Edwards the Rousseauian: People must be forced to be healthy

By AviShalom

Democratic presidential pre-candidate John Edwards backs mandatory preventive care, as quoted in an AP story:

If you are going to be in the system, you can’t choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK.”

He noted, for example, that women would be required to have regular mammograms in an effort to find and treat “the first trace of problem.”

Of course, a predictable right-wing response to this proposal is to take what appears to be a "libertarian" line about "big government" taking too much involvement in citizens' private lives and choices. But I would suggest a left-libertarian perspective, which would start from a rather different first principle.

Health care is an individual right -- a fundamental requisite to liberty--not to be taken away by any governmental or private institution. It is at least as important a right as the right to enjoy the fruits of one's labor (important point, this being Labor Day in the USA) or one's entrepreneurial ingenuity.

However, rights come with responsibilities -- in this case to the community that would look after its individual sick (or after the widow, the orphan, the sojourner...), regardless of their ability to pay.

Thus I am willing to accept Edwards's formulation, provided it comes with universal, single-payer health care. Choice of doctor for all, guaranteed treatment when sick, mandatory preventive care.

That's a deal I'll take any day for myself and as part of a social contract with my fellow citizens.

Of course, Edwards is not calling for universal single-payer. But let's call his bluff. He is suggesting that every presidential candidate should be asked the question, "Does your plan cover every single American?" I give him credit for that. I am no expert on health care, but I am skeptical that his plan would cover everyone.

As I found through Political Compass, Edwards is the closest to me in the two-dimensional space (social authoritarian-libertarian vs. economic right (liberal)-left) of any of the candidates with at least a theoretical chance of being nominated and elected. (Personally, I am much closer to--indeed, actually more libertarian than -- Dennis Kucinich and Mike Gravel.) However, even Edwards is in the right-authoritarian quadrant (albeit barely). He has the right -- er, left and libertarian -- instincts. But he needs a strong pull from "below." From us.

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Update: Of course, I was being pointedly ironic in the title I gave this post. As anyone who has ever read the Social Contract will know, it is a reference to Rousseau's famous line that people "must be forced to be free." That line has been much debated over the years, and it has also been much misunderstood, with some taking it as a justification for totalitarianism. For that reason, it makes me wince just a bit. But I also think Rousseau was fundamentally correct, and in no way should we let totalitarians' self-justification guide our thinking about Rousseau. People need to be encouraged (not coerced) into seeing connections between themselves and the community, which needs participation and engagement of its individual members if it is to remain a free society.

I take that to be the spirit (if not the intent) of the statement by Edwards. There is indeed (or should be) a social contract in the area of healthcare, and like all contracts, it entails mutual obligations.

Was Rousseau a left-libertarian? I had not thought about that before today and I have not read Rousseau since my grad school days; I certainly do not think he was the totalitarian that he is sometimes taken to have been, on account of the mis-use of the “forced to be free” line.