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Columns and Articles by Dr. Laina Farhat-Holzman

October 18, 2011

Community: Is Letting the Penniless Sick Die an Option?

Humans do not do well without community. Even religious hermits could not have survived without food and the support of community.

We are not flock animals, guided only by instinct; we are willful individuals with a range of choices in our behavior. Community, however, requires control of behaviors. We learn these rules, which are rewarded or punished by our leadership.

In the simpler culture of family and clans, authority was usually accorded to the strongest member—usually the patriarch. His rule was obeyed until age left him vulnerable to challenge from his sons. Some early communities were also governed by those who appeared to have secret powers—seers, magicians, and healers (priests).

No matter what sort of governance leaders have had, they do better when their people think this power is legitimate. Legitimacy may depend upon tradition (doing what they have always done), or consensus of the elders.

Throughout history, rules were enforced through fear: fear of the gods or fear of the leader. The majority of human beings did not have much choice over how their society would be governed, except for the heads of individual families, who always had power over their women and children, subject only to community disapproval.

The dilemma today comes when traditional systems are in meltdown and there is no agreement on the new system for community. We see this unfolding in the Muslim world, where the old power structure is being challenged by factions demanding either enforcement of traditions or catching up with the developed world’s participatory governance.

The United States has created a society of unparalleled wealth, freedoms, and choices; but at the moment, we are engaged in a struggle to identify what community is for us. Are we, as some claim, best served by relying on ourselves only, letting those who cannot succeed face the consequences? Or are we “our brother’s keeper,” taking such controlling care of the needy that they never develop the tools to take care of themselves? Is it dog-eat-dog or out of many, one?

Both extremes leave the majority of Americans unsatisfied, feeling a terrible absence of community. Community should neither be communist (total big brother control) nor the cult of individualism (the Survivalist code). There is such a thing as “communitarian,” in which we have individual freedoms and wills, but also care about those really in need. Communitarians want a fair society, not just a free one.

Reforming our healthcare system illustrates the conflict between these two views. Those of us with money can secure the best healthcare in the world, while those with just bad luck (loss of job, life in inner city) may even die from ailments that are treatable (if there were universal health care). And our current system is increasingly unaffordable. It could bankrupt our culture.

One excellent reporter, T. R. Reid, set out in 2009 to save us from having to reinvent the wheel of how to run a national system of healthcare. His underlying question was: why is the US the only developed country in the world to have no comprehensive system of healthcare and why is it more expensive than any other? He examines our dearth of “sense of community,” surely at odds with the usual American good heartedness.

Most important, by exploring the different models, but common principles, in the national healthcare systems of France, Germany, Japan, the UK, and Canada, he explodes the canard that these are all “socialized medicine.” They are each uniquely appropriate to the nature of their cultures, and from them, we could forge one suitable to us.

The common principles are:
• Medical training should be paid for by the government, relieving doctors of huge debts that mandate big salaries and specialties.

• All medical files are computerized and available when a patient arrives.

• Medical insurers are either non-profit or strictly regulated in their ability to charge.

• The system should control costs through preventive medicine and active public health campaigns. And a public system must have a community of doctors and nurses to regularly assess best medical practices.

Pick up The Healing of America by T. R. Reid. He gives us choices.

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Dr. Laina Farhat-Holzman is a historian, lecturer, and author of How Do You Know That? You may contact her at Lfarhat102@aol.com or www.globalthink.net.