The Plumbliners have mostly refrained from adding yet more amateur opinions to the health-care debate. I hope our readers have noted and appreciated this display of intellectual virtue. A strange feature of the debate I do feel qualified to comment upon has been the relative absence of moral philosophizing in the discussion. Leftists seem to be suggesting that we can have our cake and eat it: universal coverage at reduced individual and national expense, with minimal loss of innovation. Conservatives have a different analysis, suggesting that federal obligations will balloon and innovation will collapse. Which side has it right is not at all apparent to me. I’m surprised, however, that no one has taken what seems to me the correct position: loss of innovation be damned, we have a positive obligation to provide some level of basic health care to everyone in our society, since we can afford to do so. Even if this means that we use the same treatments in 2050 as today, accepting the obviously huge opportunity cost to general welfare. Clearly the utilitarians would tear their hair out about how immoral it would be to privilege the poor we have with us now over against the citizens of 2050, but that no utilitarians have yet torn their hair out in the debate is a symptom of how degraded our political discourse has become.
It’s not surprising that this position hasn’t been articulated, though it’s disappointing, since something like it is very close to obligatory for Catholics. Suggesting that the right thing to do might also be costly is anathema in American politics these days, the Left gains nothing by allowing for the possibility that health care reform might be a disaster for general welfare, and the Right effectively does not recognize collective moral responsibility for the poor. Still, it might be a nice thing to hear from First Things or Commonweal, instead of arguments about exactly to what extent one may ignore what is written in social encyclicals.