Social Justice Reconsidered: Report from the Philadelphia Society

I recently sat in on the Philadelphia Society’s annual meeting, an extended examination of the term “social justice.” In some ways, I like the term, given the way it is often used to remind us that every aspect of life is morally significant. At the same time, social justice sometimes serves as a substitute for careful thought, especially about economics. This short essay is my full evaluation and recommendation for the path forward. Do I get it right?

While the phrase “social justice” has been used since the Jesuit priest Luigi Taparelli coined the term in 1840, Friedrich Hayek never could found a good definition, due to two persistent problems. First, strictly speaking, the concept is incoherent. As Russell Kirk argued in his lecture “The Meaning of Justice,” Aristotle’s definition of justice as the virtue of an individual in “giving every man his due” has shaped Western civilization for millennia. It makes no sense, however, to describe impersonal states of affairs as just or unjust. The second problem is that those who use the term nowadays intentionally leave it undefined. According to Michael Novak, vagueness about what social justice actually is serves the interests of the state, ever-eager to consolidate power by using any god term available. For this reason, conservative critics are much quicker to delineate the idea, e.g., Joseph Johnson in his book The Limits of Government: “social justice is the reduction of social and economic inequality by force of the state.”

At the 49th National Meeting of the Philadelphia Society, members and guests reexamined social justice, seeking to discern the extent to which it continues to result in coercion and consolidation, as well as the prospects for articulating a contrast narrative. Joshua Hawley put it well on Sunday when he reminded the assembly of the question the Dutch theologian and statesmen Abraham Kuyper frequently asked: “What is the soundness of the social order in which we live?” Conservatives have just as much interest in this question as liberals. Novak argues that in his day Hayek himself did not oppose many of the ends of social justice. The term was especially common at the end of the nineteenth century as shorthand for the need to ensure the health of the masses of peasants who uprooted themselves to become urban factory workers. The means, however, often neglected the basic principles that made the English-speaking world great. Novak believes that the best way forward is to redefine social justice as a subspecies of justice itself, dealing with both the skill of cooperating in labor with others and the goal of benefitting a community, not just oneself. As Lee Edwards emphasized on Saturday, the space of civil society between public and private is both enormous and important: “300 billion dollars, 350,000 churches, 1.5 million charitable organizations including 3,800 non-profit hospitals…”

Based on the readings and the presentations, I believe the redefinition of social justice needs to center on three principles.

The freedom of individuals to work and create value must be protected. In his keynote address, Samuel Gregg affirmed the basic goodness of work, grounded in a Judeo-Christian anthropology that understands men and women as stewards of God’s inherently good creation. The free market was birthed in the High Middle Ages as a means of supporting the travel and trade of pilgrims and merchants; it eventually galvanized the development of tremendous wealth and opportunity. Intervention that stifles ingenuity and competition is actually unjust and harms both the common good and the liberty of individuals. As Anne Wortham asked, “Why would anyone consent to the forced redistribution of their property?” Beyond being coercive, centralized planning is also inefficient, an idea addressed by the second principle.

The solution to problems must be local and self-interested. To illustrate this idea, Brian Lee Crowley recounted the accidental discovery of glass-making by Phoenician sailors, who while moored on a sandy beach propped their cooking pots on lumps of nitrum. As the nitrum melted and mixed with sand, a translucent liquid was formed, and the sailors perceived how to make an invaluable new material. Crowley emphasized that glass and many other innovations (electricity, railroads, corporations, automobiles) disrupt the status quo profoundly; any centralized authority would never be able to predict or control such innovations. For this reason, genuine competition and free enterprise are essential for the pursuit of knowledge. In the same session, Roberta Herzberg described how rare it was for aid programs to ask low-income communities what they actually needed, and “solutions” were usually foreign and disempowering. For these reasons, i.e., the limits of both human knowledge and human virtue, matters ought be handled by those closest to them. Catholic social teachers call this notion “subsidiarity,” and it applies to both the state and culture. The breakout panel Helping People Help Themselves provided vivid examples of both the benefits of subsidiarity and the dangers of ignoring it. Jennifer Marshall explained how for 60 years the federal assistance program Aid to Families with Dependent Children encouraged women to not find jobs and avoid marrying anyone with a job, despite the fact that marriage is a better social safety net than any bureaucracy. Contrast this with B. Wayne Hughes, Jr., the entrepreneur and philanthropist whose charity work focuses on the restoration of the whole person: legally, socially, and vocationally, something possible only through close relationships and accountability. This brings us to the third principle.

