to term … and, if they choose to do so, the state has a compelling interest in the health of those fetuses since not to care for them in utero often means caring for them at much greater expense thereafter (when they very clearly have rights).
Of course, I’m also arguing that the very same elected officials who voted against restoring funding for prenatal care believe that the state has a compelling interest in protecting the lives of fetuses. In other words, they want the state to find ways to prevent anyone from harming fetuses whose mothers either can’t or won’t carry them to term … but they see no reason for the state to actually help fetuses whose mothers want to carry them to term.
Ultimately, Green thinks that my complaints about hypocrisy are really just a red herring and that, at bottom, the issue is about whether or not the government ought to be in the health care business. Though Green actually supported the Nebraska prenatal care bill, his questions about the role of the state are shared (and expressed more forcefully) by several others, including a Tumblr blogger and some friends (both Facebook and actual). This critique generally takes the form of a libertarian argument about taxation, the morality of enforced charity, the inefficiency of government, and the need for people to pay for the services they use. It is put forward in more and in less caring language, depending on the person.
Here’s one of the less caring examples:
No, I don’t think society should consist of having members leech off each other; the oncoming and inevitable bust of SS and Medicare as well as the European welfare state confirms this is impractical. If you think society’s duty is to take care of its weakest, then I have a quote from someone with whom you should be intimately familiar with - “I have often laughed at the weaklings who thought themselves good because they had no claws”.
Here’s one of the more caring examples:
I do not agree that healthcare is a right that the government is obligated to provide to everyone. Instead I think of it as a very important product (like food, shelter) where the goal should be to have everyone have the opportunity to buy it, but the individual should pay for it not the government.
Leaving aside the fact that I’m not actually talking about universal health care coverage or socialized medicine or anything like that in my prenatal care posts -– I’m only talking about the bill in Nebraska to restore prenatal care to indigent women -– let me set out a response.
Personally, I think we would do well to have a system that ensures some baseline level of care for everyone in no small part because preventive care is actually cheaper for the whole society and because, in the absence of health care options, people don’t get this preventive care. Instead, they get the far more expensive emergency care when something avoidable isn’t avoided. And, of course, I just generally think that it’s good for people to have access to preventive medicine, costs aside.
I think that private charities and organizations are insufficient and I don’t see any reason that they’d be able to do a better job taking care of more people in the future. It’s a nice idea and I know that it’s the fall-back position of every libertarian, but I can’t subscribe to it because it makes caring for others voluntary (which means that the option exists for that care not to happen). Most people simply aren’t charitable enough, not to the level that is required in order to keep people off the streets and in good health. It would be great if we could assume that people would substantially alter their behavior in the utopian libertarian future, but I have nowhere seen any reason that suggests I should think this would happen.
People want to take care of their own and people are notoriously bad about closing off the circle of moral accountability so that it doesn’t include people of other races and religions, the poor, immigrants, and so on. And this isn’t anything new. This is, most likely, hard-wired into us from many, many thousands of years ago. We want our genes to pass on to the next generation; we don’t much care about the genes of others (who are, by our lights, genetic competitors). I would love to believe the libertarian idea that we’d all be more charitable if we weren’t paying the taxes we currently pay. But, in this libertarian future, there’s no one to keep an eye on our charitable giving and so we’ve got ourselves a classic collective action problem. If the government doesn’t insist that I help and I don’t choose to help, what happens? People suffer. Not me and mine, of course; we’re fine. It’s other people who suffer, people who are different from me and with whom I probably have little contact.
It’s easy to ignore these people and their suffering, and I think we almost certainly would. As an example, look at those elected officials in Nebraska who so strongly opposed restoring prenatal care for indigent women; the principle reason for their opposition to a bill that saves taxpayer dollars and cares for fetuses, by their own admission, rests on the notion that such care might end up benefitting undocumented immigrants.