Unfunded Altruism

by Alasdair Denvil alexdenvil@aol.com

With all the recent talk about prescription drug and universal health care plans, we're hearing the usual lazy talk about compassion: such programs are deemed altruistic, and a society lacking them supposedly lacks compassion. This sort of thinking needs to be challenged, because it leaves out a critical element of compassion.

For instance - details aside - we envision universal health care programs as significantly paying for the health care services provided to all Americans, funded in turn by taxes taken from wealthy Americans. Of course, every taxpayer would pay into any universal health care program, but most would receive far more in services from it than they paid into it.

But consider this: If you had to pay for your own health care, and you needed life-saving surgery costing $10K, $50K, $250K, whatever, what would you do to get the money? You couldn't cover the whole amount, but you'd find ways to get a fair bit of it together. You'd take on another job, and sell or cut back on things that you didn't really need. But would you do the same for some guy you've never met who needed the same surgery? Would you scrimp and save for him as you did for yourself? No? Aren't you compassionate?

Well, yes and no. You might wish well for others, but you won't fund your compassion the way you'll fund your self-interest. Instead, you'll vote for the funds to be taken from someone else. You'll happily receive from universal health care, but not so eagerly contribute to it. Call it selfishness, or the principle of self-interest, the fact is that people won't devote the same energy, initiative and ingenuity to providing for others that they will to providing for themselves (or perhaps their loved ones). Sure, you'll support health care for that guy in the abstract, but notice how your initiative is drained, how you won't exert anywhere near the same effort and ingenuity in order to actually fetch it for him. You're embracing unfunded altruism, compassion without sacrifice.

And most people could contribute much more to the health care of others if they wanted to. They could cut down on some frivolous expenses, saving a few dollars here and there. It wouldn't be much, but with millions of families doing the same, it would add up. They could even volunteer at the local hospital, mopping floors, preparing food, etc. (the sort of things they'd think to do if they had to provide their own health care by their own efforts). They could even live healthier lifestyles (giving up smoking, exercising daily, avoiding fatty foods, not contracting STDs, etc.) which - in addition to being in their own interest - would free up health care resources for the truly needy.

But people don't do this spontaneously - there's nothing stopping them from doing it right now - and wouldn't be likely to do it as a condition for receiving services from a universal health care program. This prompts the question: if universal health care is such a noble, altruistic, compassionate project, why should the wealthy hog all the glory? Why doesn't everyone add to it? Why does the drive for universal health care lack the spirit of a WWII scrap metal drive, where everybody sacrifices and pitches in?

No surprise, the moment you enforce the "from each according to their abilities" side of Marx, people howl in protest. Universal health care is fine, but work requirements and lifestyle restrictions, well, that's a little TOO compassionate, because now I have to fund my compassion with personal sacrifice (rather than someone else's sacrifice). Even when people want the needs of others to be met, they don't want themselves, personally, to be the one to do it.

But contribution is necessary to fund compassion. Otherwise, it's just well-wishing. If you're able to help others but aren't, can you really be said to be compassionate?

(c) 2003 Alasdair Denvil