To read the newspapers, one would think there was a health care debate going on in the United States. But the word “debate” implies two parties, and the spectrum of the current discussions is limited to the deeper shades of pink, since neither the white flag of reaction nor the black flag of anarchy is being raised. What few of us like to admit is that America already has a national health care system, a collusive cartel whose members are the insurance industry, the American Medical Association, and the vast bureaucracy of state and federal agencies designed to provide medical services to government employees, the indolent, and well-to-do retirees sucking up the nation’s vitality in monthly installments of Social Security and Medicare.
Because some people are either too rich or too smart to squander their money on health insurance and others are using emergency facilities they do not pay for, we are said to be undergoing a crisis. Speaking personally, 1 would give a great deal to be able to opt out of the system. Looking back over the past 25 years, I would have done quite well, investing my money in the markets instead of squandering it on health insurance, and by the time I retired, I would have accumulated something like a half-million dollars, at which point it would be up to me to decide whether I really needed a triple by-pass more than my grandchildren needed an education.
But, someone will say, what about all those medical expenses? The truth is, the mere fact of insurance is by itself responsible for driving up the cost of health care. If there were a genuinely free market for medical services—and by free I mean a market not distorted by insurance or regulation—most medical doctors would earn roughly what college professors do, that is, slightly more than they are worth. But under the current fascist system, which Mr. Clinton would like to turn into something more like National Socialism, we find ourselves in bondage to a medical cartel that virtually compels us to divert a large part of the nation’s resources away from creating and doing and toward mere carcass maintenance.
The most telling comments on our national obsession with health were made, some time ago, by Plato, who realized that many diseases were the result of indolence and vice. The more licentious a society, the more disease-ridden—and litigious. In an immoral society, he said, hospitals and courts of law flourish. Is it not disgraceful, asked Plato, to honor doctors and lawyers and to waste time on treating problems that a prudent man might have avoided? He had particularly harsh words for one Herodicus, a valetudinarian who invented a medical treatment for prolonging life: “In constantly attending to his fatal disease, he was not able to cure himself, but he spent his life nursing himself in idleness, suffering anxiety if he departed from his regimen, and using his skill to ward off death, he reached the age of senility.” Plato concluded his argument by saying that self-indulgent people, who contribute nothing to their societies, arc not worth the trouble to keep alive. The Athenian was not thinking of a modern nation-state but of a small city in which everyone was related to each other, if only fictionally. Applying his insight today, we might question the wisdom and morality of elderly patients who, in clinging to mere existence, divert resources away from their grandchildren.
We are already a society of self-indulgent valetudinarians, and the first effect of a national health system will be to enhance our already well-established therapeutic mentality—although we shall ultimately, as Garrett Hardin suggests, have to begin weeding out the most worthless from the ranks. Of course, in a private, pay-as-you-go system, there would be no need for euthanasia, but in the American future only the very rich will enjoy the luxury of free choice.
The nondebate over health care is only a small part of the great welfare lie we keep repeating. What, after all, is welfare? Literally, it is well-being, a condition which each man must define for himself and which no government can provide. “Social insurance,” “social security,” “social justice,” and “human services” are all equally meaningless phrases used to disguise the alarming growth of government income and government power. If we mean to talk about making a decent provision for the poor, the relevant word is charity, which is a term of Christian moral theology.
As natural men—pagans or atheists—we do have obligations to family and friends, but to strangers we owe nothing. The attempt of contemporary philosophers to construct a philosophical justification for charity would fall on deaf ears in any society that had not received the Jewish Scriptures or the Christian Gospel. Indeed, Marxism and other leftisms can only he understood as post-Christian political philosophies inconceivable in any other world. Communism is only the kingdom of God with God left out.
On this subject of Christian charity—welfare, if you like—there are two fundamental errors—heresies we might call them—that must be eliminated before we can take up the specific details of any so-called welfare policy, whether it is foodstamps or national health care.
The first heresy is individualism, the doctrine that the object of human life is the happiness or self-interest that an individual pursues on his own and for himself. This is the heresy of Cain, the first man who asked “Am I my brother’s keeper?” Of course he was. Men are not beasts—or worse than most beasts, like rogue elephants or feral dogs that look out only for themselves. We all have responsibilities to our children, our parents, our kinfolk and friends—even to neighbors we may not particularly like. Every family is, to some extent, a communist collective, and every small town, as Garrison Keillor once said, operates on a principle of informal socialism.