Faith and virtue must be preserved within civic society. The glorification of secularism and what John Richard Neuhaus calls the “naked public square” has not helped individuals, families, or the culture. Agreeing with Novak, Samuel Gregg argued that any appropriation of social justice under the larger cardinal virtue of justice must be supported and informed by natural law and divine revelation. Such appropriation would also necessarily resist the consolidation of power by the “value neutral” government, which fails to account for the dignity and moral dimension of persons in its social welfare programs, its education curricula, and its orientation toward charities and non-profit organizations. In conclusion, for social justice to be truly just, it must recognize the liberty of everyone to create, the priority of localized self-interest, and the value of virtue and faith.

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  • Matthew Loftus

    Agree with all of these. However, certain basic necessities of life– namely, housing & health care– are not easily managed, maintained, or funded locally. How do we balance the importance of subsidiarity with the fact that most local institutions depend very heavily on city, county, state, and federal resources in order to help people?

    • CT

      I think you have to slowly wean local insitutions off of the dependency of the state and federal government. The further away control of institutions becomes, the more bureaucratic and inefficient they become. If cities and counties partnered with private charities and churches and worked together issues like housing could be addressed even more efficiently than they are now.
      As far as health care goes, the more free market solutions that are employed the further the cost goes down. Reducing the cost of healthcare must be the primary goal. Then one can address how to help those truly in need obtain it. The ACA is such a disaster for many reasons, but the primary one is that it does not reduce the cost of healthcare.

      • Matthew Loftus

        CT,
        Do you have any citations to support your assertion that free market solutions lower cost? (for example, looking at this article, the free market is not helping much http://content.healthaffairs.org/content/early/2011/08/03/hlthaff.2010.0893)

        In terms of housing, would you expect that churches & private charities would, say, match the $8.7 billion-dollar budget of Section 8 housing (which has a years-long waitlist nonetheless)? How “efficient” do you expect them to be?

        • Derrick

          Here is just one example, when local doctors create their own free market models. This doctor offers care on a low-cost subscription and provides higher-quality service rather than the factory model.
          http://money.cnn.com/2013/06/11/news/economy/cash-only-doctors/index.html

          Concerning housing, you have to look outside the government and corporate model. Local communities like the Amish show what can be done without mortgages and “billion-dollar” budgets. I’ve been in the housing industry for 25 years and found many ways to beat the system.

          There are many options once we start looking beyond the existing models. Local family farms provide fresh organic foods to local communities at a lower cost with annual purchase programs. Community Supported Agriculture (CSA) is just one way this can be done.

          • Matthew Loftus

            well, okay… but does it work for poor people?

          • CT

            Great question. There does need to be a safety net for those who are disabled or very old. However, under the current system these are the very individuals who get the shaft. This will increase ten-fold with the ACA.

            It is important that we define what it means to be poor in this country. As a health care provider I have seen more people than I can count on Medicaid who drive expensive SUVs and have an Iphone. There is a disconnect somewhere with the priorities. When others abuse the system, it is taking money out of the pockets of those truly in need (the disabled and elderly).

        • Derrick

          Here is another example of free market competition at work in a number of sectors:
          http://www.businessweek.com/articles/2013-08-12/revealed-elon-musk-explains-the-hyperloop

        • CT

          Most of the free market solutions have not been tried, so little research exists as to their efficacy. Those who advocate this approach are health care professionals like myself who simply are applying common sense to the problems in health care. A few examples include medical savings accounts as discussed by Dr. Carson. Another example is found in Kansas where a group of physicians have successfully reduced the cost of health care. There are many other examples. What we do know is that universal or government run health care does not work. The loser is always the patient, every time. Other countries have tried this approach and it has been a failure.

          As for housing, if you think section 8 housing is humane or charitable you have never been to one. Those who work in ministries in this area will tell you (people I have known personally) that those running the programs use their authority to keep people in the housing projects. Otherwise they are out of a job. Surely we can do better than this. If we can get people out of the cycle of poverty, the housing need will decrease.

