I haven’t had any health-care for ten years or more. Haven’t seen a doctor. Have only had special blood-tests when donating blood a few times. I’ve been lucky for sure but it’s also likely that I’ve gotten good advice from non-interventionist doctors who told me to avoid the medical system as much as possible. To be sure, they did tell me to find another non-interventionist doctor wherever I happen to live and to go for a check-up every couple years, but I made a decision to do the work I felt God called me to do and I’ve made not a penny from my writing. Trying to be consistent with my beliefs, I’ve accepted help from relatives and friends but haven’t applied for any sort of government aid.
Why haven’t I made any money? I can only repeat what I was told by independent literary agents as well as ex-employees of the mainstream publishers: the American mind has deteriorated so badly that even the employees of the publishing industry can’t handle demanding books. There is no market for what I’d call real books — not that I deny the goodness of a certain amount of mind-candy in the intellectual diet.
In any case, there is apparently no need or at least no felt need in the United States for books or other products which might develop the mind. This would imply that Americans, probably most in the modern West, feel no need for a well-developed mind just because they have fulfilled Adam Smith’s fear that the citizens of the prosperous West he foresaw would feel no need for moral integrity. Yes, in general though not in all cases, I do tie together moral integrity with a proper cultural level for your historical circumstances.
Let me move back to the question in the title by considering a quote from Kenneth Minogue’s The Liberal Mind:
[W]hile the welfarist is concerned with vague general ends, it is in fact the means which are crucial in society — for the simple reason that the ends are never reached. [page 106]
This implies our true ‘needs’ are for means to reach ends rather than being ‘needs’ for the ends themselves. As they say, “Teach a man how to fish rather than giving him fish.” As our means expand, so will the ends we might personally define as ‘needs’ and so will our luxurious desires. All of this should be, must be, defined within an understanding of a good human life and that will involve means more than ends.
There’s an interesting and more specific line of thought I’d like to quickly explore. If we were to develop greater means, I think it’s likely we find ourselves in a different place than we would have planned. Going forward from that place, we would start desiring still different ends, perhaps ends we couldn’t even imagine. In the meantime, we, or our descendants, would have started developing means we certainly couldn’t imagine.
To make “vague general ends” our focus is also wrong because such misthought and misbehavior will lock us and perhaps our descendants into pursuing, with ever greater desperation, goals which have revealed themselves as strange.
Let me now switch to a practical issue of great immediate importance.
We are at a transition point. The Modern West is decaying a bit prematurely but it would have happened at some point. This decay into decrepitude and senility is happening early because of our lack of courageous and creative response to the very successes of the Industrial Revolution and various sorts of reformations including those in religious and political communities.
We are looking at the need for very basic changes which are likely to lead to a variety of changes in our political communities. There are likely to be many hurt as we respond to this decay of the West and its various communities, but far more would be hurt and hurt for generations to come if we don’t respond in some plausible and proper manner. One of the most dangerous of temptations in the early phases of our responses is that of reforming various parts or aspects of communities which are fundamentally flawed and need to be dissolved or radically restructured. Only time will tell us exactly where to head as God’s story moves on, but we shouldn’t be looking backward and using too many resources to solve ongoing or new problems by way of defective institutions.
So far as Social Security and Medicare are concerned — they could have been designed to maximize conflicts between generations and between various ethnic and religious groups which have very different ways of approaching financial matters, caring for the elderly and those who fell through various safety nets, and so forth. The Euro-zone is currently being destroyed by conflicts between the Northern and Southern Europeans. The American population almost certainly has similar conflicts because of different ethnic traits — on top of the generational conflicts already showing. For example, members of some ethnic groups tend to seek high cash income while the members of other groups will seek business ownership with lower cash income in the short-term along with the build-up of business assets. All else being equal, the first will be better off with retirement annuities, cash benefits, whether purchased from a private institution or supplied by a government program funded by some sort of taxes. They might even be better off with a sub-optimal government program with a bad tax strategy. The second might be best off if they can leave their business assets to the next generation under favorable circumstances in return for being supported in their retirement years. Meanwhile, tax and regulatory policies in the United States have destroyed the viability or at least attractiveness of traditional family businesses.
In other words, despite what big-mouth and invincibly ignorant politicians and ‘expert analysts’ say, there is no one solution which is perfect for all of us. At least, we haven’t discovered it and we aren’t likely to do so or even to find a variety of better solutions for the different groups in our larger communities so long as we remain committed to our current ways of doing things, spending time and energy and other resources to reform institutions we should allow to die.
We’ve trapped a lot of human beings into dependence upon these government programs which worked well at least for some but only so long as we met the solvency requirements of these not-quite but sort-of Ponzi schemes. It’s probably a bit more complex for Medicare but Social Security was in good shape so long as we had annual net (after inflation) growth of 3% in the national economy and a ratio of about 3 active workers for each retired worker. We passed to the bad side of any such point of solvency by the early 1990s or so.
I suspect our good-looking, pre-2000 economic statistics were fraudulent since at least the 1970s, but a little thought would indicate that even a well-designed pay-as-you-go system can have serious problems with even a relatively short stretch of economic problems and the consequent inadequate premiums/taxes. So far as the workers go: I believe we currently have 1.8-1.9 active workers for each retired worker on Social Security. It’s likely that we would have run into the demographic problems even if our economy had grown non-stop and were projected to continue to grow. At the very least we would have had to up the 3% net growth as the birth-rate fell. I’ll leave it to the reader to contemplate my claim in light of history or to explore the issue in an historical context — not the hot-house context of current politics and growing generational conflicts.
So how much health-care do we need? Part of the answer is that any human beings who dumb themselves down in front of the television screen after becoming dependent upon the goods and services of a huge and immensely complex society with an advanced technology better learn to have relatively modest needs in the realm of health-care and elsewhere. We Americans, if we don’t start acting in a responsible manner, might soon have trouble maintaining our basic fresh-water and sewage systems and that would cause more damage to our health and a greater shortening of our lifespans than the loss of our oh-so modern hospitals.
The complete answer would be a very complex version of my commentary above: we have no right to demand of this world any level of health-care or retirement benefits or the like. What we have is a duty to build the sorts of communities which have the means to care for their members according to the traditions and overall purposes of those communities. If we succeed in building the means, including the music and other arts which bind communities, we’ll be able to help care for ourselves and others in the appropriate ways, which may or may not involve high levels of the sort of industrialized health-care which is the standard in the decaying West.