The greatest of English reactionaries, Samuel Johnson, said that the true test of a civilization was its treatment of the poor. This is often quoted to show that even a high lory was in favor of the welfare state, but Johnson said civilization, not government, and he did not make the mistake of assuming that a social obligation is a government obligation. For that is the other heresy of charity, the collectivist assumption that men live for the common good. This is the heresy of Satan, who took our Lord up into a high place to offer Him all the kingdoms of the earth. For any merely good man, what stronger temptation can there be than the opportunity to do good to the entire world? But if we are put upon the earth to be the keeper of our actual brother, that docs not mean that we have the right or duty to look after a stranger or his brother.
Americans today are afflicted with a virulent form of the disease Charles Dickens described as telescopic philanthropy: we care more for strangers than for neighbors and send our young men to die in a Somalian civil war that no one understands. We refuse to pay the support of the sick and disabled members of our family, preferring in many cases to put our enfeebled parents or retarded children into facilities paid for with other people’s money, and yet we are proposing to lavish our money an national health care for total strangers.
This diabolical heresy crept into philosophy by way of the Enlightenment. Voltaire stirred up sympathy for the victims of the Lisbon earthquake, and his nemesis Rousseau was all tears and pity for anyone he did not know. It was only his family and friends he mistreated. But the great Satan of modern philosophy was Immanuel Kant who thought that human beings were bound by some general and abstract duty that could not be limited or compromised by all our little duties to those we love and are responsible for. In Kant’s opinion, we are not acting morally when we do a charitable act simply-because we enjoy doing charitable acts. Morality enters the picture only when we are acting on a motive of universal duty.
The reductio ad absurdum of the Kantian idiocy are those contemporary philosophers who, like John Rawls, Bruce Ackerman, and Thomas Nagel, treat a nation—or all humanity—as a great social experiment in which each of the members owes the same things to all the others and it is not legitimate to make exceptions for such accidents as family connections, personal friendship, or national citizenship. Here, in a nutshell, is the philosophy of what Walter Williams calls the Bush-Clinton administration. We go abroad seeking monsters to slay and beggars to comfort as if the national motto were not “In God We Trust” but the old commercial jingle “I’d like to buy the world a Coke and keep it company.”
I have said there were two heresies, but in fact they are one and the same: a refusal to see man as he is. Ultimately, individualism always fails, because it is built upon nothing real in human nature, and when it does fail, the individualist leaps immediately into some form of collectivism. The J.S. Mill who began life as an individualist wound up saying that universal love to all mankind would sweep the world, provoking this famous outburst from James Fitzjames Stephen: “Humanity is only / writ large, and love for humanity generally means zeal for my notions as to what men should be and how they should live. He that loveth not his brother whom he hath seen is peculiarly apt to suppose that he loves his distant cousin whom he hath not seen and never will.”
In the past, the welfare of human beings was the exclusive concern of themselves and their families and kindreds, and the family was a semi-sovereign state responsible for the health, education, and welfare of its own members. The Jewish and Christian Scriptures command us to look after ourselves and our dependents and to practice charity. As Augustine put it, charity is the “virtue which joins us to God in love,” and it is, as St. Paul tells us, a greater gift of the spirit even than faith.
But charity under the duress of taxation is not charity at all, even if it is voted for on the democratic but un-Christian principle of one man, one vote. One of the worst effects of national welfare systems is that they diminish our capacity and our desire to do voluntary works of charity. Until modern times, the rulers of Europe provided relief to the poor only in times of great necessity or to the widows and orphans of veteran soldiers. The Roman emperors, it is true, distributed grain and bread within the capital, but this was a sure indication that the population of Rome was a degenerate mob that looked up to the emperor as its ultimate patron. Even so, the imperial largesse was a miniscule contribution to the welfare of the Empire’s population, and state philanthropy in the ancient world was generally limited to bare necessities—grain, oil, money.
In Christian Europe, it might be supposed, rulers would be tempted to exercise charity toward their peoples, and in eases of emergency, a prince might open his granaries to his subjects—as did the Egyptian pharaoh who followed the advice of Joseph. The Christian Gospel commands those of us who accept it to do good, as we arc able, to widows, orphans, and the destitute, and throughout Christian England—before Henry VIII and his thuggish nobility nationalized the Church in England—monasteries and parishes provided charity to the needy.
In Christian Europe, the scope and powers of the state—if it is fair even to use such a word—were severely limited, and cutting across all political loyalties was the Christian’s loyalty to his church. The twin powers of Pope and Emperor were poles around which gathered quite different social energies. If kings and emperors were supposed to maintain law and order and defend their subjects, the Church provided moral guidance as well as spiritual and material comfort.