          If you have any more questions regarding health care and free market solutions, feel free to ask. This post is just getting to long to address each idea.

          • Matthew Loftus

            I am a health care professional myself and I am really tired of seeing medications that my patients need to stay out of the hospital that cost them hundreds of dollars a month to purchase because the drug companies charge them so much. I’m also really tired of seeing patients that work who can’t afford necessary procedures, co-pays, etc.

            Universal government run health care doesn’t work? Then why are infant mortality rates lower in most European countries?

            re: section 8– there are many unpleasant aspects of section 8, but it’s certainly better than the free-market landlords who let children be poisoned with lead paint. I don’t think it’s very useful to smear an entire class of government bureaucrats as people who intentionally keep others in poverty in order to keep a job. That sort of rhetoric doesn’t really help us find solutions.

          • CT

            I agree, I share the same frustration. But at the end of the day, it is a problem of cost not accessibility. ACA attempts to address accessibility and not the real problem which is one of cost. One suggestion is to allow health insurance across state lines, which would lessen the monopoly certain companies enjoy currently. Health savings accounts would be beneficial for major procedures. There are multiple other options that are better than government run healthcare. The patient outcomes are very poor in the countries who have adopted this system. Especially for the really ill and those who require major procedures.

          • Matthew Loftus

            which patient outcomes are so poor in these countries? citation please.

          • CT

            http://www.nationmaster.com/graph/hea_dea_fro_can-health-death-from-cancer
            If you will note, all of the top 8 before the US are European countries. SImply stating that the infant mortality rate is better in Europe than here does not correlate with other outcome measures of other disease, you know this. While the UK is ranked lower than the U.S. as a whole, their outcomes are much worse when it comes to certain forms of cancer.
            Patients in single payer systems wait longer for life-saving treatments and testing procedures. This is a documented fact. You do not have to go to a peer-reviewed journal to find this out. Longer wait times mean a delay in treatment, which is never good for the patient.
            This is very personal to me, as I recently had a family member diagnosed with cancer. I thank God every day that he was diagnosed before the ACA came into full effect and that we do not have a single payer system. Time was of the essence in his case and it saved his life.

          • CT

            Single payer only works for those who are generally in good health or for regular check-ups. If you have cancer, a cardiac disease, or any other chronic illness your chances of receiving quality health care are next to zero. That is why people travel to the states to be treated.
            The health care industry in this country was by no means perfect and reform was needed. But even then it was the best in the world. That needs to be remembered.

          • Matthew Loftus

            If you don’t think that infant mortality is a good indicator of the quality of a healthcare system, I’m not sure we can have a particularly fruitful conversation.

            In addition, if you think that being #9 in cancer mortality (when we spend much, much more per capita on health care than these other countries) is something to brag about… well, again, same thing.

            If longer wait times were bad for chronic disease management, wouldn’t we see increased overall mortality in those countries?

            see also: http://www.urban.org/uploadedpdf/411947_ushealthcare_quality.pdf

          • CT

            You did not read what I wrote because that is not what I said. I stated that infant mortality rates have no bearing on other disease outcomes. Infant mortality rates have no bearing on the efficacy of cancer treatment, cardiology, and the outcomes of treatment for various chronic illnesses. Thus it is incorrect to state that because a country has a better infant mortality rate, their overall healthcare is better. That is “cherry-picking” statistics and is inaccurate.

            Given that our population is larger than any European country, the fact that our cancer rates are below many of them is quite astounding. Especially when you consider the obesity problem we have. People come from all over the world to MD Anderson. If you think of many of the prominent medical treatment centers in the world, most are located in the U.S. not to say our system is perfect, it needs reform. But not through the ACA or single-payer.

            The source you cited is partisan (RJW Foundation sponsored). You may not have been aware of this. It is difficult to find honest research and statistics these days, even in healthcare. This is for both political and monetary reasons. There are many who will become very rich off of the ACA.

          • CT

            I would also add that the country at the top of the list for cancer mortality is the Netherlands. This is a country with universal health-care and probably the most socialistic in Europe. It’s population is also very small comparative to the U.S.

