Healthcare Reform: Fuzzy Concepts & Fuzzy Logic

This blog has purposely avoided getting too personal, in the sense of being about this blogger. And it has tried to avoid getting too political, in the sense of being partisan or acrimonious. However, in a departure from this usual stance, this post will draw on a personal, political conversation I had this week with my own neighbor about a yard sign on his front lawn.

Parsing the fuzziness in our discussion could shed some light on fuzziness in the healthcare debate.

My neighbor explained that his favored candidate will push for freedom – freedom from lockdowns, freedom from masks, generally freedom from government intrusion. He then also complained that his candidate had received unwarranted “blowback” in the press for pushing the state legislature to investigate fraud in the 2020 election. I asked my neighbor whether he distrusts both the courts and the press, both of which have found no more than trivial isolated cases of any such fraud. My neighbor gave an agnostic explanation – “you can never be sure.”

Let’s look at these two ideas – freedom and disbelief of evidence – and how they shed light into some fuzzy corners of the debate over healthcare reform.

Fuzzy Idea: Only One Type of Freedom?

Political philosophers actually speak of two types of freedom – freedom-from and freedom-to. This terminology was first introduced by Russian-British 20^th century philosopher Isaiah Berlin.

Freedom-from, or “negative” liberty, presumes that there is not a single unitary Good pertaining to all in a community but rather multiple Goods, valued differently by different individuals. In a pluralistic community, members should be free of government-imposed obstacles to pursue their own Good, and especially free from extreme tyranny. The image of the “ruggedly individualist” colonist comes to mind. This view of freedom would track with “limited-government libertarianism,” in today’s parlance.

Freedom-to, on the other hand, or “positive” liberty, presumes that there is a Common Good that can be effectively pursued through a social contract. Citizens subsume some of their individualistic desires so that they are “free to” enjoy (greater) benefits that can be achieved only by joint cooperation.  They would accept limits on their individual actions in order to exert their power through their civic institutions. The images of the moon landing, the COVID vaccine rollout, and the interstate highway system come to mind. This would track with “civic republicanism,” in today’s parlance.

The healthcare debate can be framed, at least on the philosophical plane, as a search for the best mix between the individualistic freedom-from and the synergistic freedom-to. What is the optimal balance between respecting individual choices versus banding together to have a more efficient, effective, and equitable healthcare system?

I would answer my neighbor: America’s challenge is not a false choice between Tyranny and Chaos but rather the quest for “Aristotelian wisdom, balance and moderation” in a pluralistic society.

Fuzzy Logic: Can Non-Existence Be Proven?

Let’s say that I can show you no evidence that something does exist, like a ghost, a conspiracy, or election fraud. But let’s say that I instead turn the tables, and put the burden on you to prove to me that these don’t exist. You can’t, and so I win.  Since you can’t prove that a ghost, a conspiracy or election fraud don’t exist, therefore they do exist, or at least might exist.

This logic is, of course, fallacious, or fuzzy at best. It is logically impossible to prove non-existence (except in limited self-contained systems).

Frankly, some of the arguments I hear against universal healthcare — be it universally regulated, universally financed, or universally administered – hinge on a vague claim of existence of a plot to coopt healthcare reform for nefarious purposes. Terms that slip into these conversations about healthcare reform include deep state, communist, un-American socialism.

I would answer my neighbor: It is impossible, as a matter of logic, to prove the non-existence of a sinister plot. The futile exercise of even trying is a distraction from the substantive debate.

Take Action

This blog concludes that it will be more productive to direct our efforts at civil policy-focused discourse, principled logic, and positive action.

Image Credits

Title:  Isaiah Berlin

By: Arturo Espinosa, CC BY 2.0, via Wikimedia Commons

URL: https://commons.wikimedia.org/wiki/File:Isaiah_Berlin_for_PIFAL.jpg

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Title: Caïn venant de tuer son frère Abel, sculpture by Henri Vidal (detail)

By: Frank Bärmann, CC BY-SA 4.0 via Wikimedia Commons

URL: https://commons.wikimedia.org/wiki/File:Figur_in_Paris.jpg