What we could now call welfare—food, clothing, shelter, medicine—was distributed by the Church to members of the local parish. The monasteries, on the other hand, gave emergency relief to strangers and beggars. The Church in medieval England can be seen as a vast network of nonpolitical associations providing relief and welfare to those in need. On the eve of the Reformation, at least three percent of monastic income was devoted to relief of the poor—a really vast sum, and the wills of well-to-do Christians specified what sums should be spent on food and clothing for the poor. These were often quite significant, although few could match Richard II’s scheming uncle, John of Gaunt, whose will provided 50 silver marks a day for 40 days after his death, 300 more on the eve of his funeral, and 500 on the day of his burial—a staggering fortune.
In addition to monasteries and parish relief, England was dotted with religious hospitals that provided health care as well as food and shelter to those in need. Most of this vast system of Christian charity was destroyed when Henry VIII suppressed the monasteries in order to enrich himself and his friends. In creating a new class of fabulously wealthy protocapitalists, he also destroyed the only welfare system that could have ameliorated the problems created by the growing disparities in wealth and the oppression of the poor.
Henry VIII created the welfare problem in England, and by his and his successors’ efforts to centralize political authority, he made it impossible to do anything about it. Each step the English have taken has only made matters worse: outdoor relief as administered by the parish encouraged idleness, but indoor relief and workhouses divided families and made beggars wards of the state. Ultimately, England resorted to the cradle- to-the-grave social insurance that has degraded the English working classes to the point that if it were not for Pakistani and Jamaican immigrants the whole country would grind to a halt. This is the model for the American future, whether we reelect Bill Clinton or elect one of the Republican look-a-likes that are already asking for our support.
This English socialism—as inappropriate to multiethnic America as it is—is the godparent of our own welfare state, but in recent years, the Tory variety of socialism has also found a home in a nation besieged by Thatcherites. And what do they tell us? I suppose the code word is empowerment, a term borrowed from the 60’s left that really sums up the main drift of British socialism. If one is to believe the Anglo-American Thatcherites, there is a federal obligation to enable the poor to get on their feet, buy up pubic housing, and start small businesses.
In the Bush-Clinton administration, HUD has been a focal point of this empowerment cant, and both Jack Kemp and Henry Cisneros have advocated massive schemes of wealth transfer under the guise of privatization and enterprise zones and the like. Under Kemp’s plan, public housing units could be “sold” to the inhabitants at a cost to the taxpayer of only—the price of a decent house here in Rockford.
Empowerment, which means giving people the right to take what does not belong to them, is alien to the American tradition. Marxism and other forms of socialism are exotic imports first brought into America by refugees from the revolutions of 1848. The true birthplace of Marxism is not Germany but England, whose poorer classes lived a nightmare existence. If Marx and Engels had stayed in Germany, they might never have gone half so far as they did, and if they had spent more time in the United States—by which I do not mean New York City, which even in those days was a foreign city—they might have given up on socialism entirely.
In England Marxism seems to make sense. Herman Melville was astonished by the sight of “poverty, poverty, poverty, in almost endless vistas” and commented that in America “such a being as a native beggar is almost unknown; and to be a born American citizen seems a guarantee against pauperism.” Decades later, the sentimental Marxist Jack London, who was always complaining about the oppression of the poor in the United States, had to go to London to write People of the Abyss. Since 1902, when London plunged into the East End of London, the rulers of the United States have more and more chosen to walk in England’s footsteps, and whatever the Congress decides to do with the Clintons’ plan for managed competition, a national system of socialized medicine is in our future.
The mainstream Republican response has been very discouraging, and—what is worse—the conservative response has been trifling; let’s not do it yet—let us wait for states to try it out; it will cost too much; it is impractical. All true, but not the basis of a counterattack. The best Republican proposal is Senator Gramm’s bill to establish medical IRAs, but the ultimate effect would be to empower the federal government as the nation’s nurse. The other so-called conservative solutions to welfare are only lukewarm leftism, a dog’s breakfast New Deal. If the devil was, as Dr. Johnson observed, the first Whig, then the first conservative might have been some devil’s son who had heard rumors of what heaven was like but refused to oppose Satan on the grounds of party loyalty. “Besides,” he was fond of saying, “a true conservative conserves the status quo; he does not try to turn back the clock.”