          • Matthew Loftus

            I agree that infant mortality rates have no bearing on cancer survival or chronic disease management. I think that infant mortality is a pretty important indicator of the quality of our health care system on its own and is at least of equal value to cancer mortality, which is why I cited it. You seemed to be dismissive of this, which is why I brought it up again.

            If the RWJ is too biased to provide a reliable report on the quality of our health care compared to other nations, you are free to either (a) point out their errors in methodology or (b) provide an alternate source did data to support your claim regarding the superiority of the U.S. health care system.

            It is interesting that you mention the profit that can come from the ACA. Those who could see their profits decrease are the large, siloed hospitals and the many procedurally-oriented specialists that they employ. I also think that this is of relevance, as much of the “chronic disease management” that takes place in this regard involves numerous costly interventions with little overall benefit (e.g. carotid artery surgery for asymptomatic people, aggressive glucose control for type 2 diabetics, etc.) Most meaningful reform will take place at the level of the primary care medical home, implementing evidence-based strategies for modifying long-term behaviors to help prevent disease. It is very difficult to argue that we do this better than other nations, considering that most universal health care systems place a great deal of emphasis on effective delivery of primary care.

            While the care provided at our academic medical centers in specialty services is no doubt fantastic and such centers do indeed attract privileged people from all over the world, I would posit that overall population health (not to mention how the underprivileged fare) is far more relevant to the topic at hand. One of the most prestigious medical centers in the world, Johns Hopkins, is surrounded by some of the poorest neighborhoods in Baltimore with numerous chronic health problems. It’s pretty emblematic, I’d say.

          • CT

            You failed to explain logically why you feel infant mortality rates are more important than other diesease outcomes. That is cherry-picking statistics that reflect your point of view. It is not scientific or logical.

            When looking at statistics and research, it is important to have a non- biased source. An organization that is actively pushing the ACA loses their ability to be impartial. As a health care provider, you know how easy it is to manipulate research data.

            Are you honestly suggesting that cancer can b e treated by PCP? A TBI? An SCI? Are they going to do open heart surgery there? Where are you going to find this massive super-human army? There is a shortage of PCP’s everywhere. Preventive medicine is important and great emphasis should be placed on it. However, it is not a panacea. It is completely dependent on patient compliance, a variable you cannot control. I work with children with chronic illnesses and serious disabilities. It is simply outside a PCP’s scope to treat all of their medical concerns.
            Those who receive the windfall of profits from ACA are the insurance companies and large hospitals. It is crony capitalism at its worst.

            You have conveniently ignored the horror stories reported in the UK regarding patient care. It was inhumane and against every code of ethics in medicine. You also refuse to address the problems with this system regarding cancer treatment and other treatment of serious illnesses. Are you ignoring it or do you not see it as a problem?

            Your argument regarding Johns Hopkins does not make logical sense. You are implying a causation that is not provable. The hospital has no bearing on improving the poverty level in this area. It is the poverty that is most likely contributing to the chronic health problems, not the lack of efficacy of treatment there.
            Most teaching hospitals are in impoverished areas. They offer access to quality health care, not for the privileged, but for the poor.

            problems, not the lack of efficacy of the treatment there.

          • CT

            Excuse the typos above.

          • Matthew Loftus

            Infant mortality rates are generally regarded as a fairly durable and useful measure of the performance of a health care system, mostly because it is strongly linked to numerous other social determinants of health & economic development.

            I am not suggesting that PCPs treat cancer. There is a place for PCPs and for specialists– both are crucial. However, our current system is weighted towards the specialists, and as Starfield’s work has demonstrated, it’s not good for mortality and it’s definitely driving costs up.

            I have not ignored the problems about delays of care. I asked you if you would expect that these delays would translate into increased overall mortality, and you did not answer my question. Horror stories abound about care in the U.S., too– again, if you have statistics reflecting the fact that they are worse in, say, Canada, feel free to share them.

            My argument about Hopkins was based on your assertion that our health care system is superior because it is world-renowned. I think that a superior health care system ought to involve hospitals that have a meaningful relationship with the communities around them and works for the health of said communities. Hopkins is also one of the largest institutions, period, in Baltimore (as are most hospitals) and so one would expect that they would want to address the poverty that is making the people around them sicker. Going back to the OP (tryin’ to keep it there as much as possible!), these are fairly basic principle of subsidiarity, population health, and neighborliness. They run counter to much of the siloed way of doing things and they are not easy to adopt, but I think they are worth it. As the OP would suggest, they are the only way of doing things.

