During my 20+ years spent in the classroom guiding discussions about health policy, ethics, and leadership, the semester always began by positing this question:
To what extent am I (or are we) willing to contribute or sacrifice, so someone we do not know, and will never meet, might have access to the kind and quality of education, housing, healthcare, and safety we want for our loved ones?
How we answer this question drives decisions about investing, health plan selection, housing, donations to charities and causes, and even selecting colleges.
When considering personal resources and the distributions to support loved ones, or for the common good, we differentiate the act in one of two ways. To contribute (Oxford dictionary) is to: Give (something, especially money) in order to help achieve or provide something. To sacrifice (Oxford again) is: An act of giving up something valuedfor the sake of something else regarded as more important or worthy.
Implicit in the comparison contributions are freely given and with good intention; and sacrifices are painful and often made when we feel we have no choice.
The concept of contributing or sacrificing for an outcome we may not use, or have a stake in, is not on the agenda in the 2016 political discourse. We want action NOW, and we want to WIN, and we want it not to be difficult.
There are useful examples of how we consider those we love (the us) in the redistribution of resources that demonstrate we are open to contribution and sacrifice.
According to the College Board: Average published tuition and fees at public four-year colleges and universities increased by 13% in 2015 dollars over the five years from 2010-11 to 2015-16, following a 24% increase between 2005-06 and 2010-11.
For loved ones, we are willing (whatever the price, and for however long) for education. But what are we willing to spend for educating someone else’s child? Would the answer be different if the child were a female Muslim immigrant from Afghanistan?
We need look no further than the four state ballot measures in 2015 to see how we voted on funding public education funding. Three proposals to increase or provide funding failed, and the one proposal that did pass (in Texas) increased the tax exemption for homesteaders over 65, thus reducing resources to education.
When it comes to health, or health care the evidence of “no limits spending for loved ones” is even clearer. According to one study (Banarto, McClellan, Kagy and Garber, 2004), 30% of all Medicare expenditures are attributed to the 5% of beneficiaries that die each year, with 1/3 of that cost occurring in the last month of life. And March of Dimes reports Preterm birth costs employers more than $12 billion in excess health care costs.
Some estimates suggest one of every seven dollars spent for health care are spent in the first seven days and last seven days of life, on care for a patient who is not participating in the decision making process.
Truly we do not hesitate to contribute and to sacrifice for the people we care about.
The moral question in this election is how much are we willing to contribute or sacrifice for the good of “the other”?
In the 24-hour media roundtables, and dinner discussions about presidential, state, and local elections, there is one glaring omission: any moral framework. How do we individually, and collectively, consider resource issues as we define our future?
Decisions in any democracy are always about how we approach, and come to agreement about, the allocation of resources for ourselves, for others, for future generations, for the common good of our communities, and… for the world.
One of the major complaints about Drumpf, Clinton, and Johnson, is the “all about me” nature of their personalities, politics, promises, postings, and polemics.
The candidates are not alone, recent polling shows a majority of voters share the concern: “What will happen to/for me?” under various scenarios. The Brexit vote was a direct result of viewing public policy through this lens. Thus we hear a great deal about me, my, and mine.
Roger Simon’s recent book: I Know Best: How Moral Narcissism Is Destroying Our Republic, If It Hasn't Already, defines this newest self-focus with the following: “You are what you say you are. You are what you proclaim your values to be, irrespective of their consequences.”
Consider what made America truly great; solidified the idea of standing together;and distinguished our nation as a beacon of hope. It was not how we thought only of ourselves in difficult times; it was how, as a people, we were willing to make sacrifices for the freedom and well being of others.
A few examples:
The March of Dimes campaign to fund research to end polio
The Second World War
Red Cross Blood Donations
The Giving Pledge
The Federal Highway System
In 2014 Americans donated $358 Billion to charities an all time record!
So have we become entirely selfish, is moral narcissism fed by the culture of celebrity, inevitable? Or are we open to the needs of people who are not us, and more importantly, people who are very different from us?
John Rawls, a political and moral philosopher had a skillful way of considering resource distribution. In his book: Theory of Justice he introduced an approach called the original position.
In the original position, parties (through an organized process) select principles to guide the basic structure of the society they will live in. However, they don’t know information about their own particular characteristics: gender, ethnicity, religion, social status, economic status, and, crucially, their personal idea of good. Using the original position to allocate resources leads to impartiality and rationality.
Carol Gilligan, author of, In a Different Voice, and framer of the Ethic of Care, providing a relational approach for considering ethical decision-making, was interviewed in 2011 predicting our current situation. “Rather than asking how do we gain the capacity to care, the questions become how do we come not to care; how do we lose the capacity for empathy and mutual understanding? It is also crucial to clarify that within a patriarchal framework, the ethics of care is a “feminine” ethic, whereas within a democratic framework it is a human ethic, grounded in core democratic values: the importance of everyone having a voice and being listened to carefully and heard with respect. The premise of equal voice then allows conflicts to be addressed in relationships. Different voices then become integral to the vitality of a democratic society.”
It is clear: the elections in the US, are not about impartiality or rationality, nor are voices heard or spoken with respect. The news of the day is about partisanship, irrational fears, and collective anxiety. The more selfies we take, the less we know about who might have been right in front of us. If 2016 continues to be “all about me”; we cannot step out of ourselves to consider fairness and justice for future generations, no matter how many times we invoke them.
Waldo Tobler, best known for bringing the power of computers to map making, also offered his “first law” in geography: “Everything is related somehow to everything else. But those things in closer proximity are more related than other things that are further apart.” In short, if it isn’t happening for me or to us, it isn’t important. The best visual example of this ‘first law’ was Saul Steinberg’s famous cover illustration of the March 29 1976 New Yorker. Imagine Steinberg drawing Hillary’s, Donald’s, or Gary’s view of America, and the world! It would make for a wonderful illustration of the campaign ahead. But if geography determines our perspective, it is also a contributor to the rhetoric bifurcating the world into camps of “self” and “other.”
Is there a different path?
What if try re-framing moral issues? What if we acknowledge our self-focus as perhaps strength, and engage our thinking using a modified original position?
Martin Buber, philosopher theologian, considered existence in two ways: The I-It and I-Thou.
I-it is an experience of the world where beings do not actually meet or connect. Instead, "I" examines and considers an idea, or conceptualization, of the other and treats that being as an object. In this context the other are not people we know or will ever know: they are simply who we imagine they are!
I-Thou is the opposite. In this framework, a relationship stressing the mutual, holistic existence of other beings is real and understood. It is a concrete encounter, because these beings meet one another in their authentic existence, without any qualification or objectification of one another. Buber contends human life finds it’s meaning in I-Thou relationships.
Before we make the decision to vote for one candidate, or against another, this November consider this question:
What is this leader asking me/us to contribute or to sacrifice so someone I/we do not know, and will never meet, but hold in respect as another human being with value and a voice, can have access to the kind and quality of education, housing, healthcare, and safety we want for our loved ones?
Knowing who we are might provide a clear response. Not knowing who we are in making the contribution/sacrifice makes it less clear, but more logical. But responding and knowing might just be “the other” to someone else, might change everything, including the outcome.