The bottom line is that we’re not in this together. We are atomistic consumers who only care about our own welfare and those we know, provided they are not living perfidious, irresponsible lives. Goldhill’s solution makes sense in the absence of a widely-shared sense of the General Welfare but a collective response to a collective problem would be better.

Yes, and what is possible in the here and now is also limited by the dissolution of such structures. And given that politics is the art of the possible, etc.

Maybe I overlooked it but where exactly does charity come into play in Goldhill’s proposal? If ‘the poor’ are not able to spend the government money in their HSA’s, why would they be more likely to need charitable contributions from family and the church? So many people are bankrupted by medical expenses already.

If health is considered a right, would not the designation of it as a ‘human right’ be pre-political?

The guarantee of a certain amount of funds to spend on health care is not the same as ensuring a certain standard of health care so it conflicts with the idea that it is a right. A consumer-centric approach to health care reform is marred by the assymetry of information that exists between the providers and consumers of modern specialized medicine.

“…It is also limited by its ultimate dependence upon the concept of rights. The assistance of the poor and disadvantaged by the church and by extended communities IS A PRE-POLITICAL SOLUTION to health care reform, a solution that situates our health in the complex web of human relationships. And as such, it is a solution that can not be implemented as long as the language of rights remains the dominant framework for our discourse about health care. Despite its long Christian heritage, the notion of rights has been stripped of its pre-political meanings and has been reduced to signify that which exists only in a political context. For this reason, the question of whether health care is a right can only be answered in terms of the government’s involvement or lack of involvement in it.”