          • CT

            But you cannot argue that because infant mortality rates are better in one country, that their health care systems are overall better. That is too broad of a generalization. It also does not take into consideration that low birth weight babies are counted as live births in the U.S. where in many European countries they are not.

            I am sorry, I must have missed your question regarding delay of care and mortality rates. I was not purposefully dodging the question.

            Here is a study in the US tying increased wait times to increased mortality. For some reason the link will not paste. But the article is titled “Delayed Access to Healthcare and Mortality” by Julia D. Prentice and Steven D. Pizer.

            Another research article on PubMed found that delay in treatment with colorectal and breast cancer greater than 12 weeks increased mortality rates. Again, for some reason the link will not post.

            The job of a hospital is to save lives, not eradicate poverty. While many do good charitable works, they cannot do everything. That would be impossible. Perhaps local agencies could partner with the hospital, but Johns Hopkins is not just a hospital. It is a teaching and research facility. Realistically, asking them to initiate poverty initiatives would detract from their primary mission.

            I will post statistics on socialized medicine later. I am working hard to find an unbiased source.

          • CT

            http://www.nber.org/bah/fall07/w13429.html

            The link is working now. This is a study commissioned to compare the Canadian system with the U.S. system.
            To wrap up our discussion and somewhat redirect it back to the original subject I will simply state that it is important that devotion to a particular political ideology must not blind us to the real issues at hand. If we are to help people out of poverty (which is the primary goal) and provided affordable, quality health care, we must be open to new ideas. We cannot make idols off of programs that were initiated in the 1960’s that have undergone little reform since then. We cannot cite the merits of socialized medicine without acknowledging its real drawbacks for the old, disabled, and the seriously ill. Not to mention the debt that it incurs for the country.

            Bono made some rather profound statements last week. He stated that capitalism is more effective at combatting poverty than aid. He did not advocate for the abolishing of aid, nor do I. He simply made the common sense point that capitalism nets a longer lasting beneficial impact than aid alone.

          • Matthew Loftus

            I’m sorry– you can’t say that just because more babies survive their first year, that their health care systems aren’t better overall? Tell that to the WHO.

            If the U.S. has more low birthweight babies, perhaps our healthcare system isn’t doing enough to address the risk factors for decreasing low birthweight babies (look up the IMPLICIT project for how primary care docs are addressing this!) Similarly, if our cardiovascular mortality is worse because we are more obesity, perhaps our healthcare system, policy measures, etc. aren’t doing enough to prevent or treat obesity. The rest of the link that you cite is a confused mess of statistics without relevance (overdiagnosis/overtreatment is always a concern when discussing cancer screening and CT scanners.) At the bottom they acknowledge support from a foundation that is probably equally as agenda-driven as RWJ.

            The NHS, interestingly enough, makes (old) data for cancer wait times available: http://webarchive.nationalarchives.gov.uk/20100406182906/http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/HospitalWaitingTimesandListStatistics/CancerWaitingTimes/index.htm (not seeing many >12wk wait times there.)

            You still have not presented convincing evidence of “real drawbacks for the old, disabled, and the seriously ill” of “socialized medicine.” In fact, you’ve zeroed in solely on wait times and cancer mortality, both of which are not so great for the poor & minorities in America.

            “The job of a hospital is to save lives, not eradicate poverty.” You’ve made a false dichotomy here, friend. There can be a middle ground– working towards the health of a local community and addressing the risk factors that are prevalent. Again, this siloed kind of thinking is part of why we spend so much and get so little in terms of improved quality, much less, length, of life in American health care. I would suggest that, for many health care professionals, this isolating system (as well as “the power of the free market”) is just as much of an idol.

          • CT

            Other countries have different standards for what they consider live births compared to the U.S. which skews those statitics.

            We have more low weight babies due to the advances in NICH technology. More premature infants are surviving than in previous years. It has little to do with lack of prevention.

            I have given adequate citations to support my position. The article I gave was not a confused mess of statistics and you need to prove that it was financed by a partisan organization. I actually researched the RWJ before making that claim.
            The reality is that these do not support your political ideology. As I stated earlier, attitudes like this prevent achieving real solutions to real problems.