Do the French Jacobins murder priests and nobles, confiscate the Church’s property, and level all social distinctions? What is the conservative response, once there is a restoration of monarchy? Why, to pass laws securing the sanctity of stolen private property. Do a weak-minded girl and her homosexual husband invade her father’s kingdom with a Dutch army, corrupt his top military officers, and send the old man running for his life? Why then the conservatives will hail it as the Glorious Revolution and prate like Burke of the settlement of 1688 that is the foundation of liberty and order. And when a cynical Machiavellian bribes the people with their own money, drags them into a ruinous war, and imposes something approaching a total state upon their backs, what is the conservative response to FDR and his New Deal? It is to defend it as a bulwark against communism, and while criticizing its excesses, to refuse to strike at the beast’s head.
The conservative response to the welfare state since the 1940’s, with the honorable exception of a few lovable cranks, was to trim the fat, hold the line, and wait for the next onslaught of socialism that would carry the ball ever closer to the 100-yard line of 100 percent government. These were the policies of the Eisenhower, Nixon, and Reagan administrations, and the fact—staring us in the face—the fact of their utter failure even to slow the advance, much less reverse the progress, of socialism tells us everything we need to know about the futility of such Fabian tactics.
Most contemporary conservatives—all honorable men—assume there is enough health in the American body politic to make it worth preserving. They are wrong. It is not conservative temperaments that are needed in the coming struggle, but radicals who are willing to change things root and branch. For this reason I prefer to speak of the right or the right wing, not so much because it indicates a movement of opposition to the left, but because what we are upholding is the right, now and forever.
If we wish to be honest with ourselves, there are only two choices. We can be either Jacobins or Jacobites, communists or Christians. I here is no Anglican via media between God and the devil. You must take your stand and make the best of it, and if you choose not to choose—that is, if you wish to be neoconservative, neoliberal, fusionist conservative, or Tory Wet—then you have consigned yourselves to those suburbs of hell Dante reserved for the angels who could not make up their minds which side they were on.
To fight against the politics of Kant and his universal duty, we need the polities of Aristotle, who tells us that justice and friendship are coextensive, that if we do what is right because it is commanded, we act out of fear, and that we can only be just if we act out of love toward people we know. Aristotle’s greatest student, St. Thomas, puts the question very clearly. Rather than lavish our wealth on the evil—criminals, drug addicts, child molesters, AIDS-stricken homosexuals, unwed mothers, and vagrants—Thomas tells us that we should will the greatest good to those who are closest to God. On the other hand, our charitable responsibilities are also proportional to the degree of affinity: “In what concerns nature we should love our kinsmen most, . . . and we are more closely bound to provide them with necessities of life.”
The entire welfare state of public schools. Social Security, AFDC, enterprise zones, food stamps, even foreign aid is built on the opposite premise. The more evil a man is—or as we should say, ethically challenged—the more money he receives; and each of us, through taxes, is compelled to divert wealth and resources away from family and friends and into the pockets of strangers and those who claim to minister to their needs. These are not policy questions or problems for a cost/benefit analysis. Welfare programs represent the systematic organization of evil, hell institutionalized on earth, and we must begin to fight them on moral and theological grounds.
But if our American education is too limited for Latin and Greek, if Aristotle and Thomas are both too difficult, we have other resources on which to build a conservative rejection of the welfare state. A recent bogus best-seller was a piece of nonsense entitled All I Really Need to Know I Learned in Kindergarten. This title might have made sense, if children were still taught the proverbs and Mother Goose rhymes that formed our grandparents’ character.
The answer to national health care is the old saw that an apple a day keeps the doctor away, or early to bed, early to rise makes a man healthy, wealthy, and wise—which is to say, take care of your health and welfare by working hard and living properly. To the calls for consumer protection, I say unto you, “A fool and his money are soon parted.” And to the whole panoply of New Deal welfare-state policies and dreams, I offer: “If wishes were horses, beggars would ride; if turnips were watches, I’d wear one by my side; and if if’s and an’s were pots and pans, there’d be no work for tinkers.” Finally, to Kant and Rousseau’s dream of universal philanthropy, consider this wisest bit of proverbial wisdom: “Charity begins at home.”
These are simple home truths, not the lies and distortions that we pretend to believe. We must begin the reformation of the country by first reforming ourselves, and the place to start is to call things by their right names. Managed competition and empowerment are both nothing less than socialism, and much that flies the conservative flag these days would have been called communism even in the 1950’s.
As Confucius realized, “ancients who wished to demonstrate virtue throughout the world would first govern their own states well. Wishing to govern their own states well, they would first regulate their families. Wishing to regulate their families, they would first cultivate their own persons. Wishing to cultivate their own persons, they would first rectify their hearts. Wishing to rectify their hearts, they would first seek sincerity in their thoughts”—this last item is explained as allowing no self-deception. Calling a spade a spade. Here, over 2,000 years ago, is an outline of the only welfare policy an Old Right conservative can believe in.