            There is no false dichotomy. Either you are willfully disregarding my comment after it (which is disingenous) or you just missed it. I said that while hospitals “do many charitable works, they cannot do everything.” I never suggested they should do nothing, just that it was not their primary focus. I would assume if you were a patient there, you would want them to cure you first. This began because you implied Johns Hopkins was somehow complicit in the poverty surrounding them. Which is absurd. I know of few hospitals who do not take into consideration the whole patient. Every hospital in America has social workers in it.

            It is clear that your views on this subject are influenced heavily by your political ideology. I am interested in what lowers health care costs, benefits all patients, and gives control back to the patient. Socialized medicine doesnot meet any of these objectives. It it did, I would be open to it. Name one government program that has not grown to become bureaucratic and inefficient. You cannot. History shows this. Why would I advocate a system that will hurt my patients? My conscience will not allow me to do that, regardless of politics.

          • Matthew Loftus

            Re: low birth weight babies, U.S. infant mortality is still high compared to other countries even taking the consideration into account: http://www.cdc.gov/nchs/data/databriefs/db23.htm

            Again,
            I think the point about Hopkins is very illustrative of the OP: an institution that has been present in the community for over a century and has reaped enormous profit and prestige for itself must consider what is going wrong if a sheik can fly there to be treated but someone around the corner can’t get a mammogram paid for. Again, we are barking up the wrong fragmented, senseless, libertarian tree when we talk about hospitals doing acute care + “charity work” because, with the exception of a few specialty hospitals, most hospitals in America today are part of larger systems and directly or indirectly reinforce the silos we have built.

            You mention social workers in the hospital. Most of what they do all day long is finagle ways to get
            resources from the state or federal government for their patients. Is this a good thing or a bad thing in your opinion?

            If you cannot appreciate the partisanship of the Achelis Foundation (I did some digging myself), then I would humbly suggest that we are both
            motivated by political ideology. Your last paragraph suggests that I am blinded by ideology and you are motivated only by your desire to help patients. I don’t think that’s fair or accurate; you and I are both committed to helping patients and have some evidence to undermine or support the value of single-payer healthcare (we haven’t even gotten to the Oregon study yet, which would be another bundle of fun!) If anything, the back-and-forth has demonstrated that it isn’t single-payer that’s the issue as the design of the system itself– which is what I’m getting at with my Hopkins example.

          • CT

            You may want to read how Johns Hopkins was founded before you choose them as your example and their core values.

            http://www.hopkinsmedicine.org/the_johns_hopkins_hospital/jhhhs.html

            I am sincere when I state that political ideology does not influence me in this area. It is what is best for my patients, and government run health care is not. For example, mammograms are being cut under the Obama administration because of ACA. It made headlines a while back.

            Your condescending comment about libertarianism, is illustrative of how your politics influence your views in this area. How you equated libertarianism with the silo approach I will never know.

            Once again, politics can never get in the way of patient care. I do not know what branch of health care you work in, but I work with the most vulnerable. The ACA is already taking its toll and it has not even been fully implemented. I do not shy away from the fact that I am a conservative/libertarian, but at the end if the day my personal politics cannot interfere with what I believe is best for my patients. That is lower costs, patient control of health care (not government or insurance companies), and quality care. The ACA nor single-payer meets these criterion.

          • Matthew Loftus

            Our conversation is rapidly becoming less fruitful; I will leave you with a link detailing some of the struggles that Hopkins has had relating to its community. Good or charitable intentions do not equal appropriate development: http://www.mariselabgomez.com/ (another fascinating book is “The Immortal Life of Henrietta Lacks,” which is pretty much required reading for anyone in human subjects research.

            I was using “libertarian” more colloquially; certainly it is not meant to discuss the Libertarian party per se.

            I work in primary care with a very vulnerable population; I live in a neighborhood and go to a church that works with (and is served by!) a different vulnerable population. I do not doubt in the least your commitment to your patients, but I do think that you’re missing some of the big picture here because of your fear of “socialized medicine.” I encourage you to read the blog of Kenny Lin, a Christian doctor in DC who is writing a book called “Conservative Medicine” that you might enjoy. http://commonsensemd.blogspot.com/

          • CT

            I am sorry that you feel the conversation is no longer fruitful. No institution nor organization is perfect nor will they ever be this side of heaven. I choose to honor organizations like Johns Hopkins, who are making an effort (they were just named the number one hospital in the U.S. by US News and World Report), even though they may fall short of their stated objectives.

            I try my best not to make any decision based on emotion, so fear is not at the bottom of my aversion to socialized medicine. I do not like what I read and hear about in countries like Canada and the U.K. who have adopted this form of healthcare. I do not feel it is in the best interest of my patients. As I stated before it does not meet my primary goals for health care reform which are to 1). lower costs to make it more affordable 2). give patients control over their healthcare (not government nor insurance companies), and 3). provide the highest quality of care.

            I read over some of the content of the blog you recommended. I agree with some of what is stated, but not all. I will end our conversation on what we do agree on. Health care reform is needed in this country. The costs need to be lowered to make health care more affordable. It is my honest prayer that political ideology and goals (ie the push for single-payer) will not prevent us from coming up common-sense solutions. I encourage you to explore the many alternatives to socialized medicine that are out there. They address many of the concerns that you have. Keep an open mind. Good luck in your practice.

          • CT

            Can you cite the recent examples of free-market landlords who poison with lead paint? There is much greater recoourse of action if in a privately owned community. Building codes must be met and their is always the courts.
            I want to keep all conversations polite and respectful. I would simply state that unless we engage in truth-telling how can we find solutions? The fact that one or two section 8 housing managers does this is a travesty. Note that I never painted all with a broad brush, but stated that it exists. Have you ever been to a section 8 housing project? I would venture that if you had, you would find that 99.9% would want to live somewhere else.
            Charles Dickens is one of my favorite class of authors. He fought relentlessly against poverty, but he was not afraid to satirize and critique the “charity” that was handed out by the government of his time. We must be willing to do the same if the poor are really to be helped.

          • Matthew Loftus

            http://www.bostonglobe.com/metro/2013/02/27/newton-lawyer-must-pay-and-delead-apartments-settle-housing-suit/gPMqRgsj8F8wIZtsCnwgNP/story.html here you go.

            I actually live in a community full of Section 8 housing, actually, and chose to live here to be a part of transforming the community. And while I would love to see a free-market solution to everything, the fact of the matter is that a lot of my neighbors depend on section 8 vouchers, among other government programs, to keep a roof over their heads and food on their plates.

          • CT

            Your cited article actually proves my point. The landlord was taken to court and lost. He had to pay massive damages. How successful do you think the inhabitants of Section 8 housing would be at suing the government for failing to fix mold and disrepair?

            I think we may be talking past each other a bit. I think we can do better than Section 8 housing. We give money to microfinance small businesses to eradicate poverty in underdeveloped countries, yet do not do half as much for our own countrymen. Charles Murray has done extensive research on how poverty has increased since LBJ’s War on Poverty initiative. Not all attempts to fight poverty are efficacious or helpful. We can do better.

          • Matthew Loftus

            If we can do better than Section 8 housing and the federal anti-poverty efforts are doing more harm than good, how should we disassemble and reassemble the system that we have now?

          • CT

            That is the question of the day. Unfortunately, many of these programs have taken on a political aspect which makes it difficult to even question their efficacy let alone reform them. I think Clinton took a step in the right direction with Congress to reform welfare. We need to talk to the people who live in Section 8 housing. Not just assume they are comfortable living off of the government. What are their dreams and aspirations? We could create better programs to help them out of Section 8 housing instead of the emphasis being the other way around.
            We are the country who invented the Ipad, the smart phone, etc. If we de-politicize these programs and look at solutions that might actually work ( both free market and government), I feel confident we could be more successful at helping people out of poverty. That is the goal, not just relief.

            I would love to list ideas for specific reform in each area, but that would be a very long post. Please do not think I am purposefully being ambiguous.

  • Jeffry Butter

    I refer all to “Social Justice and the Christian Church” by Ron Nash. And offer this comment: I’ve worked in and around a lot of government bureaucracies, which are really good at building big programs that spend a lot of money not helping people.

  • Kevin Peterson

    more of this, please. fantastic!